Inspection on 12/06/08 for Maddalane

This inspection was carried out on 12th June 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Maddalane 158 Victoria Road St Budeaux Plymouth Devon PL5 1QY Lead Inspector Jane Gurnell Unannounced Inspection 12th June 2008 09:15 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 Maddalane DS0000071154.V365221.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. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maddalane Address 158 Victoria Road St Budeaux Plymouth Devon PL5 1QY 01752 360253 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) Mrs Susan Carol Currie Mrs Susan Carol Currie Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 8. The is the first inspection of this service Date of last inspection Brief Description of the Service: Maddalane is situated in a residential area of St Budeaux. It is close to the shops at St Budeaux Square and also transport links into Plymouth. The home is owned and managed on a day-to-day basis by Mrs Susan Currie who took over ownership in January 2008. The home offers six bedrooms: a single and a double bedroom on the ground floor and three single and one double bedrooms on the first floor. On the ground floor there is a bathroom and toilet suitable to be used by people with restricted mobility, as well as a shower room and toilet. A further bathroom and toilet is situated on the first floor: the bath is fitted with a chair again to assist people with restricted mobility. A stair lift provides access to the mezzanine level and there are three further steps to the firstfloor landing. A lounge, dining room and conservatory are situated on the ground floor and provide pleasant communal areas. Outside is a level patio area which leads to the laundry room. Maddalane is registered to provide care services to older persons (OP) whose assessed care needs on admission do not fall within the categories of dementia or physical disability. The weekly fees at the time of this inspection ranged from £320 to £460 and is dependant upon the level of support required by each person. Items not included in the fees were hairdressing, chiropody, newspapers and magazines, clothing and toiletries. Information regarding the services provided at Maddalane can be obtained directly from the home. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was unannounced and undertaken on the 12th of June 2008 between 0915 and 1315. Mrs Currie, the owner was present throughout. There were six people living at home at the time of the inspection and all were spoken with, as was the member of staff on duty. The care plans for three people were examined in detail and other documents such as staff recruitment and training files and those relating to the maintenance of the equipment of the home were examined. What the service does well: What has improved since the last inspection? What they could do better: Care plans must contain more information about each person’s day-to-day needs and the action by staff to meet those needs. Recruitment practices must be reviewed to ensure that all the necessary documentation, such as two written references are obtained prior to the commencement of employment. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 6 Arrangements must be made for staff to received updates in First Aid, Moving and Handling and Fire Safety training. 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. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 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 Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5. Quality in this outcome area is good. People considering moving to Maddalane are provided with sufficient information to help them make an informed choice about where they live. The home’s admission process ensures that people are assessed prior to moving in to ensure that their needs can be sufficiently met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions to the home since the change of ownership, however, Mrs Currie detailed the admission procedure which included an assessment of people’s needs and inviting people to spend time in the home meeting the other residents and staff. An examination of the proposed documentation demonstrated that not only would personal and health care needs be assessed but also those relating to social, cultural and religious needs. The home does not provide intermediate care. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. Care plans do not fully record people’s needs therefore consistency in care support cannot be guaranteed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All six people living in the home were spoken with and all praised the new owner and her staff team. People described Maddalane as a real family home and confirmed they are supported in a manner, which promotes their independence and recognises their preferred routines. The care plans for three people were examined in detail. These plans are the documents used to identify people’s care needs and the action required by staff to meet those needs. The care plans were developed from assessments of people’s abilities with day-to-day living activities, health care needs including nutritional and skincare requirements and any identified risks such as those to do with poor mobility and the risk of falling. Not all of the assessed needs had been recorded onto the care plan. For example, one lady was receiving treatment from the district nurse for a leg ulcer but this was not Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 10 recorded on the care plan although when spoken with the owner and staff were fully aware of her care needs. The care plans did describe people’s preferred routines and demonstrated that people were free to get up in the morning and go to bed in the evenings when they wished and that the routines of the home were very flexible. Care plans had been signed demonstrating the person’s involvement and consultation. Medication was stored securely and medication administration records were neat and accurate. Staff had received training in safe medication practices and certificates were available for inspection. Records indicated that people had regular access to opticians, dentists and chiropodists, as well as other specialists such as the Occupational Therapist who had provided advice and equipment for one person whose mobility had become more restricted. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. People living at Maddalane were able to enjoy a relaxed, homely atmosphere where they can make choices about their lifestyle. Dietary needs were well catered for with a balanced and varied selection of food available that meets peoples’ tastes and choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The atmosphere in the home was warm and welcoming. People were seen to be relaxing either in their rooms or with others in the communal sitting areas. People said there were no set rules in the home and they were able to make their own plans, to come and go as they please, and decide when they wanted to get up and go to bed. One person described how he went down to the shops most days, whilst another person described how she preferred to spend time in her room but that she had plenty of contact with staff and didn’t feel isolated. Staff organised leisure activities daily in consultation with people’s wishes and included card games and tabletop games, as well as gardening and cooking. People described the food as “excellent” and described Mrs Currie as being a very good cook. They said that all the food was home-cooked and that Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 12 processed foods were not used. On the day the inspection people were enjoying sweet and sour chicken with rice and banana fritters for dessert. People said drinks and snacks were available at all times and that freshly baked cakes were made daily. People said that relatives and friends are welcome to visit at all reasonable times and were made very welcome. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. Quality in this outcome area is good. Complaints and suggestions from those living at Maddalane are treated seriously. People are listened to and issues resolved promptly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All those people spoken with said they had confidence with the new owner and her staff team to resolve any issues of concern they may have, although all stressed they had no complaints whatsoever about the home. Neither the home nor the Commission had received any complaints since the change of ownership. People said they felt well respected and were free to live their lives as they wished. Mrs Currie had attended training in the protection of vulnerable adults and confirmed that she had passed this information on to her staff team prior to sourcing training for them. Mrs Currie and a member of staff spoken with were aware of their responsibilities should they suspect someone was at risk from abuse. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. Maddalane is a very pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet peoples’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The location and layout of the home is suitable for the needs of those currently living in the home. The home has retained much of its character and period features making it an interesting and attractive care home. The living room and dining room are on the ground floor as is a conservatory where people can sit and socialise and entertain visitors. Mrs Currie has invested in the property by upgrading the patio area to make this more accessible and safe to use and moving the laundry room to the garage thereby enabling the old laundry room to be converted into an en suite bedroom. There are plans to provide en suite facilities to all bedrooms. Further plans include converting the ground floor shower room into an easy access wet Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 15 room. Handrails, raised toilet seats, a stair lift and baths suitable to be used by people with restricted mobility promote people’s independence. Outside, the rear courtyard offers a pleasant area where people can sit in good weather: the area has colourful plant pots and residents were involved in choosing the plants. Bedrooms are set out on two floors with a stair lift providing access to the mezzanine floor: there are 3 further steps to the main first floor landing. Bedrooms seen on the day of the inspection were clean, bright and reflected the personal taste, interests and lifestyle of the individual. Each bedroom door is fitted with a lock to provide privacy and security. Mrs Currie confirmed that she will be changing these in time to locks that do not require a key from the inside as should the key be left in the lock, staff would be unable to gain access in an emergency. Temperature control valves have been fitted to regulate water temperature from bath taps and covers have been fitted to all radiators to protect people from the risk of scalds and burns. Those windows above ground level that opened from the lower half were fitted with opening restrictors to reduce the risk of people falling from the windows. All parts of the home seen during the inspection were found to be clean and free from odours. The laundry room had been relocated to the garage at the back of the house and Mrs Currie confirmed that staff had been instructed not to take laundry through the dining room but to use the front door, to reduce the risk of cross infection. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. Recruitment practices need reviewing to ensure only suitable people are employed at the home. Staff training relating to health and safety matters is out of date and staff cannot be certain they are practicing current recognised methods. