Inspection on 28/02/06 for 45 Mayfield Park North

This inspection was carried out on 28th February 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

45 Mayfield Park North 14/08/07

45 Mayfield Park North 20/09/06

45 Mayfield Park North 09/08/05

45 Mayfield Park North 04/02/05

45 Mayfield Park North 25/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 45 Mayfield Park North Fishponds Bristol BS16 3NH Lead Inspector Sandra Jones Unannounced Inspection 28th February 2006 09:30 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 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 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 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 Adults 18-65. 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. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 45 Mayfield Park North Address Fishponds Bristol BS16 3NH 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) 0117 9583869 0117 9709301 admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Mr Ioan Williams Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 4 persons aged 19 - 64 years May accommodate 1 person aged 65 years and over Date of last inspection 9th August 2005 Brief Description of the Service: Mayfield Park North is a care home for five adults with mental health care needs. It is operated by Aspects and Milestone Trust and managed by Ioan Williams. The property has the appearance of a domestic dwelling, which blends well with its immediate environment. It is close to shops, amenities and bus routes. Arranged over three floors, with shared space on the ground floor and bedrooms on the lower ground floor and first floor. There is self-contained accommodation on the basement that is used by a resident that is independent with living skills. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second unannounced inspection for the year 2005/06 and to gain a full overview of the home, both reports must be read in conjunction. During the inspection the residents and staff were consulted on the standards of care at the home. Records kept at the home were used to confirm the practices and a tour of the premises was conducted. There were no additional visits conducted at the home since the last inspection. What the service does well: What has improved since the last inspection? What they could do better: 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 6 The requirements arising from this inspection are based on specific information to be added to person centred plans to ensure privacy is included into their personal care routine to the two residents that share. Other requirements are based on maintaining a homely environment to the residents. Newly appointed staff must attend fire drills. 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. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 A person centred approach to meeting needs is being developed to create a framework of key principles. Views can be expressed and influence the manner in which their needs are to be met. Risks are assessed and preventative measures taken to safely reduce the level of risk. EVIDENCE: Person Centred Plans were adopted in line with good practice. Information sheets give personal details about the person. Additional information regarding “When to worry about me”, the individuals abilities to perform tasks, routines and lifestyle is described. The manager will be developing the plans by incorporating the assistance needed by the staff to maintain the preferred standard of living. The person, to evidence agreement with the content, signs care plans. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 10 The kettle lead and the cooker are switched off at night because one person is not competent to use the equipment without staff support. The residents that may have hot drinks during the night have refreshment-making facilities in their bedrooms. The section of the care plan based on “When to worry about me” focuses on the individuals mental health care needs. The residents accommodated mainly require reassurance and prompts through 1:1 with staff. Individual Care Plan Approach takes place annually with the resident, staff and key worker. As there is a vacancy for a consultant in the area, assurances have been given that multidisciplinary review meetings will take place. Three residents have no family involvement into their care planning. Another resident has involvement from a representative, but declines to any invitation to attend review meetings. External Health & Safety audits take place every three years. An audit took place at the home in 2005 and from the assessment an action plan was developed. The staff room was assessed as needing a rope ladder because it’s on the third floor and the back door required replacement. Manual Handling assessments based on bathing residents, moving furniture, making beds, with other associated assessments that require moving loads. Hazards are identified and action plans formulated. COSHH substances are used at the home and individual risk assessments are in place to ensure the persons competency with chemicals. Bleach is mainly used by the staff and by one resident that lives independently in the downstairs flat. Risk assessments are completed for all chemicals used at the home by residents, which are reviewed annually. Data sheets are appended onto the risk assessments to comply with COSHH legislation. Individual risk assessments are in place for activities that may involve an element of risk. For residents that leave the home unescorted, risk assessments on using the road safely are completed. As the resident smoke, there is a designated area for smoking and completed risk assessments for each person that smoke. Other assessments based on staying at home without staff support, using kitchen equipment and manual handling. With the exception of one, residents are safe to use equipment. One resident currently requires assistance with getting in and out of the bath and is accompanied by staff outside the home. