CARE HOMES FOR OLDER PEOPLE
Mamsey House Nursing Home Priest Street Wilton Somerset TA4 4NJ Lead Inspector
Clare Medlock Announced 4 October 2005
th 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 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. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Mamsey Nursing Home Address Priest Street, Wilton, Somerset, TA4 4NJ 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) 01984 633712 01984 632281 Clinida Care Ltd Mrs Barbara Mary Kinzett Care Home with Nursing 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Elderly person of either sex, not less than 60 years, who require general nursing care. Up to 3 beds for personal care Date of last inspection 9 December 2004 Brief Description of the Service: Mamsey House Care Home is a converted vicarage with an additional purpose built extension. The home is registered to provide general nursing care and personal care to older people. Accommodation is arranged over two floors of the original building and on one floor in the extension. The extension was registered in 1998. All rooms are for single occupancy and vary in size. All rooms except one have en suite facilities; this room has a wash-hand basin only but is adjacent to a disabled toilet facility. Communal areas comprise of two dining areas, a lounge and activities area. Residents are also able to sit in the entrance of the home to watch the comings and goings. The home has been adapted to meet the needs of residents who require nursing and personal care. There is independent wheelchair access to the main entrance and level access to some of the grounds. There is a ramp leading from the lounge to the patio where residents can enjoy the well maintained gardens in finer weather. There is a fishpond, garden seating gazebo and raised flower beds. The home is set close to a main road a few hundred yards from the village of Williton and the local shops. The home has dedicated administration staff and a nurse Manager. There is a Registered Nurse on duty 24 hour a day. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and took place between the hours of 10.00am and 16.30pm on Tuesday 4th October 2005. It found that the overall quality of care provided was very good. This inspection consisted of speaking with Service Users (Who have requested to be called Residents), family and friends, staff and management within the home. A full tour of the premises was conducted. Care records, policies and procedures and other records were inspected. Five of the Residents, four relatives, and seven staff were spoken to. The Manager provided a detailed pre inspection questionnaire to assist with the inspection. Four relative questionnaires and three resident questionnaires were received in respect of Mamsey House. What the service does well:
Mamsey House Nursing Home provide an excellent standard of care to all residents including highly dependent residents and to those who are unable to express their needs. There is a dedicated, friendly and motivated staff group who ensure that Residents have all their needs met and ensure residents access a full variety of services. Staff are very friendly and communicate well with residents and their families and provide opportunities on a formal and informal basis to ensure their voices are heard and requests acted on. The Manager and staff within the home listen to suggestions and act on requirements and recommendations set by the Commission for Social Care Inspection and other agencies. Residents spoken to were very happy living at the home and were full of praise for all staff within the home. Residents and staff enjoy a genuinely caring relationship. Mamsey House is an efficiently run, organised home which has routines which are flexible depending on the needs, choice and requests of the residents. The staff group are actively involved in maintaining the high standard of care by participating in keeping records to show what care has been given. The staff team ensure they are ‘up to date’ with the current trends and practices in health care. Staff within the home also foster positive relationships with other health care professionals who provide support, guidance and equipment to ensure the residents receive the best care.
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 6 There is an extensive, varied and well organised activities programme within the home. Staff encourage residents to maintain contact with friends, family and the local community. Bus Trips are arranged and Specialist activities are also arranged to meet the needs of residents. The home is clean, tidy, very well maintained and equipped to ensures Residents have a homely place to live and are helped to maintain as much independence as possible. What has improved since the last inspection?
The improvements made in the last year have been made following feedback from the residents. The Menu has been improved with the introduction of food choices where residents are now able to choose what they eat the following day. This has resulted in less wastage and an increase in choice for the residents. Residents continue to enjoy the standard of food. The ‘home’ now own and care for a Guinea pig which residents have enjoyed over the summer months. The garden has improved with the introduction of a Gazebo which means that residents can enjoy sitting out in the garden whilst being protected from direct sunlight. Further equipment has been purchased by the home which promotes the independence and safety of the residents. Further Hoist slings have also been purchased so that each resident has their own sling. This improves not only the safety of the residents but also reduces the chances of getting infections from shared equipment. Care Staff have also improved the way that manual handling training is managed at the home. Care staff manage this training and ensure their colleagues are up to date and safe when lifting and moving residents. Action on the requirement and recommendations made at the last inspection. New Staff files contain all the information to show the correct employment checks have been performed. This gives reassurances to residents that they are in safe hands. Care Plans have also been improved with records to show what action has been taken when a resident is at risk of falls and also show that residents have been consulted when plans are written. The Manager has also contacted age concern to access advocates for those residents who do not have family so their best interests are kept by not only the home’s staff but by an independent representative.