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All those people spoken with said they were very well supported by “wonderful” staff who were described as kind, caring and friendly. People said they were assisted promptly indicating that there are sufficient staff on duty. Discussions with Mrs Currie, the staff member on duty, and examination of the duty rota indicated that there were two staff available 07:30 to 20:30 everyday. As Mrs Currie lives at Maddalane, she provides sleep-in cover each night. Should Mrs Currie be away from the home, a staff member sleeps at the home. Everyone confirmed they have a call bell to use both day and night and have not had any difficulty receiving care during the night. The staff personnel files for each person employed at the home were examined. All staff had a National Vocational Qualification, and with the exception of one member of staff certificates were available. Although all staff had received training in Health and Safety, Food Hygiene, First Aid and Moving and Handling, the majority of these certificates were out of date indicating that Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 17 staff may not have the most up to date information about issues relating to the care and safety of older people. One of the members of staff had been newly recruited. The written references for this person had not yet been received although an application for a Criminal Record Bureau check had been made. Mrs Currie confirmed that the person was working through her induction period and under the supervision of either herself or one of the more experienced members of staff. Mrs Currie gave assurances that due to the small size of the home and with only one person requiring assistance with personal care, this member of staff did not work alone. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 18 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, 32, 33, 35, 36, 37 and 38. Quality in this outcome area is good. Maddalane is a well managed home that promotes people’s independence and choice and strives to provide a “home from home” to the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Currie has owned Maddalane since January 2008 and in that time she has built up a strong relationship with the people living in the home and her staff team. Residents and staff described her as “wonderful” and very approachable and hard working. Mrs Currie has many years experience in working in care homes and has a National Vocational Qualification at level 3 in Care and is working towards the Registered Manager Award. Mrs Currie also holds a 4 day First Aid at Work Course as well as current training in Safe Medication, Food Hygiene and Moving and Handling Courses. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 19 Mrs Currie has developed a questionnaire to allow people to formally comment about the quality of the service within the home and any suggestions for improvement: this has yet to be distributed but will give Mrs Currie a clear indication of the views of people living in the home. The minutes of staff and residents meetings were available and indicated Mrs Currie’s plans for the future upgrading of the facilities as well as allowing people to make suggestions about the running of the home. Mrs Currie works in the home every day and as such is able to work alongside and supervise the staff team. This enables her to discuss with them their own training and development needs as well as allowing her to assess their work performance ensuring it reflects the principles of the home. People are encouraged to retain responsibility for their own finances and the home does not hold any money for safekeeping. Documents were stored securely in the office and were clear and accurate. Mrs Currie was aware of her responsibilities to notify the Commission of any events that affects the well-being of people living in the home. The fire alarm system had been serviced in May 2008 and was checked each week to ensure it was in good working order. Staff had received fire safety training in the past but these certificates were now out of date. As noted under the outcome group for Staffing, other staff training was also out of date and Mrs Currie gave her assurances that training would be arranged within the near future. Although the stair lift was several years old it had been regularly serviced and repaired; the service was due in July when the spring on the seat was due to be replaced. Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 20 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 X 3 3 3 N/A 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 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 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 3 3 X 3 3 3 2 Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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(1) Requirement Each person’s care plan must provide a description of all of their current care needs and the action required by staff to meet those needs. Written references must be obtained for staff prior to the commencement of their employment. Arrangements must be made for staff to receive training in first aid. Arrangements must be made to provide a safe system for moving and handling service users. Staff must receive training in fire prevention. Timescale for action 31/07/08 2 OP29 19(1)(b) 12/06/08 3 4 5 OP38 OP38 OP38 13(4) 13(5) 23(4)(d) 31/10/08 31/10/08 31/10/08 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 Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 22 Maddalane DS0000071154.V365221.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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