Inspection on 08/09/06 for Maltreath

This inspection was carried out on 8th September 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 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 02/11/05

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 23/25 Warwick Road Cliftonville Margate Kent CT9 9DF Lead Inspector Tina Thomas Key Unannounced Inspection 8 September 2006 10:30 th Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 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.V302507.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 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.V302507.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maltreath Address 23/25 Warwick Road Cliftonville Margate Kent CT9 9DF 01843 221677 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) 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.V302507.R01.S.doc Version 5.2 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 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. Fees are:£363.88-£481.87 Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over a 1 day period. The inspector was assisted throughout the inspection by the Registered Provider Mr Nelson Okesola. To form judgements the inspector spoke with people that live in the home, the manager, the staff and the Provider. The Provider filled in documentation pertaining to the home prior to the inspection. The inspector also viewed comments made in surveys sent out to service users, their families and other health care professionals. This was a key inspection and therefore all key standards were inspected. The home has continued to improve and met all but one of the Requirements made at the last inspection. What the service does well: What has improved since the last inspection? The home has improved it procedures for the administration of medication, although further improvements must be made. All radiators now have covers preventing the risk of burns for service users. Paper hand towels are now in all bathrooms, preventing the risk of cross infection from shared towels. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 6 A new office has been built downstairs, allowing easy access for service users and visitors. A new induction which is in line with Skills for care has been introduced to enable new starters to be sure of what is expected of them in their new role. 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. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 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.V302507.R01.S.doc Version 5.2 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): 2 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. New service users are admitted only on the basis of a full assessment undertaken by people competent to do so EVIDENCE: Service users needs are usually assessed initially by their care managers. Once interest is shown in the home, the Manager and the Provider conduct their own assessment. The assessment is holistic in nature. The home develops with each prospective service user an individual service user plan based on the Care Management Assessment and care plan or the home’s own needs assessment. Rehabilitation and therapeutic needs are assessed by state registered health professionals using regulated assessment methods. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 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 the following standard(s): 6,7,9 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. Each Service user has a plan of care. Staff respect service users’ rights to make decisions. Service users are supported to take risks as part of an independent lifestyle. EVIDENCE: Two Service users care plans were viewed. They were holistic in nature. They discussed service users physical, physiological and social needs. The care plans were signed by the service users indicating that they had been part of the care planning process. Two service users who spoke with the inspector expressed that they knew what was in their care plans. The plans do not establish individualised procedures for service users likely to be aggressive or cause harm or self-harm, focusing on positive behaviour, ability and willingness. The Provider explained that this is because service users have been maintained without crisis for so long. A recommendation was made regarding this issue. Care plans held suitable risk assessments, and were suitably reviewed. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 10 Staff provide service users with the information, assistance and communication support they need to make decisions about their own lives. This was evidenced in care plans. Staff were observed asking service users ’what would you like to do about…………’ Peer support within the home is good. Some service users have had long friendships, some having lived together at other homes before coming to Maltreath. Service users manage their own finances with support. Service users who spoke to the inspector discussed the type of things they liked to spend their own money on. Service users care plans held robust and appropriate risk assessments. Action is taken to minimize identified risks. The homes unexplained absences policy was viewed and was found to be robust and time specific. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 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, 13,15,17 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. 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. EVIDENCE: Staff try and help service users to find and keep appropriate jobs, continue their education or training and /or take part in fulfilling activities. Some service users have been to college for art classes. One service user works in a kitchen one day a week. Service users spoke with the inspector about using local facilities, i.e. the shops, swimming pool, church. One service user has a walk and talk programme, others are involved in charity work. Service users were aware of local services, facilities and activities. Staff support service users to maintain family links and friendships inside and outside of the home. As previously mentioned in the report, some service Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 12 users lived together previously at another home. One service user has a relationship with someone from another home. Family and friends are welcome to the home. There was evidence in care plans of relationships and input by families. Service users and staff all agreed that the food in the home was wholesome and plentiful. They expressed that hot and cold drinks and snacks are offered regularly. Some service users are able to go to the kitchen and make their own. One service user has their own fridge in their room. Service users are asked at meetings if the are happy with the menu. There is a daily choice of menu. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 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): 18,19,20 Quality in this outcome area is adequete. The judgement has been made using available evidence including a service visit. Personal care and support is offered in a way that promotes service users privacy, dignity and respect. Physical and emotional health needs are met. The administration of medication has improved but medication storage needs 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. Service users choose their own clothes, hairstyle and makeup and their appearance reflects their personality. Times for getting up/going to bed, baths, meals and other activities are flexible. One service users was having their breakfast after 10am because they had chosen to get up late. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 14 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. Two GP’s return questionnaires sent by the commission, which reflected that they had no concerns with the home. Medication is reviewed at least 6 monthly. The home has overhauled its medication systems since the last inspection. The provision for storing medicine is poor but there are plans to provide a new storage area. . There were good records of receipt, administration and disposal. District Nurses now sign the homes Medication administration records for depot injections. The Provider has ensured that Staff administering medication have had one day medication training. A requirement was made regarding this at the last inspection. To fully meet the standard, the provider must ensure that staff are regularly reviewed to ensure continuing competency. One requirement made at the last inspection pertaining to the storage cupboard has not yet been met. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 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): 22,23 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. 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. The homes complaints book was viewed and one complaint from a service user had been actioned. The minutes from a Service user meeting show that complaints are encouraged. Questionnaires returned to CSCI prior to the inspection by service users, relatives and GP’s, with exception of one relative, concerned with staffing, 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 completed external training. Staff members spoken with had a sound understanding of Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 16 adult protection and were aware of the procedures to follow when reporting possible incidents of abuse. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 17 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): 24,30 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. Service users live in a homely, comfortable and safe environment. The home is hygienic and clean. 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. The home has a comprehensive system of refurbishment and redecoration underway. Service users choose the colour scheme within their bedrooms. Service users rooms were personalised with their own items. The smoking lounge has an extractor fan to aid ventilation. A new office has been 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 in all bathrooms inspected. Liquid hand soap was provided in all hand wash areas. Some toilets do not have hand-washing facilities and it is recommended that sanitizing gel be placed in these rooms. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 18 All radiators have been covered to prevent the risk of scalds or burns to service users. A domestic washing machine and a commercial tumble dryer are provider in the laundry room. There is also additional drying space in the back yard area for use in better weather. A sluice machine is also available. The home was found to be clean and tidy throughout with no unpleasant odours. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 19 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): 32,34,35 Quality in this outcome area is adequate. The judgement has been made using available evidence including a service visit. Not all staff are sufficiently qualified. Service users are supported by the homes recruitment policies and practices. The home is developing the training programme. EVIDENCE: The inspector spoke with care staff and viewed the staff training matrix. Service users expressed that staff were friendly and approachable. Some staff have not had training specific to mental health problems and a requirement has been made regarding this matter. One family member commented on this in a questionnaire returned to the commission. The home now has an induction programme in place, which is in line with skills for care. Less than 50 of staff are trained to NVQ Level 2 or above, to meet the standards this should have been achieved by 2005. Staff files examined contained enhanced criminal records bureau and POVA checks and at least two written references for all staff. All staff receive job descriptions and terms and conditions. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 20 The home is working to improve its training programme. As previously mentioned an induction programme is in place. Staff have received mandatory training. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 21 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, 42 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. The management of the home is good. 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. The manager ensures safe working practices and the health and safety of service users. The registered manager ensures compliance with relevant legislation. Documentation was reviewed which evidenced this, including the Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 22 fire log and the accident book. Suitable risk assessments including environmental are conducted. Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 3 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x x x x x 3 Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 24 yes 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 YA20 Regulation 13(2) Requirement 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 NOT MET 31/01/06 2 YA32 12 Staff must have the skills and experience necessary for the tasks they are expected to do, including: Knowledge of the disabilities and specific conditions of service users 08/12/06 Timescale for action 08/12/06 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 Refer to Standard YA6 Good Practice Recommendations The service user plan establishes individualised procedures for service users likely to be aggressive or cause harm or self-harm, focusing on positive behaviour, ability and DS0000062087.V302507.R01.S.doc Version 5.2 Page 25 Maltreath 2 YA30 willingness. Toilets without hand washing facilities should have sanitising gel available Maltreath DS0000062087.V302507.R01.S.doc Version 5.2 Page 26 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.V302507.R01.S.doc Version 5.2 Page 27 - 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!