Inspection on 22/05/07 for Minster Lodge Residential Care Home

This inspection was carried out on 22nd May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Minster Lodge Residential Care... 15/11/06

Minster Lodge Residential Care... 25/04/06

Minster Lodge Residential Care... 08/03/06

Minster Lodge Residential Care... 22/06/05

Minster Lodge Residential Care... 21/09/04

Minster Lodge Residential Care... 20/05/04

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

CARE HOMES FOR OLDER PEOPLE Minster Lodge Residential Care Home Minster Lodge 6 Westminster Road Earlsdon Coventry CV1 3GA Lead Inspector Kevin Ward Key Unannounced Inspection 22nd May 2007 07:55 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Minster Lodge Residential Care Home Address Minster Lodge 6 Westminster Road Earlsdon Coventry CV1 3GA 02476 552585 02476 631065 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) R M Health Ltd vacant post Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2006 Brief Description of the Service: Minster Lodge is situated close to Coventry City Centre and can be reached easily using public transport. The home is situated over two floors and can care for 27 older people who are frail. There is one shared room and the remaining rooms are single occupancy, two of the bedrooms have en-suite toilet facilities. Communal toilets and bathrooms are available close to the lounge and dining areas and also near to those bedrooms without an ensuite facility. There is a back garden, which is secure with paved areas and this can be accessed from the dining room. The home does not have its own parking facilities and parking is prohibited on the road. There is a Pay & Display car park close to the home. The current fees at Minster Lodge range between £326 and £340 per week. This does not include personal items, such as toiletries, hairdressing, private chiropody or newspapers. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This type of inspection seeks to establish evidence showing continued safety and positive outcomes for residents. As part of the inspection process the inspector reviewed information about the home that is held on file by us, such as notifications of accidents, allegations and incidents. A pre inspection questionnaire was also sent to the manager to complete to provide more information about the home before the inspection site visit. Questionnaires were also returned by two people who live at the home and two people’s relatives, containing their views of the service. A community nurse was also spoken to for her views of the service. The inspection included meeting with the most of the people who live at the home. The inspection also included case tracking the needs of three people that live at the home. This involves looking at people’s care plan and health records and checking how the person’s needs are met in practice. Discussions took place with staff on duty at the home as well as the manager. A number of records, such as care plans, complaints records, staff training certificates and fire safety records were also sampled for information as part of this inspection. What the service does well: People receive visits from a representative of the Catholic Church and the manager has said that she would provide support for people of other faiths in the event that anyone with these needs is referred to the home. The home has recently made good use of an interpreter to help in assessing the needs of a person referred to the home. Visitors are made to feel welcome at the home and comments by two people’s relatives indicate they are kept well informed about important matters. People are supported to gain access to advice from health professionals where they need it so their health needs can be met. Staff are trained to give out medication safely and good checks are carried out to make sure that medication is accounted for properly. People commented positively on the food at the home and confirmed that they are provided with regular drinks and snacks during the day. A choice menu is in place for people and they are provided with other meals if they don’t want what’s on the menu. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 6 Staff are being provided with training to help to recognise and report any suspicions of abuse. Proper action was recently taken by the manager to refer one allegation for investigation under the Local Authority adult protection procedures. A shaft lift is in place to enable people to travel between floors safely. There are walk in showers that are fitted with grab rails to help people to shower safely. Similarly the baths have hoists fitted to help people to get in and out safely with support from staff. The corridors in the home are narrow and do not provide ideal wheelchair access. Staff are being provided with a good range of training to equip them to meet the needs of the people at the home and to carry out their work safely. What has improved since the last inspection? Work is ongoing to redecorate large areas of the home. The hallways and staircases have been painted and the colours vary on the different floors to help remind people which part of the home they in. The manager explained that a number of carpets, including those in the hall, stairs and a number of bedrooms are to be replaced shortly, to improve the home for people. The senior manager said she would place an immediate order to replace a bedroom carpet with an unpleasant odour. The dining room was being decorated at the time of the site visit, improving the look of this room for people. Straight after the last inspection the manager arranged for a social worker to visit to agree appropriate safeguards for a person who is known to resist healthcare support. The manager has improved the assessment tool that she uses to check that staff understand the medication procedures at the home, to ensure that staff know how medication is correctly recorded. A person with weight loss was referred to the nutritionalist for the necessary advice and support they required. The manager is currently in the process of being registered with us. The manager also reports that she has applied for a place on the National Vocational Qualification level 4 in Care course and is waiting for a place to become available so that she can start this training. Financial records are now available at the home for a person whose finances are managed by the provider, whilst they are waiting for Age Concern to take on the role of appointee for the person concerned. