Inspection on 03/11/05 for Ideal Home

This inspection was carried out on 3rd November 2005.

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

Ideal Home 19/11/08

Ideal Home 21/05/08

Ideal Home 22/05/07

Ideal Home 02/05/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Ideal Home Knowsley Drive Gains Park Shrewsbury Shropshire SY3 5DH Lead Inspector Terry Woods Unannounced Inspection 3rd November 2005 09:30 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 Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 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. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ideal Home Address Knowsley Drive Gains Park Shrewsbury Shropshire SY3 5DH 08706092432 08706092435 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) Minster Care Management Limited Pamela Johnson Care Home 50 Category(ies) of Dementia (12), Mental disorder, excluding registration, with number learning disability or dementia (26), Old age, of places not falling within any other category (6), Physical disability (6) Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the manager seeks further knowledge and training in the areas of mental illness with respect to a care home and the individuals in residence. 4th November 2004 Date of last inspection Brief Description of the Service: Ideal Home is situated in the village of Gains Park approximately 5 miles from the centre of Shrewsbury. It is located in a residential area, within walking distance of a local post office, shops and pub, with its own car parking and gardens. It is a private care home registered to provide care and accommodation for up to 50 people, including people with a mental disorder, both under and over 65 years old, elderly people and a small number of people with a physical disability. Minster Care Management Limited has recently acquired the business. Ms Pamela Johnson is the registered manager and is responsible for day-to-day running, staffing and the development of effective policies and procedures within the home. The accommodation has 3 fairly distinct areas, the main house and converted coach house, which provide accommodation on ground and first floors and a purpose built extension to the rear of the property, which is all on one level. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 18th April 2005 over seven and a half hours and was carried out as a planned routine unannounced style visit. A full tour of the premises took place and a sample of staff files and four residents’ care records were inspected. Five staff on duty, sixteen of the residents and two visitors were spoken with during the course of the day. The purpose of the inspection was to monitor compliance of the 35 requirements made to the previous owner and review the progress made in the first few months by the new provider. To understand the challenges presented to the new owners this report should be read in conjunction with the previous report following the inspection on 4th November 2004 What the service does well: What has improved since the last inspection? The new owners recognised the lack of investment in the building and facilities at the home and it is their intention to upgrade the property and furnishings throughout, giving priority to those areas in greater need. This programme is well underway with a complete refurbishment of two WCs and a bathroom with a shower cubicle to the ground floor and a further bathroom on the first floor. Disused fireplaces in the front dining room and lounge have been removed and furniture, including that in the smoke room, is being replaced. A delivery of divan beds had arrived which is the commencement of the task to replace the stigmatised metal ‘hospital’ beds used inappropriately throughout the front wing. A review of all systems and procedures is being undertaken with support from the company’s area manager to ensure compliance with National Minimum Standards and parity with the organisation. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 6 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. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 7 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 Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3 The home has a satisfactory and functional admissions procedure providing an effective needs assessment and suitability evaluation for prospective guests. EVIDENCE: Minster Care Management Limited has produced a new Service User Guide for the home. This is a well-written document and is inclusive of an individual service user agreement setting out the terms and conditions of residence for each person. All residents have a copy of the guide and were seen present in their rooms. Observations within residents’ files and through conversations with the manager it is clear that an assessment of need is carried out prior to admission. The manager gave recent examples whereby individuals were refused admission due to the home being unable to meet their needs. There is also evidence of regular reviews being carried out by visiting professionals from either the Health Authority or Social Services. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 There is a clear and consistent care planning system in place, which provides staff with the information they require to meet residents’ needs Staff are sensitive to the individual needs of each service user and meet these in a professional manner The medication process, as a result of the recent review, is now a wellorganised, safe and effective service for the benefit of those in residence EVIDENCE: Each service user has a plan of care generated from their initial needs assessment. Plans were seen to be well organised and individuals needs outlined in a detailed manner. There is evidence within all four files inspected of monthly reviews, however the Company intends to introduce a more effective evaluation process to the home to ensure good continuity for residents. Multi disciplinary visits are recorded on file together with evidence that residents are enabled to access community health services. On the day staff were observed respecting individuals’ privacy and dignity when entering bedrooms, bathrooms and toilets. It is noted that in shared Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 10 rooms residents have a storage system for keeping individual toiletries separate, however it is clear that they often choose not to use the facilities. The home operates the Boots monitored dosage system for the administration of medication. The Company has reviewed procedures to comply with requirements made during the previous inspection and the system is now appropriately managed. A current photograph of each resident has also been inserted into their medication file. Records, with the exception of one minor discrepancy, are very neat and well kept. A senior carer on duty administering medication at lunchtime was able to talk through the process confidently and report on the effectiveness of the system. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The home provides a good quality lifestyle for the people in residence. Meals at Ideal Home are of a good wholesome type offering both choice and variety and catering for special dietary needs. The care approach at the home enables the person with dementia care to make use of their remaining abilities while providing the necessary compensation for their disabilities. EVIDENCE: The home has a designated activities organiser who arranges activities for residents throughout each afternoon. Two residents spoke of returning from a shopping trip that morning and reported on using the local bus service regularly, which gives them independence. The designated smoke room with its own extractor unit is a popular and wellused meeting place for the residents at the front of the home. The inspector joined five residents with varying degrees of dementia for the mid-day meal. Residents were clearly pleased with the meal and commented positively on the quality of the food provided at the home. Staff were observed assisting residents as required and were in attendance throughout the mealtime. Conversations with the cook and observations in the dining room Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 12 confirmed that menus have now been changed to provide choices for residents, which includes special diets as required. Staff interviewed in the dining room demonstrated a good knowledge of dementia care and were able to discuss residents’ individual preferences, skills and strengths. One lady was helping in her own way to ‘clear’ the tables and staff confirmed their knowledge of her past occupation working in the food service trade and their understanding of her desire to be helpful and make use of her remaining abilities. The inspector noted other good indicators of ‘well being’ concerning those residents with dementia including a sense of humour, showing pleasure and expressing appropriate emotions. Visitors were seen coming and going throughout the day. Those spoken to were pleased with the service being provided to their relatives. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has a satisfactory complaints system in place. The arrangements for the protection of residents from abuse are satisfactory. EVIDENCE: The home has a clear complaints procedure, a copy of which is included in the Service User Guide for residents’ information. Ideal Home has recently been acquired by Minster Care Management Limited and there has been no complaints received by the home or at the Commission for Social Care Inspection offices during this time. A copy of the Multi Agency Adult Protection Policy is in place at the home. All newly appointed staff attend an induction afternoon, which incorporates adult abuse training. A good system of managing and recording residents’ personal allowances is in place. This was completed in consultation with the local Social Services Department. Sample records were cross-referenced with individual cash wallets and found to be correct. The Company has a procedure for monitoring the home’s management of residents’ money, which includes the regular auditing of records Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24, 25 & 26 The new owners are implementing a programme that will improve the environment to benefit those in residence. EVIDENCE: The accommodation has three fairly distinct areas comprising of the main house and converted coach house, which provide accommodation on the ground and first floors and a purpose built single story extension to the rear of the property. There is a communal lounge and dining room in the main house, a quiet room and a designated smoking room. The extension has a pleasant lounge and a separate lounge/dining room, which incorporates a kitchenette. An internal courtyard provides an attractive outside area with seating and a gazebo for the comfort of residents. Accommodation in the extension was seen to be of a good standard and it was considered service users were living in a comfortable and homely environment. In all areas of the home, bedrooms were personalised to reflect the lifestyle and tastes of the individual. The previous inspection to the main building and coach house had reflected a lack of investment in both maintenance and replacement of furnishings by the former owner in recent years. Specific items Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 15 and areas have not been repeated in this report, as it is the new owner’s intention to upgrade the property and furnishings throughout, giving priority to those areas in greater need. Work has started on the ground floor where a complete refurbishment of two WCs and a bathroom with a shower cubicle is nearing completion. Disused fireplaces