Inspection on 03/05/05 for Maltreath

This inspection was carried out on 3rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Maltreath 28/07/08

Maltreath 04/09/07

Maltreath 08/09/06

Maltreath 02/11/05

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 Liz Hendry Uannounced 3 May 2005 9:00 rd 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 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 Stationary 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 H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Maltreath Address 23/25 Warwick Road,Cliftonville,Margate,Kent,CT9 9DF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 491 3579 Temperance Care Limited Stella Oludotuh Okesola Care Home 11 Category(ies) of Mental Disorder (8) Mental Disorder - over 65 registration, with number (3) of places Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The Manager to have completed NVQ 4 in Management and Care by 2005 Date of last inspection N/A Brief Description of the Service: Maltreath is located within Cliftonville on the outskirts of Margate. The home is situated 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 lay out of the home, it is unsuitable for individuals with poor or limited mobility. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the homes first unannounced visit since new owners took over in November 2004. Time was spent talking with residents and staff and reviewing care plans. Policies and procedures were not inspected on this occasion due to the managers attendance at a NVQ training course. What the service does well: What has improved since the last inspection? What they could do better: There are a number of things the home needs to do to make sure that the people who use the service get consistent care from staff who are well trained and know what to do to meet their needs. The home is not providing a consistent service and this must improve to meet the service users needs. There is no clear or consistent care planning systems in place to provide staff with the information they need to meet service users needs. Arrangements for protecting service users are not satisfactory placing them at possible risk of abuse. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 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 H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 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 standard(s) 3 The absence of information, including written needs assessments, and risk assessments, potentially puts service users at risk of harm and means that their needs may not be met. EVIDENCE: Service user care plans were seen and found to hold little information regarding any potential restrictions on choice, freedom, services and facilities. Due to limited levels of understanding and specific abilities of the service users those spoken to were unaware of the contents of their needs assessment, and did not understand personal restrictions placed upon them. Staff on duty during the inspection were spoken with and confirmed that training courses had been applied for through a local training centre, however due to limited availability many have been unable to attend recent courses. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7and 9 There is no clear or consistent care planning system in place to adequately provide staff with information they need to meet the needs of the service users. EVIDENCE: Information held within individual care plans was examined and found to be insufficient, not kept up to date and showed no evidence of detailed risk assessment. Many service users spoken with were unaware of what a care plan was. Which demonstrates a lack of communication between management, staff and residents. Environmental and individual risk assessments where completed were inadequate, and provided very little information, meaning staff and service users safety and wellbeing is potentially at risk. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 10 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 standard(s) 13,14,15 and 16 Links within the local community are limited and there is little evidence of social, recreational and educational opportunities. EVIDENCE: Individual care plans viewed showed little evidence of social, recreational and educational activities. Service users were seen to be sitting in communal rooms watching television, completing word puzzles and wandering around the home during the course of the inspection. Low staffing levels means that there is little flexibility and few opportunities for residents to partake in community based activities. No evidence could be found to suggest that service users are given opportunities to meet people and make friends with those who do not have mental health problems. One service user spoken with confirmed that they regular go home for weekend visits and enjoy working closely with the staff, however no evidence could be found within this individuals care plan to support this. Staff on duty were seen to interact well with residents who were sitting within the communal areas. Little interaction was given to those residents who had chosen to be in their bedrooms. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 11 Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 12 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 standard(s) 18,19 and 20 Personal care and support is offered in a way to promote service users privacy, dignity and respect. EVIDENCE: Service users spoke of staff providing personal care in a manner that promoted privacy and respect. Guidance and support in meeting personal hygiene standards is freely offered by staff and is available at all times. Staff spoken to confirmed that a key worker system is in operation within the home, this involves staff taking on additional duties for specific residents. During the course of the inspection it became evident that staff promptly report individual healthcare needs to the appropriate health professionals without delay. Records need further development to ensure all visits or communication with health professionals is clearly documented. Medication is administered and recorded in line with the Royal Pharmaceutical Guidelines of Great Britain. Storage of medication should be reviewed to ensure external creams are kept separate from internal medication and temperatures within the medication cupboard are appropriate to the medication stored. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 13 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 standard(s) 23 Arrangements for protecting Service Users are not satisfactory placing them at possible risk of abuse. EVIDENCE: Staff spoken to who had recently attended adult protection and abuse awareness training courses had a basic understanding of the procedure to follow and who to report possible incidents of abuse to. The homes policies and procedures on adult protection were located within the managers office and as a result were unable to be viewed. The manager for the home must ensure that all staff have a clear understanding of adult protection and whistle blowing procedures both within the home and within the community. The homes policies and procedures for enabling service users to access their personal monies was unclear, staff were observed using their own personal money to provide residents with spending money in the absence of the manager. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 14 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 standard(s) 24 and 30 Improvements to the interior fixtures and fittings of the home would enhance the service users quality of life. EVIDENCE: A tour of the home was undertaken, while the home meets the basic comfort needs of the all residents, further redecoration and refurbishment would seek to enhance the quality of life for all service users. A new kitchen has recently been installed and provides service users and staff with good facilities for providing a range of home cooked meals. The exterior of the premises has been well maintained and a seating area to the front and rear is used by many of the residents. Staff spoken to had not attended infection control training, and as a result increases the risk of infection within the home. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Only limited progress has been made in addressing staff shortages and staff training and as a result service users do not receive consistent care by suitably qualified and trained staff. EVIDENCE: A maximum of two care staff are on the floor during any one shift. Staff spoken to confirmed that the manager is available the majority of the time to deal with emergencies. Due to the layout of the building and level of needs of the residents an additional member of staff should be available for each shift. This would enable existing staff to attend training courses and spend time with residents on a one to one basis. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The home has inadequate risk assessments pertaining to the health, safety and well being of both staff and residents. EVIDENCE: Accident/ incident reports are completed sporadically, no evidence could be found of review following an incident/accident. Accident report forms were missing for some occasions that had been recorded within the staff communication book. COSHH cupboard was found to be suitably labelled and kept locked at all times. An intercom system was in place for one service user who was confined to their bedroom. Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 17 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 x x 1 x x Standard No 22 23 ENVIRONMENT Score x 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 1 x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x x 1 1 2 2 x Standard No 31 32 33 34 35 36 Score x x x x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Maltreath Score 2 2 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 1 x H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 18 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 12 Requirement The manager is to make proper provison for the care, treatment, education and supervison of supervision of service users. The registerd manager is to ensure that each service user has a comprehensive written plan as to how the individuals needs in respect of health and welfare are to be met. Each plan is to include written evidence of service user involvemnet and consent.. The registered person shall for the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. Personal restrictions and limitations be clearly identified on each residents care plan and evidence service user involvement and consent.. The registered person shall ensure that unnecessary risks to health and safety of service users are identified and so far as possible eliminated. Each service user must have H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Timescale for action 01 July 2005 01 July 2005 2. 6 15 3. 7 12 01 July 2005 4. 9 13 01 July 2005 Maltreath Version 1.30 Page 19 5. 13 and 14 16 6. 20 13 7. 23 13 8. 30 13 9. 35 18 10. Maltreath 42 13 and 37 comprehensive risk assessments for all activities and tasks within the home and the local community, which should show evidence of regular review.. The registered person should consult service users about their social interests, and make arrangements to enable them to engage in local, social and community based activities. External creams are to be stored in a sealed container away from internal medication. Daily temperatures within the medication cupbaord are to be recorded in line wth Royal Pharmaceutical Guidelines of Great Britain. The registered person must make arrangements by training staff or by other measures to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Written records of service users monies should be clear and legible. Residents monies are to be made available to the residents at all times. The registered person should maje arrangements to prevent infection, toxic conditions and the spread of infection at the home. All staff are to attend infection control training. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qulaified and competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users The registered manager is to 01 July 2005 01 July 2005 01 July 2005 01 August 2005 01 July 2005 H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 20 ensure that risk assessments are carried out for safe working practices. All accidents, injuries and incidents of service users and staff are recorded and reported 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 15 16 19 24 Good Practice Recommendations Servce users are provided with opportunities to meet people and make friends who do not have their disability/illness. Service users responsibility for housekeeping tasks should be documented within the individuals care plan. All visits to healthcare practitioners should be recorded adequatley and follow up visits clearly documented. The home would benefit from a general programme of redecoration and refurbishment Maltreath H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 H05 H56 S62087 Maltreath V224423 03052005 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!