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 7 The manager confirmed that she has spoken to the fire officer about the use of fire door guards (devices to hold doors open) in place on 7 bedrooms and has been advised that they may be used but need a risk assessment to support their safe use. The manager agreed to complete the risk assessments promptly to ensure that they are safe to use, so that people are not placed at unnecessary risk. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Minster Lodge Residential Care Home DS0000050158.V334938.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 Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply to Minster Lodge. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s essential needs are now being assessed before they move in so that the home has information to plan to meet their needs. EVIDENCE: The manager explained that no one has moved into the home on a long-term basis since the last key inspection. However one person was admitted on an urgent short-term basis, whilst alternative accommodation was identified. The manager explained that the person’s circumstances prompted a swift admission and did not allow for extended visits. The manager reports that she had visited the person concerned to start an assessment of their needs and had been provided with a copy of the social work care plan to underpin the assessment. A copy of the manager’s brief assessment notes were seen on file, recorded on A4 paper and but had not yet been transferred to the home’s assessment format and social work care plan was also seen on file as verification of these facts. The file also contained a care plan template that the Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 10 manager had started to complete prior to the person leaving the home. The manager said that this was incomplete as the assessment was ongoing and there was limited information about the persons needs as he had only recently arrived in the country from overseas. The manager explained that she had used an interpreter to assist communication with the person concerned at the time of the initial assessment so that his needs could be better understood. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are provided with support from care staff and healthcare professionals so that needs are met satisfactorily. The rating for this group of Standards has been compromised by some missing information in care plans, which might result in inconsistent or unsafe care practices. EVIDENCE: Three people’s care plans and records were examined. Overall the care plans cover a good range of common needs, e.g. physical, emotional, dietary, (including likes and dislikes), communication, mobility, history of falls, continence and sleeping. Moving and handling, skin care risk assessments and nutrition assessments were also seen in people’s files. The care plans and risk assessments had been dated to demonstrate that they have been recently reviewed. The home has improved the range of care monitoring records over the last year. Recording sheets are now in place for recording people’s are, such as bathing, shaving, food and fluid intake, weight monitoring and turning records (where required). Entries found in a sample of care records indicate Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 12 that overall people’s care is being adequately recorded to enable the manager to monitor people’s care needs. Some gaps have been previously identified in the home’s weight monitoring records and the manager has reminded staff of the need to kept these records up to date, (note seen in diary). Entries in the person’s health records indicate that the home has made good use of the Nutritionalist and the GP to effectively address concerns about a person’s weight loss. Information contained in the care plan and records of a person with poor mobility and pressure area care needs indicates that appropriate action has been taken refer the person for community nursing support. Suitable records are being kept of the nurse’s visits and the records show that care is being provided to relieve the pressure areas. Comments by staff explained that preventative care is taking place to protect the person’s skin from breaking down, however these measures had not yet been recorded in the care plan. One person had torn their skin the night before the site visit. This information had been verbally passed on to staff arriving on shift but had not been recorded. Consequently it was not clear how the injury had occurred so that the risk assessment could be updated to reduce the likelihood of a similar incident in future. One person has experienced breathing difficulties, which has resulted in the need to call the paramedics and resulted in several admissions to hospital. Discussions with a Team Leader and the manager indicate that appropriate action was taken in these instances, however the care plan has not yet been updated to provide a protocol for staff to follow in the event of a recurrence of this problem. This is necessary so that all staff know what symptoms to look out for and what point to call the paramedics or give medications. Entries in people’s healthcare records indicate that they are being supported to gain access to support from relevant health professionals, such as GP, nurses, dentists, chiropodist, optician and nutritionalist where required. Suitable arrangements are in place for the safe storage of medication. The medication cupboard