in the front dining room and lounge presenting a possible trip hazard have been removed and furniture, including that in the smoke room, will be replaced. Furniture in the bedrooms to the front area will also be upgraded to include lockable drawers and wardrobes and the replacement of the hospital type beds. The first floor bathroom was in the process of being refurbished on the day of the inspection. The laundry now has a full time manager who has completely reorganised systems to operate more effectively for residents. Areas identified during the inspection requiring priority attention are; The hot water outlets in the old house where the sinks in residents’ rooms are not regulated nor are there any warning notices posted. Rooms Y & T had a strong smell of urine impregnated into the carpets and a more effective method of cleaning for the comfort of all concerned is needed. Bathrooms and toilets are not being maintained to a satisfactory standard of cleanliness and it was agreed that cleaning systems are in need of review. Some residents are not provided with bedside lamps with no explanation recorded in their care plan. A cracked windowpane in room 12 presented a cutting hazard for the individual accommodated therein. Assurances were given on the day that these issues would be rectified as a matter of priority. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 There is a stable staff group working positively and enthusiastically in providing the residents with a quality of life to meets their individual requirements and aspirations EVIDENCE: Examination of the rotas confirmed that there were satisfactory numbers and skill mix of staff on duty to meet the needs of the current service user group. It was considered that the home operates a thorough recruitment procedure. All staff have a face-to-face interview, CRB checks are received prior to commencement of work and two references sought. All new members of staff undertake induction training linked to the TOPSS training programme. This was confirmed through induction records and by staff in conversation. They also spoke of a variety of training opportunities on offer including support to progress through the NVQ programme. With the exception of one part time care assistant post, there are currently no staffing vacancies. One recent addition to the staff team however is a training officer post appointed by the Company. Minster Care Management Limited seek to develop a well-trained staff group at Ideal Home and intend to have organised training sessions for staff every Wednesday afternoon. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 The Company is developing and maintaining a well-supported staff group and constantly improving the service to meet residents’ aspirations. Systems are now improving to ensure that residents’ health, safety and welfare are promoted and protected. EVIDENCE: The home has undergone management changes during this last year with Minster Care Management Limited acquiring the business and Ms Pamela Johnson taking up her position as the registered manager. Ms Johnson holds the Registered Managers Award and NVQ level 4. She is also supported by the new Company through the area manager both face to face on a regular basis and through the telephone as needed. Record keeping has improved and those inspected include resident files, staff files, supervision, training, medication, visitors, food provided and risk assessment. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 18 The fire officer visited in October however his report has not yet been received. It was reported that there were no issues for concern. All senior staff receive regular formal supervision from the manager. This is delegated down and confirmed by staff in their workplace. Monthly visits by a Company representative under Regulation 26 are required to be carried out and a copy of the report sent to the Commission for Social Care Inspection at Chapter House in Shrewsbury. It is noted that a complete review of all systems and procedures is being carried out by Minster Care Management Limited with recognition that this takes time to complete. It is however commendable that the majority of the outstanding thirty-five requirements made at the last inspection and inherited from the previous owner have been addressed and rectified. Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 19 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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 2 X 2 2 X STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 20 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 OP19 Regulation 16.2.j Requirement The manager must monitor the system for carpet cleaning to ensure that carpets are of a reasonably clean appearance and free from offensive odours at all times. All bathrooms and toilets must be maintained to a satisfactory standard of cleanliness and cleaning schedules/systems followed which minimise cross infection Bed side lamps or over bed lighting must be supplied to all service users. If it is deemed inappropriate this must be supported by a risk assessment and entered onto the individuals care plan Service users must be provided with lockable storage space The home is required to ensure that all hot water outlets used by residents are regulated locally to provide water close to 43°C The home is required to repair the cracked window pane in room 12 Timescale for action 14/11/05 2 OP21 13 (3) 14/11/05 3 OP22 16 (2) (c) 14/11/05 4 5 OP24 OP25 16 13.4.a 03/03/05 09/01/06 6 OP25 23.2.b 14/11/05 Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 21 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 Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Ideal Home DS0000064647.V263429.R01.S.doc Version 5.0 Page 23 - 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. 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