Inspection on 16/08/06 for Mapleton Community Care Centre

This inspection was carried out on 16th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mapleton Community Care Centre 01/11/05

Mapleton Community Care Centre 16/06/05

Mapleton Community Care Centre 04/11/04

Mapleton Community Care Centre 30/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Mapleton Residential Home Ashburton Road Newton Abbot Devon TQ12 1RB Lead Inspector Judy Cooper Unannounced Inspection 10.00 16 August 2006 th 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.V305486.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 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.V305486.R01.S.doc Version 5.2 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 http/www.devon.gov.uk/adoption.htm 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.V305486.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Females may be admitted over the age of 60 years within the Dementia, Old Age, not falling into any other category, and the Physical Disability Categories 1st November 2005 Date of last inspection Brief Description of the Service: Mapleton is owned by the Local Authority (Devon County Council), However a consultation process is currently being undertaken, in line with the Devon County Council Modernisation programme, which will ultimately decide the future of several residential establishments owned and run by the Council with Mapleton having being identified as one of these establishments. 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 completed a major refurbishment programme, which has resulted in the increased size of several of the home’s bedrooms, and general upgrading of others. The entire ground floor (now known as the Maple Unit) is being used to accommodate up to twelve residents in single rooms (although none are ensuite, there are adequate communal toilets 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 disabled toilets and a further large toilet and shower unit. Additionally on the ground floor, there is one lounge area with French doors out to the front garden and a separate dining room, which will benefit, in time, by having an extension to provide required additional communal space (there has, however, been some delay in fully completing this work). This will then lead into the rear garden of the home. There is also a kitchen for this ground floor unit. The home’s office, laundry and sluice areas are also sited on this floor. A small smoking area has been provided within a rear porch way. Permanent and respite residents, who are using this floor, have direct access to the home’s level garden. Upgrading to the first floor of the home (named the Bluebell Suite) is also now complete and provides twelve residential bedrooms, lounge and dining areas as well as a variety of baths and toilets including an assisted bath, a walk in shower facility and several disabled toilets. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 5 There is also an office, kitchen and medication room sited on this floor. A sluicing area and a macerator is finally to be installed on this area in the near future, before the unit becomes operational. When the unit is in use it is intended that this facility will operate completely independently from the permanent residential unit sited ion the ground floor. A final decision in respect of which client group(s) will be offered care on the first floor has not yet been finally agreed upon, although it is intended that the care provided will be for the older mentally frail resident, offering a variety of respite and intermediate care facilities. Until this is formally confirmed the rooms remain unoccupied. A newly installed shaft lift ensures there is level access between the two floors. It is further envisaged that a small day care centre is to be created within the home’s current existing large communal dining/lounge area. This will operate completely separately from the home’s residential facilities and will no longer be used by the residents, unless they choose to visit, as residents have been provided with the required communal space on each floor solely for their own use (with the exception of extending the newly created dining area on the ground floor, which, it is understood, should be completed within the next twelve months). As a final decision regarding the operating arrangements for the home has not yet been agreed upon, the existing large dining area consequently remains in use for the permanent residents currently at the home. The current resident fee charged is £556.57 per week. The name of the building has now changed, following the upgrading programme, from “Mapleton Residential Home” to “Mapleton Community Care Centre”. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place on Wednesday 16th August between 10.00a.m and 4.30 p.m. Opportunity was taken to observe the general overall care given to current residents. The care provided for two respite stay residents was also followed in specific detail, from the time they were admitted to the home, which involved checking that all elements of their identified care needs were being met appropriately. A tour the premises, examination of the home’s records and policies, discussions with the senior carer in charge of the home at the commencement of the inspection, followed by the two assistant managers (who came on duty later), residents, staff on duty, as well as two visitors to the home, all informed this inspection. Staff on duty was also observed, in the course of undertaking their daily duties. Other information about the home, including the receipt of several questionnaires from residents, staff members, and a residents’ relatives/advocate has also provided further feedback as to how the home performs, and this collated information has been used in the writing of this report. What the service does well: The home continues to provide the current nine permanent residents and various respite residents with a very well maintained, homely, bright, relaxed, comfortable, environment. Residents continue to benefit from a “community spirit” within the home and are encouraged and enabled to socialise with each other as desired. The management and staff continue to enable residents to maintain good links with the nearby local community and visitors are encouraged and welcomed into the home. The result of which is that residents benefit from companionship with each other and continue to feel a valued part of the local community. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 7 The very stable staff group remain well trained and continue to work well together as a team, which ensures that residents’ needs continue to be known and well met, whilst residents have a sense of continuity and security due to staff remaining in post for long periods of time. Staff morale remains particularly high, and staff remain very enthusiastic about the possible planned changes for the home (described previously). Consequently the atmosphere within the home is a very positive one which both residents and staff benefit from. Further in depth, additional staff training has been provided and has ensured that staff are both competent and confident in their exiting roles as well as being prepared for the possibility of providing care for a new category of clients (i.e. those with a mental frailty or dementia) if this is to be the additional category of client the home will offer care to. One of the homes real strengths is the management of the home. The registered manager has been employed for approximately three years as the manager of Mapleton Community Centre, having worked previously in a senior care capacity within the service. She has an excellent knowledge, and understanding, of both the residents’ needs and of the staffs’ abilities to meet them and what training needs may be required to ensure the quality of care provided is of the best possible. All spoken with during this inspection, including residents, staff, and relatives praised her leadership skills as well as her knowledge of residents’ needs and all felt supported by her. She, herself, is supported in her role by an experienced and efficient assistant management team as well as an experienced senior care staff team. Although a degree of uncertainty remains regarding the long term plans the Local Authority has for Mapleton, the management and staff should be commended for ensuring that standards of care and staff morale remain extremely high. What has improved since the last inspection? The second floor of the home has been completely upgraded to provide accommodation of an excellent standard (see previous description of service). Since the last inspection the management of the home have improved and streamlined their recording and filing systems within the home. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 8 This aids all who need to access the information and, ultimately, helps ensure that all staff are aware of how best to provide care for the residents by allowing them to now have an easy and quick accessibility to all records. It also helps the management of the home maintain a good quality audit system, which ensures the home runs in the best interests of the residents at all times. Additional, relevant training continues to be made available which ensures residents are cared for by a very knowledgeable and aware staff group and also training has been provided which has allowed the staff to be prepared for any change/addition to the home’s existing categories of residents to be cared for in the future. What they could do better: Three recommendations were made following this inspection. These were made in relation to: Ensuring any medication refused by a resident is recorded as such. Residents’ care plans also contain full records regarding any change to a resident’s medication as requested by a G.P. Consideration should be given to providing some further degree of safety to the approach to the first floor from the main downstairs hallway. This is because it is intended to provide accommodation for clients with mental health frailties on the first floor and this entrance/exit from the first floor unit is currently very open and would prove hard to supervise on a continual basis. An existing recommendation remains in relation to: Ensuring sufficient communal space is provided for the permanent residents sited on the ground floor, if the current large existing dining room/lounge area changes use to become a day care centre. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 9 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.V305486.R01.S.doc Version 5.2 Page 10 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.V305486.R01.S.doc Version 5.2 Page 11 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): 3 The quality in this outcome area is good. The admission process continues to be well managed with any respite residents’ needs well known prior to admission, to ensure that the client can be certain that their needs will be met whilst at the home. EVIDENCE: As in line with agreements previously drawn up, the home has not admitted any permanent residents for over twelve months but does continue to offer several respite care places (however only utilising the ground floor). At the inspection the details for two most recently admitted respite clients was inspected in detail and it was concluded that a full and detailed admission procedure had been undertaken in each case. No admission is made until a full assessment of need is received from the placing care manager. This in turn is read thoroughly by the home’s management who are fully aware of what care the home can confidently offer. This process ensures the needs of any intended respite care resident will be fully met whilst at Mapleton. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 12 Both of the two clients were able to confirm themselves that they had been made very welcome at the home and that their needs were being met. Also, during the inspection, a visiting relative of one of the respite residents was able to further confirm that the care the respite resident had received was: “excellent in every way”. The manager will not be admitting any new permanent residents until the overall future of the home is decided. However it is hoped that the final outcome will be that the home will be able to offer the twelve newly upgraded beds on the first floor to provide care for older people with mental health needs and to this end staff have undertaken indepth training to prepare them to be able to provide the specialised care required for this category of resident. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 13 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): 7,8,9,10 The quality in this outcome area is normally excellent, but can only be scored as adequate on this occasion. All residents are normally looked after well in respect of their health and personal care needs. However, an omission within a resident’s care plan, and another omission on the same resident’s medication record could have placed the resident at risk. Residents’ privacy and dignity is always upheld and their life style choices respected and all efforts made to facilitate them. EVIDENCE: Care plans were seen in respect of the two respite clients whose care was inspected in detail. These were noted as being thorough and covered all required care needs as well as social and psychological needs. Both clients had been involved in the drawing up of their care plan and the relatives spoken to were aware of the care that each resident was receiving. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 14 Staff were also seen to be aware of what care was needed and were seen to be providing the agreed appropriate care to both residents. One relative used such words as “brilliant, lovely place” to describe how she viewed the care given to the relative she was visiting. She felt that the staff gave her relative support and gave the example of how they tried to encourage the client to walk as much as possible with support. The daughter, herself, feels supported and now enabled to receive some necessary medical attention, which was impossible whilst caring full time for the client. She had been “very impressed with everything”, and “would love her relative to be able to have further stays if possible at Mapleton”. The second relative stated that the resident she was visiting had been in the home for over four years. She stated that the care the resident received was “fantastic”. The home had recently put on a party for her Mother’s birthday and it had “been wonderful”. The relative stated that the staff always maintained the residents dignity and gave the example of how the staff always ensure that her Mother’s clothes were always sorted out properly and that those put out for her all matched colour wise, even down to the shoes”! The relative could not think of anything at all that could be improved upon. It was, however, noted that one resident’s care plan had not yet been updated with some information received the previous day from a G.P in relation to a recommencement of a necessary medication. Also the same resident’s medication administration record sheet did not show that the resident had subsequently chosen to refuse the prescribed medication. The consequence of this was that other staff were not fully aware of what, or when, the G. P had prescribed the medication, nor of the fact that the resident had then subsequently refused the medication, the result of which may have had serious implications. This was evidenced in discussions with staff whilst case tracking one of the residents involved in this inspection process. Following subsequent discussions with the registered a manager, following the inspection, the manager stated that a compulsory training day was now to be held, for all staff involved in the administration of medication at the home, within the next week. This is to ensure that the staff learn from this experience and that residents are again fully protected by staff ensuring that home’s medication procedures are fully followed. The other current nine permanent residents have been at the home for significant periods of time and their needs remain well known, documented and are reviewed regularly. Again very favourable comments were received from these residents, which included such comments as the home is: “Very comfortable”, kind”, Mapleton Residential Home “we couldn’t be better looked after”, “the staff are very DS0000032567.V305486.R01.S.doc Version 5.2 Page 15 The residents’ health care needs were being met, including any specialist needs. Clinical needs are well provided for and the home has a hoist and other lifting equipment including lifting belts and slide sheets, assisted baths, as well several disabled access toilets and walk-in showers. During the inspection it was noted that wheelchairs needed for transportation were used correctly with footplates and a lap strap in place to help minimise any risk associated with using a wheelchair. All residents’ individuality and dignity was noted as being firmly upheld by staff at all times during the inspection and all residents spoken to confirmed this always to be the case, as did the visiting relatives spoken with. An example of how the management ensure residents’ privacy and dignity can be noted by the provision of a laminated card that is handed out to all visitors to the home which, on one side, gives full details of the home’s fire procedure and on the other states: “We are pleased to invite you into our home, and would ask you to respect our residents privacy and rights”. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 16 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): 12,13,14,15 The quality in this outcome area is excellent. Residents continue to enjoy a peaceful, pleasant yet varied life at the home, with visitors encouraged and links encouraged and maintained with the local community. Various informal activities are made available with new activities also provided to help vary residents’ lives at the home. Excellent meals continue to be provided. 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. On the day of inspection residents who wished to were enjoying watching the film “The Sound of Music”. It was pleasing to note that a staff member was also present with the residents helping those that needed help with prompting to have a fuller understanding of the film and was also encouraging interaction between the residents generally. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 17 There are regular activities and trips out provided and the home has a variety of relevant and interesting craft/activity materials available for resident use. During the inspection it was noted that several residents have been making party hats and decorations for the planned annual garden party to be held later this month, which will incorporate a celebration of the completion of the upgrading of the home as well as forty years of operating as a residential home. A two monthly news letter is produced for residents and other interested parties and it was seen to contain relevant and interesting details about forthcoming events, past celebrations, residents’ birthdays and other details that a resident may like to know. Staff support is evident at the home with one staff comment being: “it is like being part of a large family”. Therefore it was no surprise to learn that many of the staff are undertaking a sponsored walk to race monies for the home. It was a noted from the visitor’s book that visitors came and went at various times and the two visitors spoken with were able to confirm that they were always able to visit whenever they chose and were always made welcome. Equality and diversity was noted as being maintained during the day to day care of the residents. Two example of this were: The management have provided a hearing aid loop in one of the lounges to aid those with hearing problems to be able to enjoy T.V viewing. A television area has been easily available, near the current dining room, for a resident who uses an electric wheelchair, but would find the journey down to the home’s new designated T.V room more difficult. Therefore by ensuring that a T.V is sited in an easily accessible area this allows the resident to remain completely independent in respect of being able to watch T.V. whenever the resident chooses. Residents stated that they were happy with the meals provided and that there was always choice made available. The day’s menu is always communally displayed and they are drawn up with resident involvement. The menus in the kitchen state the following at the end of each page: “All vegetables and fruit are delivered fresh daily and used in the above menu. Menus designed after discussions with our residents at their committee meetings, and their requests. Drinks and refreshments and ice-cream are served regularly throughout the day and at residents’ requests”. On the day of inspection the meal was freshly made cottage pie, two fresh vegetables, followed by strawberry blancmange and orange jelly. To end the meal, small pieces of fresh fruit are served to each resident to help encourage residents to eat fresh fruit. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 18 It was noted that a member of the management staff sat with the residents during lunch and a staff member also had their lunch with the residents. The assistant manager explained that the home’s staff felt it was important to engage with residents at all levels and eating with them, or being with them at mealtimes, helped spark conversations and lent encouragement to some to eat as they had different company and so different things to talk about. The assistant manager felt it had it had subsequently made mealtimes generally a more social event. It was also pleasing to note the relaxed manner in which residents were able to eat their meal. Any help needed by staff to aid feeding was done discreetly and gently and additional help to aid independence, such as adapted cutlery were provided as routine. It was evident that residents enjoyed mealtimes and this was confirmed by the very positive comments received from residents regarding the food provided at the home “excellent”, “good food”, “plenty of choice”. An example of how residents’ individual needs/choices, regarding meals are met can be seen in the following example: One resident was feeling unable to face either choice of meal, on the day of inspection, and spoke to the cook (who actually was a member of the care staff as the home’s cook had unexpectedly gone off sick). The member of staff discussed what the resident felt they could eat and their choice was then provided. The resident consequently enjoyed and ate all their lunch. A staff member’s comment that was received by the Commission stated the following: “I feel Mapleton is a lovely environment to work in for staff and a lovely home for all clients and cannot think of anything else that needs improving on at present. Mapleton is a very happy and caring home providing excellent care for all clients”. Indeed comments received from residents themselves and their relatives confirmed that the residents also felt this way about Mapleton. The home operates a key worker system and the visitor was also able to confirm that they, and the resident, were well acquainted with the resident’s key worker and that the resident did use this service for personal aspects of care and for the little things such as getting specific items of shopping etc. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 19 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): 16,18 The quality in this outcome area is good. Arrangements for protecting residents and responding to their concerns are satisfactory. Residents are confident in being able to voice and concern they may have and staff are fully aware of the procedures regarding adult protection. EVIDENCE: The home’s complaint policy remains displayed and is also contained within the home’s statement of purpose. Residents, spoken to, were quite clear as to how to complain and felt they could easily approach the manager or any staff member should they have any cause to. The staff have all attended vulnerable adults training and this is regularly reviewed and training updated as required. The Local Authority’s internal complaint procedure is also displayed in a prominent position. There have not been any complaints received regarding the service within the past twelve months. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 20 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 The quality in this outcome area is good. The upgrading programme has resulted in Mapleton being able to offer a very high standard of accommodation. The home is very comfortable, very clean, well maintained and provides a safe standard of accommodation for the residents. EVIDENCE: The tour of the home confirmed that the Local Authority/manager and staff within the home have both provided and maintain very good environmental standards within the home. Since the last inspection in November 2005, the first floor of the home has been upgraded to provide twelve well appointed and excellently presented bedrooms (none are en-suite but all are near a communal toilet and will be provided if with a commode if needed/requested). Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 21 Additionally there is sufficient lounge and dining space and several disabled toilets, two bathrooms (one housing an assisted bathing facility and another a normal bath) with a further providing a walk in shower room. There is an office for the staff for this floor, a separate kitchen and a medication room. It is also intended that a new sluice and macerator, to dispose of used clinical waste, is to be installed prior to this floor being used. A large computer terminus, which serves the Local Authority, is sited within the office area, on this floor, and although it is situated within a purpose built cupboard, the noise generated from this could clearly be heard both in the office and in the adjoining room, which is to serve as a residents’ lounge. Discussion took place regarding the possibility of providing more soundproofing to the cupboard before the floor is used to provide accommodation to residents. Discussion also took place in respect of providing some further degree of safety to the approach/exit to/from the first floor, which immediately accesses the main stairway, which leads into the hallway and out of the home. This is because it is intended to provide accommodation for clients with mental health frailties on the first floor and the entrance/exit from this unit is currently very open and would prove hard to supervise. A new, large passenger lift has also been installed at the home to provide easy access between floors. The home’s fire log book was inspected and found to be in order. The local fire and rescue service visited the home in January 2006 and all was noted as in order by the fire service at this time. The home presented as very clean and there was anti bacterial hand gel available in prominent areas as well as an individual supply of plastic gloves discreetly, but prominently, being available in each resident’s room. There were no unpleasant odours what so ever throughout the home and the cleanliness of the home should be commended. The laundering needs of the residents continue to be met appropriately with some discussion taking place as to utilising the now redundant meals on wheels office to provide a new laundry area for ironing etc. Appropriate and adequate washing facilities are also sited within the home. Staff also receive cross infection training. An air conditioning unit was noted as being sited within the main hallway to help with the recent hot spell. All residents, and staff spoken to commented on how happy they were with the home’s environment and the recent upgrading that had taken place, with some stating that they “feel lucky to be at Mapleton”. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 22 Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 23 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): 27,28,29,30 The quality in this outcome area is good. Staff at the home are very well trained and supported, and always employed in sufficient numbers to meet the residents’ needs at all times. EVIDENCE: All residents spoken to confirmed that the staff care for them very well. Training is provided regularly. Recent examples of training provided has included statutory training i.e. fire awareness, first aid, moving and handling and the protection of vulnerable adult training. Other examples of training provided has included falls awareness training, dementia care training and a thorough, newly introduced (replacing the existing one and taking into account, The Skills For Care expected standards in relation to induction training) training package for new members of staff. Further in depth training in dementia awareness, provided by an external provider, has also been organised to take place in September this year for all the staff employed at the home. Also noted was the fact that specific training is provided for the differing needs of different members of the staff group. Examples of this can be seen in the following: Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 24 The cook has received training in reducing risk areas within a kitchen setting, in relation to the preparation etc of food ( hazard analysis critical control point training). The management of the home have received training in commencing and maintaining a good quality audit system within the home, training in health and safety for responsible persons, managing attendance, managing quality dementia care and finance procedure training. This continued level of appropriate, specific as well as generic training ensures that all staff are both appropriately trained and consequently able to provide suitable care for the residents currently at the home, as well as being prepared for the possible new category of resident that may be accommodated at the home in the future (see summary). Staff on duty were spoken with and it was evident that they took great pride in their role and felt that ensuring residents had a good quality of life, irrespective of need or diversity, was the most important part of their role. The home maintains a very stable staff group. Minor changes that have occurred have been due to personal circumstances and retirement. This overall staff stability allows residents to feel secure and confident of the carers’ abilities to care for them, which was reflected in the numerous positive comments received from residents about the staff. Since the last inspection the manager has appointed two new staff members. Both of these staff member’s recruitment records were seen to be in order with a full application form, two written references and an enhanced CRB check being received. Both of the staff members concerned were spoken with at the inspection and were able to confirm that their recruitment had been in order and both were able to confirm that they had received a large amount of support from both existing senior members of staff as well as from the management of the home. This has ensured that residents remain protected by the appointment of suitable staff who all receive adequate support and training to enable them to be able to undertake their roles confidently whilst being aware of residents’ needs. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 25 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): 31,33,35,38 The quality in this outcome area is excellent. The home is managed efficiently and well, with the manager being easily available and approachable. The registered manager undertakes her role very professionally and has an awareness of all residents’ needs and the staffs’ abilities to meet them. The home provides a safe, secure environment where residents’ safety and well being is maintained. EVIDENCE: The registered manager has the Registered Manager’s Award and along with the other members of the management team undertakes regular, relevant training to both support them with the management of the home as it stands and to prepare them for the possible change of direction the home may take (see summary). Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 26 The manager has been in post for approximately three years and is very well acquainted with the day to day running of Mapleton. She is both well liked and respected within the home by residents and staff, and by outside professionals and visitors to the home. A comment received from a visitor referred to the manager as being: “fantastic” and one of the assistant managers as being: “incredible with all other staff being excellent in the care the care and detail they give to all residents”. All those spoken with (both residents and staff) stated how confident they were with her management of the home and how she led by example being always available, approachable and ensuring that residents’ needs are met on a daily basis, as well as planning for their long term needs/goals. Staff also stated how there was “always an open door to the office” and that they felt confident to be able to speak to any of the management team about any concern they may have, be it personal or professional. The manager, along with her team of three assistant managers and two night care officers, undertakes the management tasks within the home efficiently and professionally ensuring all required records are as required. All records inspected were up to date, concise and detailed (other than the two small instances mentioned previously under health and personal care). The residents’ finances are managed in such a manner to ensure residents’ monies are safe guarded and are accountable for. There were detailed records in respect of residents’ finances. The Local Authority will hold up to £50.00 for each resident (for which interest accrued is payable to residents), after which monies are banked in an individual account for each resident. A representative of the Local Authority undertakes a formal monthly in-depth review of the service and provides both the manager and the Commission with a written record of this visit as required under regulation twenty-six. The manager holds regular resident and staff meetings with minutes seen. A new quality audit system has been set up within the home to ensure that all records are reviewed, easily accessible and that the management remain informed as to the residents and others views on how the home meets their needs. The management of the home are keen to obtain feedback from residents and others as to how the service runs and consequently encourages feedback at all opportunities i.e. respite questionnaire feedback forms, resident feedback forms etc. The two assistant managers, present during the inspection, stated that routine health and safety issues continue to be well managed within the home, and those records inspected i.e. fire log book, fire risk assessment, home’s risk assessment evidenced this to be the case. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 27 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 x x 3 Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 28 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 Refer to Standard OP7 Good Practice Recommendations Care plans should contain up to date information regarding any changing care need of a resident, including any medication changes so that all staff are able to note these changes and carry them out accordingly. The identified responsible person in charge of administering medication should always ensure that any medication refused by a resident is recorded. This is to ensure all staff are then aware that the resident has not had the medication prescribed and can take any action necessary if the resident is then unwell. Consideration should be given to providing some further degree of safety to the approach to the first floor from the main downstairs hallway. This is because it is intended to provide accommodation for clients with mental health frailties on the first floor and the entrance/exit from this unit is currently very open and would prove hard to supervise. DS0000032567.V305486.R01.S.doc Version 5.2 Page 29 2 OP9 3 OP19 Mapleton Residential Home 4 OP19 The registered Provider should ensure that sufficient communal space is provided for the permanent residents sited on the ground floor. Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 30 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 © 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 Mapleton Residential Home DS0000032567.V305486.R01.S.doc Version 5.2 Page 31 - 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. 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