CARE HOMES FOR OLDER PEOPLE
Mapleton Residential Home Ashburton Road Newton Abbot Devon TQ12 1RB Lead Inspector
Judy Cooper Unannounced Inspection 1st November 2005 14:00 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 Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Mapleton Residential Home Address Ashburton Road Newton Abbot Devon TQ12 1RB 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) 01626 353261 01626 202713 Devon County Council Mrs Margaret Jean Breslan Care Home 26 Category(ies) of Dementia (26), Old age, not falling within any registration, with number other category (26), Physical disability over 65 of places years of age (26) Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16/06/05 Brief Description of the Service: Mapleton is a large detached building on a busy road (set back a little), less than a mile from Newton Abbot town centre. The home is on a bus route and there is a general store adjacent. The home has recently almost completed a major refurbishment programme, involving the ground floor of the home, which has resulted in the increased size of several of the ground floor bedrooms, and general upgrading of others on this floor. The entire ground floor is now being used to accommodate up to twelve residents in single rooms (although none are en-suite, there are adequate communal W.C.’s within close proximity of each room). Two of the bathrooms on this floor have assisted bathing facilities, including an assisted shower area. There are also two disabled toilets and a further toilet and shower unit. There is currently one lounge area with French doors out to the front garden and a separate dining room which is to benefit by having an extension tp provide required additional communal space; this will then lead into the rear garden of the home. There is also a seperate kitchen for this unit. The home’s office, laundry and sluice areas are sited on this floor and are also currently being upgraded. A small smoking area has been provided. Permanent residents, who are using this floor, have direct access to the home’s level garden, which again has been upgraded. The first floor is due to commence an upgrading programme within the next week, which will take approximately six months to complete. On completion this accomodation will provide facilities for up to twelve service users in need of either intermediate care (six) and/or a short stay/carer break (six). This facility will operate independently from the permanent residentila unit. A shaft lift ensures there is level access throughout the home. A small day care centre is also to be created within the home’s current exisiting large communal dining/lounge area. This will be completely separate from the home’s residential facilities and will no longer be used by the residents,unless they choose to visit, as residents will have had the required communal space provided on each floor solely for their own use. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on a Tuesday afternoon. Opportunity was taken to tour the premises, and discuss the imminent planned upgrading of the first floor (see the previous description of the home), examine some records, talk with the manager, residents, as well as being able to observe and talk with the staff on duty, whilst they were in the course of undertaking their daily duties. The majority of the required standards were inspected at the last inspection in June 2005, when they were either met or exceeded. Those inspected on this occasion concentrated on resident welfare on a day to day basis. What the service does well: What has improved since the last inspection?
The upgrading of the home on the ground floor is now almost complete. The opening of this twelve bedded permanent unit took place in August 2004 and is known as the “Maple Unit” comprising of twelve single rooms all upgraded to a high standard. The staff continue to receive a significant amount of training, including specialist training in such areas as dementia care, to ensure that they are, and will be, fully able to continue to meet the existing and new residents’ needs.
Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 6 The management of the home had already enlarged the quality auditing within the home to take into account the views of all people who may have some interest in how the home operates. It was pleasing to note that this has continued, allowing the management and staff to have an understanding of how the service they provide is viewed and, whether they have been successful in meeting the needs of the service users. Recent internal management restructuring resulted in the creation of the “night care officers” role within the home. This allowed night staff to be promoted and they have taken on responsibility for some management tasks within the home. The result of this has been positive, allowing the day management team extra time during the day to spend monitoring the service, completely ensuring that residents’ needs are fully met. 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. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 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 Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 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): Not inspected on this occasion. EVIDENCE: Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 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): 7,8,10 Residents are looked after well in respect of their health and personal care needs. Residents are treated with dignity and respect and their individuality and independence maintained. EVIDENCE: During this inspection a care plan for a short stay resident was seen. It contained all the necessary information to show the resident’s needs were known, and how best they were to be met. No permanent residents have been admitted since the last inspection and the management only accept up two respite placements at any one time, taking resident occupancy to a maximum of twelve. This will continue until the home’s upgrade has been completed. It was noted that support services continue to visit the home as required. Residents spoken with confirmed that they felt their needs were being met and that they were very happy at the home. Residents also confirmed that they were always treated with respect and dignity and that the manager and staff
Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 10 were helpful and kind. Residents felt confident that both would help them with any area of their life that they needed assistance with. A District Nurse had written the following “ I wanted to comment officially about the excellent care being given to -------------. please pass on our thanks and acknowledgement of this excellent care”. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 11 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): 12,13,14 Residents continue to enjoy a peaceful, pleasant yet varied life at the home, with visitors very much encouraged and links maintained with the local community. Various, individual, informal activities such as gentle exercise, etc are made available at times to suit the residents. EVIDENCE: The routines within the home remain flexible to ensure that residents can choose how they spend their time. The staff provides activities as requested by the residents, taking into account each individual resident’s ability and preference. It was a noted from the visitor’s book that visitors came and went at various times. A comment from a visitor stated, “ We are impressed with the staff and the home. The staff are clean, efficient and understanding. The home is clean and has an air of efficiency and homeliness. A well run establishment”. Residents stated that they continue to enjoy the meals provided. The manager provides the opportunity for short stay residents to give written feedback after a stay at the home. Reading some of this feedback evidenced
Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 12 that residents had enjoyed and benefited from their stays, with one stating that they had found Mapleton “extremely well run and a pleasing place to visit”. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 13 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): Not inspected on this occasion. EVIDENCE: Although these standards were not inspected, it should be noted that neither the home, nor the Commission, have received any complaints within the past twelve months. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 14 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): 19,26 Mapleton provides very comfortable, clean and well maintained accommodation in respect of the areas being used by the residents. Some areas of the home are still in the process of being upgraded and as such this accommodation is not available to the current residents and has not yet fully met the required environmental standards EVIDENCE: Inspection of the home, showed the home continues to be in the process of undertaking upgrading works to ensure that it will be to be suited for its intended purpose of providing twelve permanent beds and twelve intermediate care beds. The ground floor (named The Maple Unit) is now almost completed and provides permanent accommodation of a good quality. It continues to be to the manager’s and staffs’ credit that these works have been/are being well managed, ensuring residents’ health and safety continues to be maintained appropriately, with as least disruption as possible for the ten permanent residents (as well as the two short stay residents), that are currently living in
Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 15 the home. The areas being used by the residents were seen to be clean, safe and very comfortable. Some bedrooms have been enlarged and all on the ground floor have been completely refurbished. All rooms were seen to have been personalised as desired and residents had several personal items in their rooms. Residents had been involved in choosing colour schemes etc and all were very complimentary about their rooms, and proud to show them off! Residents’ bedrooms are provided with a suitable lock to ensure privacy is maintained. Health and safety assessments have been undertaken and the manager stated that these continue to be updated to reflect any changes, caused by the building works. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 16 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): 27,28 Staff at the home are well trained and supported, and employed in sufficient numbers to ensure that residents are in safe hands at all times. EVIDENCE: Staffing levels were noted as being fully able to allow staff to meet residents’ needs both during the day the day and at night. Since the last inspection, a new, full time member of staff has been appointed to allow the manager to have in place, the necessary numbers of staff when the next phase of twelve beds are made available in May 2006. Residents said that they felt well looked after and that staff were always available if needed. The staff group remains very stable with no staff changes since the last inspection, other than the additional staff member being appointed. Training continues to be very well planned and supports the staff in providing for the varied needs of the residents, with and NVQ training and other external, as well as internal, training provided. On the evening of the inspection, an internal training programme was taking place on the difficult but necessary subject of death, dying and bereavement, which a significant number of staff were due to attend. On completion of the inspection, one of the assistant managers returned from a training day in relation to the first organised annual NVQ assessor’s workshop, which she said she had found very useful. She had been encouraged and enabled to attend whilst the home’s staff had agreed to, and
Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 17 had participated in, a learning video, which was also used during this workshop. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 18 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): 31,38 The home is managed efficiently and well. The home is providing a safe environment for the residents, by ensuring the required health and safety standards are met and maintained. EVIDENCE: The manager has been in post for approximately two years. She has many years experience of working with this resident group and has successfully completed her Registered Manager’s Award incorporating NVQ level 4 in care and management. The staff and residents continue to speak highly of the managers’ ability to manage the home and all said that they felt they could easily approach her. Comments such “very approachable and good” were commonly used about the manager. Routine health and safety issues continue to well managed within the home, which ensures that residents are cared for in a safe and secure environment.
Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 19 Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x x x x x x 3 Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard 19 19 Good Practice Recommendations The registered Provider should ensure that sufficient communal space is provided for the permanent residents sited on the ground floor. The upgrading of the first floor should comply with the required physical standards of the National Minimum Standards. Mapleton Residential Home DS0000032567.V251474.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Ashburton Office 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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