CARE HOMES FOR OLDER PEOPLE
Maple Leaf House Kirk Close Ripley Derbyshrie DE5 3RY Lead Inspector
Brian Marks Unannounced Inspection 17th January 2006 1:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Maple Leaf House Address Kirk Close Ripley Derbyshrie DE5 3RY 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) 01773 513561 01773 513501 Not given Methodist Homes for the Aged Michelle Whitmill Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 20th October 2005 Brief Description of the Service: Maple Leaf House is a 45-bedded care home with nursing for older people with dementia, operated by Methodist Homes, and which opened in August 2003. The home is situated on the outskirts of Ripley and is one storey and purpose built, with all facilities having level access. The home is divided into three wings, each accommodating fifteen people, with their own lounge, kitchenette and dining area. Décor, furnishings and fittings are of a high standard and all bedrooms are single and have en-suite facilities. There is an enclosed garden with outdoor seating. Support services are in place with a choice of GP, optician and dentist, and community psychiatric nurses, occupational therapists, physiotherapists and dietician are involved as required. Staff training has been prioritised to take place to inform and enable staff to care for service users appropriately. The home has two activities coordinator posts, who have responsibility for ensuring that a good range of entertainment and in-house activities are arranged. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place at the home over an afternoon. Additionally, time was spent in preparation for the visit, looking at previous reports and other documents. At the home, apart from examining the home’s documents, care files and records, time was spent looking around the building and speaking to visitors in one of the units. Because of the nature of their medical condition, the majority of the residents are not able to give a clear opinion of their life at the home. Staff of the same unit were also spoken to, and they were observed throughout the visit, looking after and dealing with residents and visitors. The manager was present throughout the inspection visit. The aim of inspection activity during the current inspection year is to assess a service against the ‘key’ National Minimum Standards and these are identified at the beginning of each section of the report. The majority of these keys standards were examined at the last 2 inspections so, for a more complete picture of this service, this report should be read in conjunction with the reports dated 22 June 2005 and 20 October 2005. What the service does well:
This home was built to a high specification and provides a quality environment for staff and residents. It is spacious, light and airy yet, as it is split into 3 units, the residents live in smaller living environments that are more homely in scale. All bedrooms are large and single and have en-suite facilities, and give levels of comfort and equipment for those people who have specialist nursing needs. There is a variety of communal space; this includes pleasantly arranged garden areas that are enjoyed by residents during the summer months. Staffing levels at the home have been set well above the minimum standard for this type of home and although the staff group is large, successful recruitment has produced a team with a variety of skills, knowledge and experience. Standards of induction of new staff to the home are good; staff are able to quickly get to know the individual needs of the people who live at the home and what is expected of them. The work of the staff group is guided by good quality documentation, particularly the personal care plans, and these cover a wide range of needs and activities that ensure they properly understand the individuals who live at the home. They are written in a clear style that helps staff work consistently and safely, and communication within the home between different staff groups Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 6 and those on different shifts makes sure that everybody is aware of the important things that need to be done. ‘It’s the best place he’s been in’ ‘The home is always clean and she is always nicely dressed’ ‘If I make an approach to staff they always do something about it’ What has improved since the last inspection? 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. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not specifically looked at this inspection, other than to note that all care files examined contained an assessment of each individual resident’s abilities and needs, which had been carried out before they were admitted to the home. For the full assessment of the key standards see the inspection reports dated 22 June 2005 and 20 October 2005. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 The administration of medicines at the home is safely organised. EVIDENCE: The home operates the Monitored Dosage System for medicines management on behalf of the people living there and the examination of records and storage areas indicated everything to be satisfactory and procedures to be followed ensured safety and consistency. For example, the record sheet of each person contains their photograph to make sure that administration of the medicines is to the right person. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not specifically looked at this inspection, other than as part of general discussion with the residents’ visitors spoken to. For the full assessment of the key standards see the inspection reports dated 22 June 2005 and 20 October 2005. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not specifically looked at this inspection, other than to note that all staff had undertaken basic training in respect of issues related to adult protection as part of their induction to the home. For the full assessment of the key standards see the inspection reports dated 22 June 2005 and 20 October 2005. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not specifically looked at this inspection, other than to note that from visiting wing 3 of the home, including the communal areas and 2 bedrooms, the high standards of the home’s environment had been maintained. For the full assessment of the key standards see the inspection reports dated 22 June 2005 and 20 October 2005. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 The home is well staffed with people who bring a good cross-section of experiences and skills. They join the home after the proper checks are made which make sure that only people who are right for the job look after the people living there. EVIDENCE: The staffing rota indicated that numbers of care staff on duty during the day are higher that the minimum required by law, and the staff spoken to confirmed this to be the case. Recruitment has continued to be successful at the home and records in the manager’s office indicated that staff vacancies at the home to be minimal. The manager reported that in fact she had ‘overrecruited’ and there were more staff in post than had been allowed for, which gives increased flexibility in providing care. A new post of deputy manager has been created and filled; this will offer additional support to the manager and assistant managers and help them do their jobs more professionally. Examination of the files of the 2 newest staff indicated that recruitment and selection had been carried out properly and all checks required to ensure protection of the residents had been made. A copy of the staff contract was noted on each file; this contained details of the terms and conditions of their employment so that they have full knowledge of their rights and responsibilities as employees of the home. Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38 The home’s manager has continued to make a positive impact on the home and this includes staff training in all areas of safety of the home. EVIDENCE: The manager is currently completing a Registered Manager’s course, which meets the standard of achievement of NVQ level 4 and has continued to update herself with training to meet the requirements of being a registered nurse. She reported that she continues to be well supported by her line manager from Methodist Homes, who visits the home regularly. Comments from visitors spoken to were positive about the impact she has had on the operation of the home and relationships within it, since she took up the appointment last year. From the examination of records all staff have now had instruction in their responsibilities for fire safety. This carried out by the maintenance person with individual staff and small groups throughout the year.
Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 3 Maple Leaf House DS0000042716.V275264.R01.S.doc Version 5.1 Page 16 Are there any outstanding requirements from the last inspection? Yes 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 OP29 OP31 Regulation 19(1) Schedule 2 9(2), 10(3) Requirement All staff files must contain proof of identity including a recent photograph. The manager should achieve a qualification at NVQ level 4 (or equivalent) in management. Completion of the Registered Manager’s course will meet this recommendation. Timescale for action 31/03/06 30/09/06 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. Refer to Standard OP7 OP17 OP18 Good Practice Recommendations All care records should include a photograph of the resident. The registered person should make arrangements for service users to vote where appropriate. All staff should undertake regular update training in adult protection.
DS0000042716.V275264.R01.S.doc Version 5.1 Page 17 Maple Leaf House Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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