Inspection on 23/08/05 for Mappleton House

This inspection was carried out on 23rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Mappleton House 10/06/09

Mappleton House 21/01/09

Mappleton House 23/05/07

Mappleton House 17/01/07

Mappleton House 11/08/06

Mappleton House 21/02/05

Mappleton House 05/04/04

Similar services:

Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Mappleton House 9B Chestnut Grove Mapperley Park Nottingham NG3 5AD Lead Inspector Caroline Brailsford Rob Cooper Unannounced 23 August 2005 - 10:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Mappleton House Address 9B Chestnut Grove Mapperley Park Nottingham NG3 5AD 0115 962 3714 0115 962 3714 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) Ms Lynda Callan Ms Lynda Callan Care Home with Nursing - Private 3 Category(ies) of LD - Learning Disability - 18 years to 65 years registration, with number old. of places Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21/2/05 Brief Description of the Service: Mapleton House is a care home for three adults with a learning disability.All service users are of medium dependency and are between the ages of 18 and 65.Each undergoes a comprehensive assessment prior to their admission to ensure their needs can be met.The building is a recently built bungalow providing three single bedrooms, two with en suite facilities and one shower room.There is also shared accommodation consisting of a lounge, separate dining area and kitchen.The bungalow has easy access for the residents and is close to the bus route to the city centre which is approximately one mile away. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and lasted for four and a half hours. The inspector collected evidence through looking at two service users care plans and files and checking that their needs were being met. The inspector talked to all of the service users, 2 staff, two deputies and the manager. Some other key documents were also checked, for example risk assessments, fire logs etc. The inspector also had a tour around the building and two service users showed their rooms. The deputy manager asked that the service users are referred to as residents in this report as they have expressed this wish. What the service does well: What has improved since the last inspection? The statement of purpose now contains information regarding the use of staff from Mappleton house 2 (the other house across the courtyard) Since the last inspection the manager had written a policy on cross infection, which was found in the policy file for staff. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 6 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. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5 Relevant paperwork is in place in line with the standards and regulations. The residents understood their contracts as far as possible and relatives were involved accordingly. The staff at the home were aware of the needs of individual residents which were well met during the inspection. EVIDENCE: The manager has developed a statement of purpose. This document meets the requirements of the National Minimum Standards and Care Homes Regulations including the key contract terms and the fees charged. The staff members on duty were observed to interact very well with residents and appeared to understand their needs, in particular their communication needs. Specialist services are offered where required. One person had had their needs assessed for a new chair recently and one person was noted to have communication systems linking into behaviour plans to ensure that their needs in this area were met. One resident said that she felt her needs were met at the home. Both resident’s files inspected contained contracts, the manager reported that neither could be signed or fully understood by the resident and had therefore been signed by the nearest relative. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9 The Care plans inspected covered all aspects of resident’s lives and exceed the requirements in the National Minimum Standards. Risks which are taken are understood by residents and staff and based on individual needs and planning. EVIDENCE: Two residents plans were inspected and both had been generated from the extended community care assessment and based also on the managers own assessment documentation, which is extremely comprehensive. The care plans were set out in a user-friendly format including pictures and colours appropriate to the residents needs. The document is clearly ‘owned’ by the resident, both by the way it is set out and included information. One resident was aware that she had a plan and had seen it. The plans inspected covered all aspects of resident’s lives and exceed the requirements in the National Minimum Standards. One resident said that they make their own decisions about their lifestyle, how they dress and how to spend their money. They felt able to represent their own views, needs and wishes. They spoke about tasks around the house which Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 10 they are involved in and understood why they had to have support from staff for other tasks, this had been explained to them by staff. On one file inspected there were comprehensive risk assessments in line with the needs of that resident but on the other file inspected there was no documentary risk assessments, however the staff clearly knew them well and support appeared to be appropriate to their individual development. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14,16 The residents have a lifestyle, which they choose. Independence is encouraged by staff at the home and relevant support is offered regarding choice and activities. EVIDENCE: Leisure needs are identified in the care plans and there is evidence that the residents are accessing the local community. A log of leisure activities was inspected and the inspector found that there had been visits to the local shops, pubs etc. One resident said that she enjoyed getting out and about in the community. There is a house car, which the service users access for outings and activities. One service user reported that she chooses activities and does not have to participate in anything if she does not wish to do so. