Inspection on 22/08/06 for Mallands Care Home

This inspection was carried out on 22nd August 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 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

Mallands Care Home 08/03/09

Mallands Care Home 09/01/08

Mallands Care Home 12/06/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Mallands Care Home Odle Hill Abbotskerswell Newton Abbot Devon TQ12 5NL Lead Inspector Margaret Crowley Unannounced Inspection 22nd August 2006 07:00 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 Mallands Care Home DS0000067260.V302520.R03.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. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mallands Care Home Address Odle Hill Abbotskerswell Newton Abbot Devon TQ12 5NL 01626 366244 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) Mallands Care Ltd Miss Sally Ann Gribble Care Home 31 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (31), of places Physical disability over 65 years of age (31) Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 31 service users aged over 65 years may be accommodated in the category of Old Age A maximum of 31 service users aged over 65 years may be accommodated in the category of Physical disability (PD(E)) A maximum of 31 service users aged over 65 years may be accommodated in the category of Dementia (DE(E)) 21st of March 2006 Date of last inspection Brief Description of the Service: Mallands is registered to provide care for 31 older people who may also have a physical disability and/or dementia. It is a large detached older property with a purpose built extension and provides accommodation on two floors. The ground floor has spacious communal rooms including 2 lounges one of which overlooks the garden and a dining room that is arranged in separate areas. There are 10 single en suite bedrooms on the ground floor. There are one double and 19 single bedrooms on the first floor, all of which have en suite facilities or an adjacent toilet. There are two passenger lifts for service users who are unable to use the stairs. The home provides aids and adaptations to meet service users needs including grab rails, mobile hoists, adapted baths and a walk-in shower room. At the front of the house there is level access to a pleasant garden and seating areas. The proprietors are currently extending the property to include seven additional bedrooms, a bathroom, a sluice room and an office. Mallands is located on the outskirts of the village of Abbotskerswell, near the town of Newton Abbot. There are local shops, a church and a public house within the village and a wide range of amenities in Newton Abbot. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken on 22nd and 23rd of August 2006. Mr Leadbetter, the responsible individual, was available each day and Miss Gribble, the registered manager, was on duty during part of the inspection each day. The senior care assistant and one of the administrators assisted the inspector at other times. A tour of the premises was made and service users and visitors were spoken with. Staff on duty were observed and spoken to in the course of their daily duties. Service user and staff records were inspected. Following the visit to Mallands questionnaires were received from relatives, service users, care staff and community nurses. What the service does well: What has improved since the last inspection? Miss Sally Gribble has been registered as the manager of the home. Service user records are now held securely in a locked cabinet. There are now separate recording procedures for the recording of controlled drugs. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 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. Mallands Care Home DS0000067260.V302520.R03.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 Mallands Care Home DS0000067260.V302520.R03.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Although the home has a statement of purpose and admissions procedures to enable prospective residents to make an informed choice about where they live, pre-admission assessments are not always completed to ensure service users needs can be met. EVIDENCE: Mallands provides prospective service users with good information regarding the home and its services. A new service user confirmed that he had received written information and visited the home prior to his admission and had been made very welcome by the staff. Of the sample of service users’ records examined, those of two service users recently admitted did not contain evidence to show that an assessment of the service users’ care needs had been made before their admission. One of the service users did not have a care plan. Admission is a particularly difficult time for new service users and if the assessment has not been carried out before Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 9 admission and recorded, care staff may not be fully aware of a new service user’s health and care needs. As required at the last inspection, a system has been introduced of writing to prospective service users and/or their representative to advise them whether or not the home can meet their assessed needs. However, there was no evidence of this letter having been sent to service users admitted recently. A written contract was available for the each service user and had been signed by the service user or their representative. The home does not provide intermediate care. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 10 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 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Service users are treated respectfully. There are safe practices for the administration of medication that ensure service users are not placed at risk. There are clear care planning processes, but some service uses may be placed at risk due the need for staff to have more training in meeting service users health care needs. EVIDENCE: Evidence was seen of assessments, risk assessments and care plans, which are reviewed regularly and updated. Communication and recording systems are in place and since the last inspection daily monitoring records for service users have been documented separately. There are clear systems for the storage and administration of medicines. Medication records were in order. No service users currently administer their own medication, but the registered manager said that they are offered this facility subject to risk assessment. Evidence was seen that service users medication is reviewed regularly. A visiting GP who was undertaking medication reviews at the during the inspection, gave positive feedback regarding the service the home provides. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 11 Although service users and their relatives said they are well cared for, some commented that staff were very busy. Mallands provides care for older people who may also have dementia and/or physical disabilities. It was observed that several service users were physically frail, and the inspector was informed that 10 service users were wheelchair users and 12 had dementia. Feedback from some staff, a relative and the district nurses commented on the increasing frailty of the service users who come to live at the home and the demands this makes on staff to meet their needs. Although the district nurses made positive comments regarding the staffs caring attitude, they also said that staff should have further skills and training in the moving handling of service users, the appropriate use of wheelchairs and in meeting the needs of service users with dementia. There were also concerns expressed that sometimes referrals are not always made to them sufficiently early. Service users said that the staff were very kind and that they are always treated with courtesy. Staff were observed respecting service users privacy when entering rooms and addressing service users in an appropriate and friendly manner. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 12 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 quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Planned activities take place to provide interest for service users. They are supported in maintaining contact with family, friends and the local community Service users would benefit from greater flexibility in early morning routines to ensure that their safety and dietary needs are met. EVIDENCE: There is a programme of activities provided which included games such as bingo, scrabble, and trips out. Regular themed events, chosen by the service users, take place both indoors and in the garden when weather permits. The registered manager said that staff have been exploring additional ways of providing activities for the service users with dementia. Mallands enjoys good links with the village of Abbotskerswell and is regard as a resource for the older people in the locality. Many service users have lived in the surrounding area before moving to the home. A small number of older people currently visit Mallands for day care. There is an open visiting policy and service users, their relatives and friends confirmed visitors are made welcome at all times. Some service users continue to visit family and friends locally. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 13 The registered manager said that the home promotes personal choice and supports residents to make decisions regarding their day-to-day lives. Most service users were observed to spend time in the communal lounges, rather than in their own rooms and are encouraged to eat their meals with other service users to avoid isolation. On the morning of the inspection observed that at 7.15am, 8 service users were dressed and sitting in the television lounge. Most of these were service users had dementia. Breakfast was not served until 8.30 am. The registered manager said the she was considering a more flexible approach to breakfast, so that it did not take place at a fixed time. She said that few service users choose to have breakfast in their room and all are given a hot drink at 6.00am if they choose to have one. She said that some service users choose to rise early, including some with dementia. The registered manager was asked to ensure that service users preferences regarding daily routines are recorded in their care plan. Further consideration must be given to the staffing implications in caring for those service users who are downstairs while the 2 night staff, who are the only staff on duty, are assisting service users in getting up. Service users said that the food was very good and that alternatives to the menu were always available. Service users special diets are catered for and recorded in the kitchen. The meals seen provided during the inspection were of a good standard. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 14 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): The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users can be confidant that their views and comments will be listened to and any complaints taken seriously and dealt with promptly. EVIDENCE: The home has a written complaints procedure and a brief copy of this is displayed in the main entrance. Service users spoken to said that they could address their concerns to staff or the management. Two complaints had been received by the management and dealt with appropriately. The Commission has received one anonymous complaint made prior to this inspection. There were copies of relevant legislation and guidelines relating to adult protection. Since the last inspection the registered manager and staff have attended training in the protection of vulnerable adults. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 15 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): The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users live in an attractive, clean, well-maintained home. EVIDENCE: An extension to the property was in progress. This will provide seven additional bedrooms, one communal bathroom, a sluice room and an office. This work is being undertaken to cause as least disruption as possible and two service users whose rooms are affected have been offered alternative choices. The grounds were well maintained for service users to enjoy, and provide levels lawns and paths where service users can walk. . A tour of the premises took place and all bedrooms were seen. They were found to be well decorated, clean, comfortable and personalised to individual taste. Two bedroom doors were stiff to open. Carpet was identified in one bedroom and on the mezzanine stairs, which could develop into potential trip hazards. The inspector was assured that these would be addressed and that the carpet supplier was visiting the premises later that day. The inspector discussed with the registered manager and responsible individual ways of improving orientation within the building, including improved signage for service users with dementia. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 16 The premises were clean, hygienic and free from unpleasant odours. Two domestics were on duty during the inspection and there are procedures to ensure that the home is thoroughly cleaned daily. In discussion with the registered manager and responsible individual it was recommended that paper towels are installed in communal toilets. All radiators have been covered and all hot water outlets accessible to service users have been fitted with a thermostatic safety valve to ensure that hot water is not provided above 43 degrees. The inspector was informed that windows are restricted at first floor level. There is some storage for wheelchairs but not sufficient for the numbers of wheelchairs currently in use on the premises. Discussion took place regarding the feasibility of including additional storage. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 17 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 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Care staff are employed in numbers and with a skill mix to provide an adequate level of care. Recruitment procedures are in place to protect service users from potential abuse. EVIDENCE: On the days of the inspection there were 31 service users living at Mallands and 3 people present who receive day care. There were 6 care staff on duty including the senior care assistant, or registered manager, during the day and 2 night staff who work from 8.00 pm to 7.30 am. The registered manager and responsible individual said this was sufficient to cater for the needs and numbers of service users currently living in the home. The inspector raised concerns referred to earlier in the report regarding the staffing levels, particularly early in the morning to meet the needs of service users who are dressed and downstairs before the day staff come on duty. Feedback from service users, staff and district nurses indicated that staff have limited time, although they endeavour to be helpful. The management must consider whether the number of staff and skill mix are appropriate at all times to allow sufficient time to be spent with service users to meet their needs in a safe unhurried manner. Particular consideration should be given to the routines in the early morning and early evening. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 18 The registered manager has devised a staff training programme which includes mandatory training. Most training is carried out in-house or via distance learning. Feedback received confirmed the inspector’s view of the need for training from external trainers with specialist knowledge and skills in meeting the needs of service users with physical disabilities, particularly in such areas as moving and handling, and in meeting the needs of service users with dementia. Only 5 of the 20 care staff currently have NVQ2. There are clear recruitment procedures and the necessary checks are undertaken to protect service users from potential abuse. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 19 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): 31,33,35,38 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users live in a home where there are clear administrative procedures and the premises are maintained safely. EVIDENCE: The Directors, Mr and Mrs Leadbetter have operated the home personally for approximately 18 years and are actively involved in the management and administration of the home. Miss Gribble, the registered manager has also worked in the home for several years. Service users value the continuity this provides. Since the last inspection Miss Gribble has been registered as the manager. She holds NVQ4 and is working towards the Registered Managers Award. There are clear administrative systems. There is minimal involvement with service users finances as family and/or solicitors usually manage these. Evidence was seen that any regular payments dealt with by the management Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 20 on behalf of the service users are recorded and invoiced monthly to the individual or family. The views of service users are sought via a quality survey that is undertaken regularly. Service users also attend residents meetings. The maintenance of the premises is well managed. Evidence was seen of regular checks and tests completed to maintain fire safety, electrical, gas and water systems. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 21 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 2 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 2 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 22 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 OP3 Regulation 14 Requirement All prospective service users must have an assessment of their care needs documented to ensure the care staff are aware and have planned for their needs prior to their admission to the home. The bedroom carpet and stair carpet identified must be repaired or replaced to prevent a trip hazard. The management must review staffing levels, particularly during the early morning and early evening to ensure that the number of staff and skill mix are appropriate to allow sufficient time to be spent with service users to meet their needs in a safe an unhurried manner. Staff must receive training from trainers with specialist knowledge and skills in meeting the needs of service users with physical disabilities, particularly in the moving and handling of service users, and of service users with dementia. Timescale for action 22/10/06 2 OP24 23 22/10/06 3 OP27 18 22/11/06 4 OP30 18 22/01/07 Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 23 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 2 3 4 Refer to Standard OP4 OP7 OP26 OP22 OP22 Good Practice Recommendations A letter should be sent to prospective residents and/or their representatives to confirm whether or not the home can meet their assessed needs. Service users preferences regarding daily routines should be recorded in their care plan. Paper towels should be installed in communal toilets. Sufficient storage should be provided for wheelchairs. Ways of improving orientation within the building should be introduced, including improved signage for service users with dementia. Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Mallands Care Home DS0000067260.V302520.R03.S.doc Version 5.2 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. 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