was observed to be tidy and well ordered. An examination of recent MAR sheets identified no anomalies. The member of staff giving out the medications demonstrated a very good understanding of the medication procedures and of the arrangements that are in place for accounting for the medication. The medication sheets contain a record of the number of tablets received at the home and a Team Leader carries out regular spot check audits (records seen) to account for medication prior to and after medication rounds. A stock check record is in place to avoid overstocking of medication in the home. Comments by staff confirmed that they are provided with medication training and are assessed by the manager before giving out medication. This was verified in staff training records and staff competency assessments that were seen on file. Written medication protocols were seen Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 13 containing the reasons for giving medication to people on an “as needed” basis. Entries in the diary and people’s health records contain information to indicate that people are supported to receive access to the GP to have their medication reviewed to ensure that it is still appropriate for their needs. Another record was seen documenting discussions that have been held with the pharmacist, demonstrating that the home has sought to make purposeful use of the pharmacy service to clarify medication issues A record is being kept of all medication returned to the pharmacist but currently this is not being stamped or signed by the chemist to confirm they have received it. The Team Leader said she would address this matter. Staff were seen to close doors when carrying out personal care tasks to protect people’s privacy and dignity. Comments by the people at the home indicate that overall they find the staff to be friendly and helpful. Staff were seen to be friendly and respectful when approaching people to provide support. A visiting relative commented positively on the care provided at the home and confirmed that the family are kept well informed of developments in her mother’s care. This was also reflected in comments in two questionnaires received from relatives. A hairdresser visited on the day of the inspection and some people chose to make use of her services. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a limited range of activities for people to make their days more meaningful. People are consulted about their food so that they receive the meals they enjoy. EVIDENCE: Comments by people at the home indicated that there are not a lot of activities arranged at the home on a daily basis and not many people get out very often, unless they are able to do so independently. There are currently no visiting entertainers used at the home. The manager explained that she has carried out a survey of people’s views and most people at the home are not keen to take part in many pre-arranged activities, although some activities are accepted, in particular, Bingo, quizzes and nail care. Evidence of this was seen in the notes of a meeting held with the people at the home. The home has longstanding connections with a local catholic church and a representative of the church visits the home to give Holy Communion. The manager said that there is currently no one at the home of other religions faiths that require support to worship but that she would make appropriate arrangements in the event that this was the case. The manager and the senior Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 15 manager indicated that they intended to book a reminiscence worker to visit the home as an interesting age related activity for people. During the course of the site visit a worker was seen to positively engage and stimulate the attention of a person with dementia with a ball. Comments by a person relatives confirmed that they are welcomed by staff when they visit and that they are happy with the care provided. Staff were seen to offer visitors a hot drink. Comments by people at the home and the manager confirmed that there is a flexible visiting policy in place and no unnecessary restrictions on visiting times. Comments by people confirmed that their views are sought regarding the menus in the home and to check their mealtime preferences for the next day. People were seen to rise at their own pace and to choose their breakfast and a member of staff was seen to provide sensitive assistance to a person with dementia to eat their meal in an unhurried fashion. People were seen to eat a wholesome dinner and people consistently commented positively on the meals provided by the home. As previously noted people’s food intake is being recorded to help to monitor people’s nutritional needs. The tablecloths and place settings in the dining area are old and unappealing. The manger said that she has plans for this to be improved as soon as the current re-decoration of the dining area has been completed. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall suitable procedures are in place and staff are being provided with training so that the home can respond appropriately to complaints and ensure people are protected from abuse. EVIDENCE: There have been no complaints to us about the home since the last inspection and the manager explained that there have been no complaints directly to the home. Comments by people at the home indicated that they felt comfortable to raise concerns with staff and the manager and believed the issues would be looked into. A visiting relative also confirmed that she was aware of the complaints policy and is happy with the way the manager responds to concerns that are brought to her attention. Since the last inspection there has been one allegation of physical abuse has been made against a member of staff at the home. Comments by the manager and entries in the homes records indicate that this was properly referred to Social Services and the police for investigation under the adult protection procedures. Two staff were suspended whilst the investigation was carried out. After investigation by the police the allegation was not upheld. A member of staff also confirmed that they had seen the abuse reporting procedures and whistleblowing procedures as part of studies associated with an NVQ (National Vocational Qualification) training course. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 17 Comments by some staff confirmed that they have previously received adult abuse training. On the day of the site visit some staff attended update training on this subject and the manager confirmed that further training is planned for other staff. Comments by two staff confirmed a satisfactory understanding of the different types of abuse that can occur and of the procedures for reporting issues of concern. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Ongoing improvements are taking place so that people benefit home a nicer, cleaner place to live in. EVIDENCE: Since the last inspection positive work has taken place to paint the hallways and work was in progress on the dining room at the time of this visit. The manager also explained plans to create two lounge / dining areas so that people could spread out in smaller groups if they wish to do so. Six people’s bedrooms were looked at. Overall the bedrooms were clean and comfortable although some of the décor is looking old and would benefit from brightening up. The manager said that there are plans to redecorate everyone’s bedroom shortly. Work had already started on one vacant bedroom. The manager confirmed that people would be involved in choosing Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 19 colours for their bedrooms to ensure that the bedrooms are decorated to their liking. The manager said that there are plans to replace a number of carpets as bedrooms are re-decorated. A strong odour was apparent from one person’s bedroom carpet. A senior manager said that she would place an immediate order for this carpet to be replaced promptly. There are two wet rooms for people to shower in that are fitted with grab rails to help people to shower safely. There are also two small bathrooms with bath hoist fitted to help people into and out of the bath safely. A hoist was seen in one person’s bedroom to help them to be lifted safely. A specialist mattress and cushion have also been provided to meet the needs of the person concerned. The corridors in the home are narrow and do not provide ideal wheelchair access. A shaft lift is in place to enable people to travel between floors safely. Staff were seen to make use of protective gloves and aprons that are available at the home when carrying out care and domestic tasks. Staff were seen to make appropriate use of red cotton bags for safely carrying continence laundry to the laundry room. The home has sluice and there is also a sluice setting on the washing machine for use where necessary. Yellow bins are available at the home for the safe disposal of used continence products. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory staffing levels are in place and staff are being provided with a range of training opportunities to equip them to meet the needs of the people currently at the home. EVIDENCE: The home’s rotas that were sent by the manager with the pre-inspection questionnaire indicate that there are typically three staff on duty during the waking hours in addition to the manager as well as two cleaners and a cook for part of the day. There are currently 13 people at the home and there are 14 vacancies. Comments by the people living at the home indicate that there requests are responded to promptly and that they are rarely kept waiting for assistance. The manager said that she is also available to lend extra support to meet people’s care needs in the event that this is required. Three staff have finished work at the home and three have started since the last inspection, otherwise the staff team has remained stable. Comments by a new starter confirmed that he had attended a series of courses related to Health and Safety and Care practices as part of his induction programme. Training certificates were seen on his file as verification of this fact. The courses included, food hygiene, first aid, fire safety, moving and handling, Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 21 medication and prevention of adult abuse. The staff member explained that he is being supported to apply to start training for a National Vocational Qualification (NVQ) later this year. In the pre inspection questionnaire the manager reports that 53 of the current staff currently hold NVQ qualifications or equivalent qualifications. Information provided by the manager and training certificates seen on 2 staff files indicate that staff are supported to gain access to a satisfactory range of care courses to equip them to meet people’s needs, including dementia care, mental health awareness, dietary needs and alcohol awareness, in the last 2 years. The manager explained that she is placing an emphases on nutrition training in the coming months in addition to planned training updates in Health and Safety related practices, such as First aid and food hygiene. Two staff files were checked. Both files contained evidence to indicate that Criminal Record Bureau checks are taken up to ensure that new staff are not known to present a danger to vulnerable adults. Vetting references are also being taken up. One file contained two references as required but the other persons file contained only one. The manager has since confirmed that a satisfactory reference has arrived. The manager said that she would ensure that this oversight does not reoccur and that two satisfactory references are received in future before starting any new staff. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management systems are in place for improving the quality of the service and for maintaining a safe home for people. The people living at the home are being given opportunities to comment on the service they receive so that their views can affect future developments. EVIDENCE: The manager has many years experience of working in social care settings and holds the Registered Manager’s Award and other relevant qualifications for her role. Since the site visit the manager has successfully completed the process of being registered with us. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 23 There have been developments in the home’s quality assurance systems since the last inspection. The home has several quality assurance measures in place. A timetable of quality assurance checks was seen on the manager’s office notice board, noting a range of checks and audits that the manager is required to carry out and report on each month. Examples of checks include, care plans, Health and Safety, cleaning, laundry, environment, Kitchen, infection control and medication. The notes of meetings held with the people at the home confirm that they have been informed about plans to redecorate the home. The manager also confirmed that people would be able to choose their bedroom colours as well as new curtains and bedding. Monitoring visits by a senior manager have recently started at the home and the reports are held on file alongside action plans that the manager has produced to address any issues that have been identified at the home. Last summer the manager sent out to the people at the home, their relatives and professional visitors to seek their views on the work home and said that she intends to do the same again this summer. The manager explained that one person has been referred to age concern for an independent appointee to manage their finances but is currently waiting until age concern has the capacity to take on this work. At the last inspection this person’s financial records were not held at the home and were in the possession of one of the company directors. A spreadsheet detailing the person’s income and expenditure is now held at the home. The manager explained that the person’s money is currently paid into a company account whilst awaiting an independent appointee. A senior manager confirmed that the person would receive interest on all monies deposited into the account. The expenditure records for this person were sampled. The items for which they had been invoiced by the provider was found to tally correctly with the items of expenditure recorded in the managers record, indicating that the person is being correctly billed for personal items. The manager confirmed that everyone else at the home receives either the support of relatives or they control their own finances. Information provided in the pre inspection that was completed by the manager as part of the inspection process indicates that the relevant Health and Safety checks and equipment tests are carried out at the home. Several records were sampled. Entries in the fire safety log indicate that the home’s fire alarms and emergency lights are being routinely tested and fire drills are carried out at the home. Certificates and records confirm that a gas safety check has been carried out and the manager said that she planned to arrange for electrical equipment to be tested again very shortly as it has been over a year since the Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 24 last test. A contract was seen for the maintenance of the shaft lift and lifting equipment in the home so that this is kept in safe working order for people. The manager stated that the home has recently had a successful food hygiene inspection. The home has since been issued with a new certificate and rated a 3 star service in this regard, by the Environment Health department. The home’s records indicate that hot water temperatures are being monitored to ensure that people are not placed at risk of being scalded. A record is in place demonstrating that taps in vacant rooms are being flushed through regularly to avoid any likelihood of leigionella developing at the home. Following a very recent burglary at the home which arose from staff leaving a back door open when going outside to the laundry, the manager has put a time curfew on night staff leaving the home at night to go the laundry room, as a means of improving the night time security arrangements at the home. Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 25 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes 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. 1 Standard OP7 Regulation 15 (2) (b) Requirement Review and update people’s care plans where necessary. In particular ensure that suitable guidance is put in place for staff to follow in the event that the person with breathing difficulties suffers another attack that may necessitate the need to call the paramedics. This is necessary so that staff are clear about how they should intervene and at what stage the paramedics should be triggered. Risk assess the use of fire door guards, in place on seven bedroom doors, in keeping with advice from the fire officer. Ongoing issue from last inspection 1/12/06 Timescale for action 30/06/07 2 OP38 23(4)(c) (d) 21/06/07 Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 YA12 Good Practice Recommendations Arrange for the record of medication returned to the pharmacist to be signed by the chemist verify that they have received it. Increase the range of social activities and outings available to residents. In particular provide more opportunities for those residents without relatives to go on outings and have fun. Proceed with plans to redecorate people’s bedrooms and replace a number of old bedroom carpets that are worn or stained. Risk assess the use of fire door guards, in place on seven bedroom doors, with advice from the fire officer 3 4 OP19 OP38 Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-56 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Minster Lodge Residential Care Home DS0000050158.V334938.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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