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 There are opportunities for residents to participate in community-based activities. There are opportunities for residents to seek employment and use the skills learnt at the home. Residents are known and are part of the community. Residents maintain contact with their friends and family. Daily routines and house rules respect the individual’s rights. A varied and healthy diet is provided to residents. EVIDENCE: 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 12 Two residents currently attend an activity resource centre three times weekly, one is in full time employment and one has no structured community activity. Two residents are past retiring age and one has considered employment in the past. It was understood from the manager that should this person seek employment, members of staff would pursue employment on their behalf. With the exception of one person, residents can leave the home without staff support. Residents visit local shops, cafes, and social clubs. Two residents can travel around the city independently and go on day trips without support from staff. There is 1:1 time with keyworkers, visits to the shops, restaurants, outings and places of interest are organised. One person requires staff support outside the home and therefore members of staff facilitate access into the community. Two residents are independent within the community and use public transport. The two other residents depend on members of staff to provide transport in the wider community. One person generally visits the pub on their way home from work. Another has a partner and arranges their own activities and social life. The two residents past retiring have a gentle lifestyle and pursue their own hobbies at home. For example: knitting and watching television. Members of staff inform residents about local events and group outings are organised for residents that want to join-in. One resident spends time away from the home with their partner each weekend. The partner is restricted from visiting the home and a risk assessment is in place for restricting access. Two residents have regular visitors, which can take place in shared space or bedroom. The resident that lives independently gave feedback on the standards of care. It was stated that the home enabled residents to maintain their lifestyle and routines with staff support. Residents are provided with keys to their bedrooms, keys to the home and lockable space. As the residents are literate, mail is handed unopened which residents read without support from staff. Within Person Centred Plans (PCP) is the person’s preferred mode of address. Residents are expected to participate in household chores. Within their level of abilities, members of staff support residents to maintain their bedrooms tidy, household chores and food preparation. Generally residents prepare light snacks and refreshments with staff support for the less able residents. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 13 There are no restriction imposed on alcohol and drugs are not permitted in the premises. Residents choose the meals to be served before each mealtime. There is an expectation residents prepare their meals. It was understood from the manager that with the changes in day care provision, the cooked meal has changed to the evenings instead of lunch times. At weekends members of staff prepare the meals for the residents. The record of food provided contains the meals served to each person. There is a wide range of fresh vegetables, tinned, frozen food at the home, with fruit available to residents at all times. There is a record of fridge and freezer temperature and cooked meats. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Person centred plans ensure that personal care is provided in the individuals preferred manner and consistently. The staff monitors residents’ health care needs and referrals for hospital appointments are made by GP’s where appropriate. EVIDENCE: Two residents are able to manage their personal care and two have staff support. One requires assistance with bathing, one with washing their hair and another chooses support for reassurance. Their preferred routines are clearly described in their Person Centred Plans (PCP) and specify times to rise, retire and daily living needs. Residents have no input from outside professionals. Two residents visit their GP’s independently and another will occasionally request that staff remain in the waiting room, while the other resident will 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 15 have staff support. Two residents have annual health checks through the day centre. One resident has refused any invitations for routine screening. The others will attend appointments for routine screening. Residents access chiropody and each individual chooses their own dentist and optician, which they attend regularly. The incontinence advisor is involved in the care of one person; continence aids are not supplied. One person is diabetic, controlled through diet and oral medication. Regular checks through the GP take place to monitor their health. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Residents views are sought and they feel confident to raise concerns. Through the systems in place there is a commitment towards safeguarding residents from abuse. EVIDENCE: There were no complaints received at the home or CSCI from residents for investigation since the last inspection. The manger stated that complaints are resolved promptly and residents meetings are the forums used by the residents to express their views. During residents meetings there are opportunities for residents to discuss staff issues, their experience of bank staff and make suggestions. Residents have input into staff selection. Comments made by residents during the inspection indicated their confidence with the staff’s actions to resolve complaints. The policies and procedures in place and training provided to staff indicate their commitment towards safeguarding residents from abuse. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28 & 30 The lounge where residents smoke and the porch are in need of redecoration and the quality of the ventilation in the lounge must be assessed. A comfortable and homely environment will then be provided to residents. Shared space provided is suitable for shared activities and for private use. Bedrooms reflect the residents personalities and suit their individual lifestyles. The number of toilets and bathrooms offer sufficient personal privacy. The home is clean and free from unpleasant smells. EVIDENCE: The property has the appearance of a domestic dwelling with level access into the home. It provides accommodation and personal care for four people, arranged over four floors with shared space on the ground floor and bedrooms on the basement and first floor. The third floor is used by staff for sleeping-ins at night. There is a bed-sit, with en-suite on the basement, used by one 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 18 person living independently. On the first floor there is a double room and a single room. The property is close to the local shops and bus routes Overall the building is maintained to an adequate standard and clean. The porch requires updating, as there is evidence of wear and tear. The lounge is designated as a smoking area and requires decorating. The ventilation system in the room must be assessed to ensure it fulfils its purpose. The bed-sit in the basement is fully fitted with en-suite, kitchen, sitting and sleeping space. On the first floor there are two bedrooms, two females share one bedroom and the second is single and occupied by another female. Both bedrooms contained a combination of the home’s furniture and residents personal belongings reflecting their lifestyles. For the two females that share screens are provided to maintain their privacy. The manager must ensure that within the person centred plans of these individual’s, the routines that ensure their privacy must be included. The resident living independently reported that the en-suite bathroom was being updated and explained that the refurbishment will benefit his wellbeing. There is a toilet and wash hand basin on the ground floor and a full bathroom on the first floor. As the bed-sit is en-suite, three residents share the bathroom and less than three people sharing the toilets. There is a lounge with sufficient seating for four people, a dining room with additional seating and kitchen. Residents have sufficient shared space to sit together and away from others. The residents accommodated are fully ambulant and do not require assistance with moving around the home. The laundry space is adjacent to the kitchen, with floors and walls that can be easily washable. There is a small damp area near the ceiling that requires attention. There is a washing machine and tumble dryer that are domestic in scale. The washing machine is designed to reach 90 temperature. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 36 Residents benefit from well supported and supervised staff. EVIDENCE: The external manager visits the home monthly and reports on the conduct of the home. Copies of the monthly visits are sent to the local CSCI office. Staff supervision takes place 2-3 monthly for existing staff, newly recruited staff have more regular supervision. Supervision takes place with the manager on an individual basis. House aims and philosophy, residents, training and development are set agenda items for supervision, with action plans for the next and subsequent meetings. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 & 41, 42 The inclusive atmosphere is created through a clear management approach. Records are well kept. New staff must attend fire drills to ensure staff are aware of the procedures to be followed in the event of a fire to protect residents. EVIDENCE: Feedback from the staff on duty was sought on the conduct of the home. It was reported that since the vacancies were filled, more flexibility exists. Since the recruitment of staff the team is supportive. The staff on duty explained the changes that have occurred at the home with the changes in day care provision. Additional comments that residents have adapted to the changes were made. Existing staff have completed NVQ level 3 and have access to courses that meet residents changing needs and personal development. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 21 The rota in place indicated that during the week, two staff are rostered until 5:00 pm when the levels are reduced to one. At night one person sleeps in the premises. At weekends one person is rostered throughout the day, with additional staff rostered for peak periods. It was understood that one resident is away from the home at weekends and the other two have an entrenched view of weekends, for example, work during the week and relax at weekends. For this reason the staffing levels are low at weekends and where outings are arranged at weekends, additional staff will be rostered. The manager is aware that should the residents needs’ change, staffing levels would have to be assessed. Facilities for the safekeeping of cash and valuables exist and currently two residents have cash in safekeeping. The records examined were found to be up to date and well managed, with receipts appended to evidence purchases made. The manager has not received the individual notification from the Trust regarding income support and Local Authority schedules of fees for the year beginning April 2006/07. There is an accident book for staff and residents to record injuries, there are no recorded incidents since the last inspection. The records that relate to fire safety checks and practices were examined. It is evident from the log that checks are conducted at the stipulated frequencies. While existing staff attend fire training and drills, the two most recently employed staff must attend fire drills. 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 x 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x x 3 x x 2 x x 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 12 Requirement Person Centred plans for the residents that share must include the staff’s action to maintain rights in terms of their personal care routines Newly appointed staff must attend fire drills The porch and lounge require decorating. The damp patch in the laundry requires attention. The ventilation in the lounge must be assessed to ensure the smoking area is properly ventilated. Timescale for action 30/04/06 2 3 YA42 YA24 23(4) 23(2) 30/03/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 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 45 Mayfield Park North DS0000026563.V284056.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!