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 7 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. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 9 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 standard(s) 1,2,3,4 and 5. 6 is not applicable at Mamsey House Residents and their families are given useful information and are made to feel welcome prior to and when they are moving in. Residents are assessed prior to admission which ensures the home is the right place for them to be. Residents are cared for by a skilled team of staff. EVIDENCE: A Statement of Purpose/Service User Guide was provided at this inspection and contained all the necessary up to date information. Resident contracts were inspected and appeared to lack the room number to be occupied. This was changed during the inspection and the company clerk gave assurances that this new contract would be used for new residents. Five Care Plans were inspected on this occasion. All five plans contained evidence that a full assessment had been performed prior to accepting residents. Information was seen to be taken from the homes own assessment form which is completed by the Manager visiting the resident within their home or hospital. The form used by the home did not contain all headings required,
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 10 however the care plans seen contained the additional information. Observation confirmed information is also obtained from health care providers if residents are admitted from hospital. Residents and their families are invited to visit the home prior to moving in and that longer trial visits can be arranged. There is a one month settling in period where residents can ‘change their mind’ if they are unhappy at the home. Discussion with the Matron and staff confirmed that many residents come in for respite care. One resident stated that she had come in for respite care and chose not to leave. Trained and care staff within the home have a variety of skills and knowledge to care for the residents and discussion with the Manager confirmed that should a new condition be identified staff are given training and teaching sessions to make sure they are able to care for the residents. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 11 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 standard(s) 7,8,9,10 and 11. A clear and consistent care planning system is outstanding which means that the health and social needs of Residents are fully planned, delivered and recorded to a high standard. Staff communicate well with the multi disciplinary team. There is an ethos within the home that promotes the privacy and dignity of Residents at all times. EVIDENCE: Five Care Plans were inspected on this occasion which clearly demonstrated that Residents have all their needs met and staff are aware of all aspects of their care. All Care Plans seen were up to date, well written and complete. The staff said the system of care planning and recording was easy to use and follow. Records confirmed that any changes in the general or specific needs of the Residents are identified and trends monitored. Observation confirmed these documents were ‘working documents’ and reflected the high standard of personal care given. One Residents stated that they were aware that staff had records of their care but that they were not interested in seeing them. Care Plans, the homes diary and discussion with the residents confirmed that specialist services are accessed by staff within the home. This included:
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 12 Physiotherapist, General Practitioner, Continence nurse, Podiatrist, Dietician, Optician, dentist, Speech and language therapist and aromatherapist. All Residents seen on the day of inspection looked very well cared for with the finer details of care attended to. Examples included nail, hair and eye care. Very frail residents and those being cared for in bed appeared warm, pain free and well cared for. Records and discussion with Residents confirmed that NHS services are accessed and that staff contact the General Practitioner and other multi disciplinary health care professionals promptly. All residents spoken to thought that the care they receive is very good. Residents said that staff are very kind, sensitive and respectful. Observation confirmed that staff knock on Residents doors prior to entering and prevent entry when care was being given to protect their privacy. One resident stated that they had requested not to have a male carer when they were given a bath and this was arranged in a sensitive manner. Observation confirmed that Residents are able to receive visitors in private and use the telephone in private. A tour of the building confirmed that all rooms at Orchard Portman are used for single occupancy. Discussion with the Manager confirmed that relationships and communication with Health care Professionals was excellent and that an arrangement with a local General Practitioner worked well at the home. Thank You cards and letters seen on the day of inspection read: ‘Thank you for looking after me so well I really enjoyed my stay’, Thank you for caring for my relative so well during his last 6 weeks of life, the loving care he received was a comfort.’, ‘Thank you for your friendly cheerful manner,’ and ‘Words can not thank you enough for your kindness and care.’ Comment cards read:’ We are certainly cared for in every way, I wish to say a big thank you to everyone for making our lives much better and happier.’ And ‘Obviously in such a home they are often under pressure, but there has never been a problem with the quality of care.’ Frail residents who were being cared for in bed appeared well cared for. Care plans confirmed that the staff ensure pain levels are under control and the General Practitioner and family are informed of changes in condition. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 13 The Medication system is managed by the Registered Nurses, and medications only dispensed by the registered nurses within the home. The systems of receiving medication into the home are sufficient. Discussion with the manager revealed that despite the new policy regarding the disposal of medications, staff continue to record and obtain witness signatures that medication has been disposed. Minor shortfalls were noted on this inspection. There was no up to date medication reference book. This was amended prior to the end of the inspection. Sharps bins within the home were also seen to be unlabelled and not closed correctly. The fridge temperature were monitored and records showed an adequate fluctuation of temperature. A spot check of controlled drugs was satisfactory. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 14 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 standard(s) 12,13,14 and 15. Social activities are creative, well managed and varied. Links with the community and families and friends is supported well at the home. Residents enjoy the food provided and have choice and control over their lives whilst living at the home. EVIDENCE: Visitors are welcomed at the home at any time and residents are able to go out with families and friends. Residents stated that they enjoy visits from family and friends, and enjoy the ‘special’ events put on at the home and especially like the organised bus trips. One resident said they had enjoyed the bus trip to Weston Super Mare. Observation confirmed that activities within the home are well organised and varied. Residents were observed enjoying an arts and crafts session. Discussion with residents confirmed that activities include include: Bus trips, 1:1’s, musicians, quizzes, bingo, exercises and sing songs. During the inspection residents were also seen to be enjoying visits from relatives, reading, watching TV and listening to music. The ‘home’ now own and care for a Guinea pig which residents have enjoyed over the summer months.
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 15 The garden has improved with the introduction of a Gazebo which means that residents can enjoy sitting out in the garden whilst being protected from direct sunlight. The Home have a disabled mini bus which is owned by home. This bus is used for trips which residents said were ‘marvellous’. A tour of the building confirmed that residents are able to bring in personal possessions with them when moving into the home. Residents spoken to like this. One resident said it made it ‘feel more like home’. Residents said they are offered three full meals a day and snacks are available at all other times. Residents said a new scheme has been introduced where they are asked what food they want for the next day. All Residents spoken to said that the food was ‘always good’ and that there was ‘plenty’. On the day of inspection some residents were seen to enjoy ‘seconds of the choice of three homemade puddings. These included fresh fruit salad, coffee gateau and strawberry shortbread. Residents who were being assisted with their meals were done so in a discreet unhurried, sensitive manner. Records were kept of what was offered and taken by the more frail residents. Nutritional assessments were seen in care plans. Discussion with the chef confirmed that all vegetables are fresh and fresh fruit is available. Birthday’s are marked with a ‘home made birthday cake and gift. The dining areas were both attractively presented, which provides an attractive setting and helps meal times become a social event. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 16 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 standard(s) 16,17 and 18 Mamsey House complaints procedure allows Residents and Relatives to be confident that their concerns are listened to, taken seriously or acted upon. The lack of staff knowledge of how to report adult protection allegations has the potential to place residents and staff at risk. EVIDENCE: A complaints procedure is displayed within the Service User Guide and entrance hall. This includes contact details and timescales. A complaints register is kept within the office areas and details action taken and follow up information. The Commission for Social Care Inspection has received no formal complaints regarding this service in the last year. The home have received one formal complaint. This was dealt with promptly and efficiently. All residents spoken to said they had never needed to complain but would feel able to go to the manager. One Resident said ‘I have never needed to complain.’ All three resident questionnaires stated they knew who to complain to, and all four relative questionnaires stated that they knew of the homes complaint procedure and have never had to complain. Discussion with the Manager confirmed that residents are able to vote and at the last inspection the mini bus was used to take residents to three different poling stations. The manager also stated that she was organising an age concern advocate for residents within the home who have no family contact. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 17 Observation confirmed that the home have access to a set of policies which include prevention of abuse and whistle blowing. The home also have a copy of Somerset county council vulnerable adult policy. Not all staff who were spoken to knew how to report abuse if it came from a senior member of staff. All staff said they knew they would report it but were not sure who to. This lack of knowledge has the potential to place residents at risk or affect any investigation. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 18 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 standard(s) 19,20,21,22,23,24, 25 and 26. Mamsey House provides a safe comfortable home in which Residents are able to stay as independent as possible. The home has a good standard of décor, furnishings and fittings which provide a comfortable pleasing environment for residents to live in. EVIDENCE: Mamsey House Nursing Home is accessible, safe and well maintained. A programme of routine maintenance was being performed by the maintenance man. The Gardens were attractive and well maintained. Environmental Health Office reports were seen on this inspection. The home was clean and tidy and free from offensive odours on the day of inspection. The home has two comfortable dining rooms, one lounge downstairs with level access onto a patio area, and a small quiet upstairs lounge. Some residents chose to stay in their rooms or within the entrance hall so they could watch the ‘comings and goings’ All furnishings are domestic in style and of good quality. The communal rooms are well lit.
