Inspection on 02/11/05 for Maltreath

This inspection was carried out on 2nd 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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Maltreath 28/07/08

Maltreath 04/09/07

Maltreath 08/09/06

Maltreath 03/05/05

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOME ADULTS 18-65 Maltreath Maltreath 23/25 Warwick Road Cliftonville Margate Kent CT9 9DF Lead Inspector Elizabeth Hendry Announced Inspection 2nd November 2005 09:00 Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 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 Maltreath DS0000062087.V252020.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 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. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Maltreath Address 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) Maltreath 23/25 Warwick Road Cliftonville Margate Kent CT9 9DF 0208 491 3579 Temperance Care Limited Stella Oludotuh Okesola Care Home 11 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (3) Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Manager to have completed NVQ 4 in Management and Care by 2005. 3rd May 2005 Date of last inspection Brief Description of the Service: Maltreath is located within the residential area of Cliftonville on the outskirts of Margate. The home is located close to the local shops, post office, pharmacy and health centre. There is limited parking on the street directly outside the home. Maltreath provides 24-hour personal care and support for up to 11 service users with mental health needs. Due to the layout of the home, it is unsuitable for individuals with poor or limited mobility. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second annual inspection. Time was spent talking with residents and staff and reviewing care plans. Policies and procedures were inspected. The management of the home were open and honest throughout the course of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home needs to address staff training; to ensure service users receive care form appropriately trained staff. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 6 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. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 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 Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 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): 1,2,3,4 and 5 The homes statement of purpose and service user guide is good. They provide service user and prospective service users with the information they need to make a decision about moving into the home. Pre admission assessments are thorough and as a result service users who move into the home know their personal needs and aspirations are going to be met. Prospective service users are invited into the home for a trial period prior to accepting a permanent place. All service users are provided with a clear contract of residence. EVIDENCE: A copy of the homes service user guide and statement of purpose were viewed and found to contain clear information as to the services and accommodation provided within the home. The Registered Manager spoke of providing service user specific copies of these documents to all residents. A copy of the last inspection report is available upon request. Pre admission assessments were viewed and found to be very thorough. The Registered Manager spoke of visiting prospective service users to determine their level of need and personal choices. Those assessments viewed accurately reflected those assessments completed by care management teams. The registered manager spoke of service users being invited into the home for trial visit or overnight stay, before being offered or accepting a place within the home. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 9 The homes terms and conditions of residence was examined and found to contain clear information as to what is and is not included within the weekly bed fee. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 10 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 and 9 Service users know that their personal goals are reflected in their individual care plans and that potential risks are managed. EVIDENCE: Individual care plans viewed clearly identified the level of need for each service user. Care plans were found to contain information regarding preferred daily routines, hobbies and health care needs. Guidelines for staff to follow when providing care to residents were clear and concise. Service user signatures were in place evidencing service user involvement. Individual risk assessments clearly identified risks, potential risks, likelihood and strategies for overcoming or reducing these risks. The Registered Manager spoke of reviewing risk assessments on a regular basis. The homes missing persons policy was viewed and found to contain clear instructions for staff to follow including timescales. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 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): 12,13,14 and 17 Service users are encouraged and supported to access the local community and develop hobbies and interests. The meals in the home are good, offering both choice and variety and catering for special diets. EVIDENCE: Service users were observed partaking in arts and crafts during the inspection. Service users spoken to said they enjoy visiting the local shops and cafes. The Registered Manager provided a copy of the homes activity schedule prior to the inspection, which identified a wide variety of activities available to all residents who wish to participate. Individual interests are clearly identified within care plans. Two service users have voluntary jobs within the local community. The registered owner said that a few residents are currently on a waiting list to attend a day centre. Service users spoke of using public transport to access the wider community. The home does not currently offer service users the option of a seven day annual holiday as part of the basic fee. Menus provided prior to the inspection identified a wide variety of nutritious and wholesome meals, with choices offered. On the day of the inspection the Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 12 home held good quantities of both branded and value food products. Service users commented on enjoying the meals and that they were able to have hot and cold snacks at any time. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 13 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 and 20 Personal care and support is offered in a way that promotes service users privacy, dignity and respect. A review of medication handling was undertaken by a CSCI pharmacist inspector who concluded that the proprietor and manager were striving to attain good standards in medication handling but that certain areas such as medicine storage and the administration process need addressing. EVIDENCE: Service users spoke of staff providing personal care in a manner that promoted their individual rights and privacy. Guidance and support in meeting personal hygiene standards is freely offered by staff and is available at all times. The home has a key worker system in operation. Records viewed identified that staff promptly report and address any healthcare concerns. The home accesses the local dental surgery, health centre and chiropodists. Annual opticians visits are also encouraged. The home has clear and concise policies and procedures for medicine management, which are easily accessible. Some procedures such as those for self-administration and medication errors require more detail. There were good records of receipt, administration and disposal. The provision for storing medicine is poor but there are plans to provide a new storage area. The cupboard in use lacks security, as does the room. Some medicine was not kept Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 14 locked and the new supply of medicine was still in the delivery boxes on the floor. It was noted that medicine pots were named and, from the process for administration described, it appeared that some secondary dispensing was taking place. The home has an up to date BNF. It was reported that staff had received training in medicine handling but no certificates were available at the time to verify this. There was no evidence that staff competency was being monitored. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 15 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 and 23 The home has a good complaints policy with evidence that service users feel that their views are listened to and acted on. Arrangements for protecting service users are good, protecting them from possible risk of abuse. EVIDENCE: The homes complaints policy was viewed and found to be clear and concise. Copies of the policy are included within the statement of purpose, service user guide and displayed within the entrance of the home. Service users spoken to were fully aware of the procedure to follow when making a complaint, and all said that they would feel comfortable making a complaint without fear of reproach. Questionnaires returned to CSCI prior to the inspection contained positive comments regarding the running of the home and service available. The homes policy and procedure on adult protection was examined and found to contain clear and concise information for staff to follow. Staff files viewed confirmed that enhanced criminal records bureau checks and POVA first checks are completed for all new members of staff. The Registered Manager confirmed that all permanent members of staff have recently attended external training in adult protection and are awaiting the receipt of certificates. Staff members spoken to, both agency and permanent had a sound understanding of adult protection and were aware of the procedures to follow when reporting possible incidents of abuse. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 16 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 and 30 Recent investment has improved the appearance of the home, providing service users with a comfortable environment in which to live. Infection control procedures within the home require improvement to ensure all service users are fully protected. EVIDENCE: A tour of the home was undertaken, the majority of fixtures and fittings were found to be domestic in nature and of good quality. During the inspection a comprehensive system of refurbishment and redecoration was underway. Significant improvements in a number of areas were already noticeable. The registered owners talked of replacing the existing dining room table and chairs with a more homely, domestic set. Service users spoken to said that they had been asked to choose the colour scheme within their bedrooms and were pleased with all the improvements being made. A new office is being constructed on the ground floor to enable each of access for service users wishing to speak to the management of the home. Paper hand towels were found to be absent form all bathrooms inspected. Liquid hand soap was provided in all hand wash areas. The laundry room is located to the rear of the property; the home has a domestic washing machine and a commercial tumble dryer. There is also additional drying space in the back yard area for use in better weather. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 17 The home was found to be clean and tidy throughout with no unpleasant odours. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 18 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): 32,32,33,34,35 and 36 Staff morale is good, resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. The arrangements for staff training require further development to ensure that service users receive care from appropriately trained staff. The staff have a good understanding of service users support needs. This is evident from the positive relationships, which have been formed between staff and service users. Since the last inspection the standard of vetting and recruitment practices has improved, with appropriate checks now being carried out to ensure service users are protected. EVIDENCE: Staff files examined contained enhanced criminal records bureau and POVA checks for all staff. Evidence of staff supervision taking place on a regular basis was also held within individual staff files. The registered manager and staff spoken to confirmed that they had been issued with a terms and conditions of service. Staff were observed communicating well with all residents. Individual training files viewed identified a shortfall in mandatory training. The registered manager spoke of using a local organisation to train the staff but due to limited availability of spaces there names had been added to a waiting list. Confirmation of this was seen. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 19 Of those staff members spoken with, all were found to demonstrate a sound understanding as to the needs of each service user within the home. The registered owners of the home explained that three members of staff are currently undertaking an NVQ, with a further two due to start at the end of November. Staff rotas viewed identified a minimum of two members of staff on duty at any one time. The home does not currently have a training matrix and it was therefore difficult to establish the level of training required for each support worker. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 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): 37,39 and 42 The management of the home is good. The systems for service user consultation are good with a variety of evidence that indicates that service user views are sought. The health and safety of service users is generally well protected. EVIDENCE: The registered manager and the registered owner are currently undertaking an NVQ Level 4 and their registered managers award, which is nearing completion. The registered manager has many years experience working with this service user group and is committed to her own personal development in order to fully meet the needs of the service users. Minutes of service user meetings were viewed, and were found to demonstrate regular consultation meetings with residents as to the running of the home. A copy of the most recent inspection report is available upon request. Questionnaire returned to CSCI from relatives and service users prior to the inspection were complimentary of the service they receive. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 21 All service users living within the home were made aware that the announced inspection was going to take place. Fire safety records viewed showed regular servicing and general maintenance. Fire extinguishers viewed were found to have recently been checked and the required standard met. The homes accident book was viewed and found to comply with the data protection act 1998. Staff files identified that not all staff involved in the preparation and cooking of food had undertaken food hygiene training. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 3 2 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Maltreath Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000062087.V252020.R01.S.doc Version 5.0 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 2 Standard YA20 YA20 Regulation 13(2) 13(2) Requirement All medicine is kept locked The storage of medicine is improved as advised and a metal medicine cupboard is purchased to accommodate all medicine in use. A lockable cupboard is provided for the new supply Medicine is prepared and administered to one service user at a time and as per the Royal Pharmaceutical Society’s guidelines The home is able to evidence that all staff handling and managing medicine are trained and competent The registered person must at all times ensure that the persons employed by the registered person to work at the care home receive (i) training appropriate to the work they are to perform. (The home must provide all new starters with comprehensive induction training) The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. (Paper hand towels to be located within all hand DS0000062087.V252020.R01.S.doc Timescale for action 30/11/05 31/01/06 3 YA20 13(2) 30/11/05 4 5 YA20 YA35 13(2) 18(1) 31/01/06 01/01/06 6 YA30 13(3) 04/11/05 Maltreath Version 5.0 Page 24 washing areas.) 7 YA42YA24 13(4) The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. (All exposed radiators to be covered to prevent injury or harm to service users, and all members of staff involved in preparation and cooking of food within the home are to undertake basic food hygiene training) 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA14 YA20 YA20 YA20 Good Practice Recommendations Service users are given the option of an annual holiday as part of the bed fee. All hand transcriptions are signed and a second person also checks and signs to ensure accuracy Staff record on the MAR chart when service users have received their depot injections from the CPN The home has detailed procedures for all medicine handling and management in the home. Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Maltreath DS0000062087.V252020.R01.S.doc Version 5.0 Page 26 - 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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