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 19 There is a spacious lobby / entrance hallway which is furnished to provide a pleasant and comfortable seating area for visitors and service users. There are sufficient bathrooms and toilet facilities, which allow wheelchair access. The home has wide corridors and toilets. The baths are assisted. There are portable hoists for those requiring assistance, with each resident having their own sling. The home has a nurse call system throughout the building. All rooms inspected had adjustable beds. Bedrooms were seen to be clean and well presented, comfortably furnished and to have been personalised by service users. The home has central heating and radiators are covered to prevent the risk from burning on hot surfaces. The home was warm and comfortable at the time of the inspection. Windows provide adequate ventilation and are restricted in opening above ground floor level. Hot water temperatures are checked on a weekly basis and are recorded. Records were inspected on this occasion. Emergency lighting is installed throughout the home and is checked monthly. The premises were clean and free from unpleasant odours. The homes staff manage the control of infection to a high standard. There are hand-washing facilities throughout the home. Gloves and aprons are available for staff to use and there are safe systems for the disposal of waste for example foot operated flip top bins are used and the home has waste collection contracts. There are sluice facilities. The laundry systems are well managed. No concerns were raised with the inspector about the management of clothing or the laundry process. The Manager stated that a new mesh bag system was being used to help prevent the loss of small items which include tights and socks. Residents said the home was always very clean and their clothes were washed well and the ‘odd item that gets lost is usually found quickly’. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The improved recruitment procedure ensure staff have the correct employment checks prior to working. The efficient programme of induction, appraisal, and supervision of the stable staff group ensure all staff are supported and competent to do their work. EVIDENCE: Off Duty records confirm that there is a stable staff group with a skill mix that ensure Residents needs are met and that the home is well maintained and a safe and comfortable place to live. Staff and Residents spoken to stated that there had been an average sickness and absence of staff. Observation of staff suggestions confirmed that the Provider has offered an incentive scheme in the past for those staff with minimal sickness rates. All residents said staff were very kind and caring. All comments about staff, received on the day of inspection, were positive. All staff on the day of inspection were very friendly, approachable and helpful. Residents stated the staff were always like this. Discussion with the manager confirmed training is accessed through courses, in house training and from health care professionals. Care Staff have access to NVQ training and the home have 50 of their staff at NVQ2 level or above. The homes diary and staff files confirmed that the home perform staff supervision and appraisals. Staff spoken to said they feel well supported.
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 21 Discussion with the Manager and once Care assistant confirmed that new staff have a formal induction which is adapted to meet the learning needs of the individual. Staff spoken to said the ‘shadowing’ of new staff goes on for as long as is necessary for the staff to know how to give the right level of care. Five Staff files were inspected on this occasion. New staff files contained all information required following a requirement set at the last inspection. Two trained staff files did not contain an up to date copy of Nursing Midwifery Council Pin number. Discussion with the administrator and Manager confirmed that the renewals had been done but that a record was not on file. Assurances were given that this shortfall will be amended by the next inspection. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 22 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37 and 38. The Manager has a good understanding of the importance of developing a good relationship with Residents, relatives, which results in a good standard of care and high staff morale. The Manager is supported well by the Provider and staff within the home, with all staff demonstrating an awareness of their roles and responsibilities. The home is well managed and provides a safe environment for residents to live in. EVIDENCE: Mamsey House Nursing Home is owned by Clinicare Ltd. The organisation has clear lines of accountability and is directed by a retired local General Practitioner. The clinical management for the home is provided by the Manager, who is an experienced Registered General Nurse. The Manager keeps updated though study days, peer discussion and keeping up to date with changes in health care practices. The Manager is currently studying towards a Registered Managers Award.
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 23 The Provider visits the home and ensures the business is run smoothly. Maintenance records were available but not closely inspected on this occasion. During the inspection staff were directly and indirectly seen and heard speaking with the Manager, seeking advice where necessary. There appeared to be a genuine caring relationship shared between Residents, staff and the Manager within the home. Residents said it was always like this and that they were very fond of the staff. One Relatives comment card stated ‘ In six and a half years, the courtesy and friendliness of staff has been unfailing.’ One residents comment card stated ‘If I need to be in a nursing home this is probably as near to home as I am likely to find.’ Staff, residents and residents were all very complimentary about the Manager and her leadership. Staff said that she was approachable, supportive and firm but fair. Observation confirmed that communication is effective within the home and relatives were seen to come and speak with the Matron and nursing staff when ever they wanted. There appeared to be a very relaxed atmosphere during the inspection. Discussion with the Manager confirmed that quality assurance is provided by informally answering any questions and addressing problems as they arise, using suggestion boxes, resident and staff meeting and performing audits and questionnaires. Records of all these methods were seen at this inspection. The home employ a company clerk who provided evidence of financial viability and certificates of insurance. The clerk also processes invoices and Residents personal monies. The clerk stated that small amounts of cash are given by families and kept in an account. Receipts and records are kept which itemise each transaction for each resident. Discussion was held about when Residents do not have enough for an occasion and how this is managed. The clerk stated that this was unusual but would be taken from the account and families invoiced for the shortfall. The inspector raised a question whether other residents were aware of this practice and what happens to any interest accrued in the account. The Clerk and Manager gave assurances that this would be addressed. The Clerk stated that the Provider, Clerk or Manager do not act as appointee for any resident. The ‘Home Diary’ and staff files confirmed staff have appraisals and staff supervision sessions and are well supervised by the Manager. All records within the home were is good order, secure and up to date. Staff said they had received mandatory training in fire safety, moving and handling, infection control and some had received first aid training. One Carer
Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 24 proudly explained that the care staff are responsible for manual handling training and that this works well as mistakes can be corrected or training given on a daily basis as well as the formal sessions. First aid boxes and accident books were seen within the home but not inspected. A tour of the building confirmed that the staff within the home maintain a safe environment for the Residents despite a shortage of storage space. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 25 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 3 3 3 2 3 3 3 Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 26 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. 2. Standard OP9 OP35 Regulation 13(2) 13(6) Timescale for action The Manager must ensure sharps 01/11/05 boxes are closed and labelled correctly. 01/12/05 The Manager must ensure 1. A system is introduced to ensure money is not borrowed/taken from Residents to fund shortfalls of other residents and 2. Any interest earned is appropriately distributed evenly and fairly with the agreement of all residents/Representatives. OR 3. Each resident has a separate account for personal monies. Requirement 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 OP3 Good Practice Recommendations The Manager should ensure the assessment tool used includes the headings: Weight Gain/Loss Oral Health Foot Care History of Falls
D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 27 Mamsey House Nursing Home 2. 3. OP18 OP29 and Family relationships. The Manager should ensure all staff know how to and who to report allegations of abuse to including who to contact if the abuse is from a senior member of staff. The Manager should ensure a system is introduced to ensure Nursing and Midwifery PIN updates are kept on file. Mamsey House Nursing Home D53-D02 S3270 Mamsey House V243103 041005 Stage 4.doc Version 1.40 Page 28 Commission for Social Care Inspection 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
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