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 12 All personal leisure needs are identified in the care plans and service users are asked to identify their ideal weekends and weekdays. Activities are recorded in the service user files and include dancing music, TV etc. One resident spoke of her holiday this summer with the staff and other residents smiled when this was mentioned. Staff said that this was a positive experience for all involved and there were holiday photos around the home for residents to look at and talk about. Staff reported that they only enter the service user’s bathrooms and bedrooms with the permission of the service user, one resident confirmed this. During the inspection there was lots of positive interaction between the staff and the residents and it was apparent that the residents came first and were valued by the staff. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 The arrangements for the administration of medicines is well organised in the home and the staff understood the policies and procedures. The records could be improved to ensure and check that medicines have been given at appropriate times throughout the day. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 14 EVIDENCE: There is a contract with a local pharmacy where support, training and guidance has been offered in this area. The staff reported that this has been very helpful and they have received their training. Records of the administration of medication were inspected, up to date and mostly well kept although there were four Gaps in the records where it appeared that medicines had not been administered. The staff gave reasons for this but this was not reflected on the recording sheets. There were protocols in place for the administration of PRN medication; the inspector was able to cross reference within service user’s records that PRN medication is given appropriately. The medication is stored in a locked cupboard. A protocol for the administration of invasive medication is present and signed by the service user’s GP. The signed document was not in the resident’s file, however the staff were very clear regarding the protocol and that this had been approved by the GP. Staff reported that they had been trained to administer invasive medications by the district nurse. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 There are appropriate policies and procedures in place to ensure that residents can express their views and complain. EVIDENCE: There have been no recorded complaints since the last inspection. One resident, when asked, knew how to complain. There is a complaints procedure in the home. This is present in both the statement of purpose and in the service user’s guide. This document meets the requirements of the National Minimum Standards and Care Homes Regulations. There is also a more user- friendly version, which includes the residents preferred methods of communication. Staff were also aware of the homes complaints procedure. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30 The residents live in a homely, comfortable and safe environment. There is enough space, both private and shared and the home is well kept and clean. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 17 EVIDENCE: The premises are suitable according to the purpose of the home and are accessible to all the residents. The premises is well maintained and decorated in a homely manor. Furnishings and fittings are of a good quality. There is good access to facilities in the local community. The premises are fully accessible to the residents and have been assessed by an occupational therapist. The inspector found that records of fire checks were up to date and that fire drills and tests on fire alarms were recorded. A COSHH file is in place and includes all new substances, which are now used in the home. Risk assessments have been written on the environment to include the steep driveway and other areas around the property. PAT testing on electrical equipment has not been completed in the last 12 months and is now overdue, however this has been organised by the manager. The laundry facilities were appropriate and there were policies and procedures in place to control the spread of infection. The staff spoken with were aware of these. Any soiled laundry is carried through the kitchen in sealed bags and more heavily soiled items are washed on the correct washing cycle at Mappleton House 2 which is on the same site. The manager plans to discuss these procedures to ensure safe working practises when the Environmental Health Department come to do their annual inspection. There are policies for communicable diseases and cross infection. There was a strong odour coming from a resident’s bedroom and en suite, the deputy manager reported that there had been a recent leak from the toilet on to the carpet which was the cause. During the inspection the handyman was replacing the carpet and ordering the parts to ensure the leak was fixed as swiftly as possible. By the end of the inspection the odour had been removed. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34 Staff know the residents well and good relationships have been developed. The staff are sufficient in numbers and appropriately trained and skilled to deliver a service of high quality. Appropriate checks on staff have taken place. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 19 EVIDENCE: The manager confirmed that all staff are appropriately recruited and that gaps in employment are checked and two references are taken up prior to staff working at the home. 2 staff files were selected and were well presented and contained all required information. This included two written references and CRB checks at enhanced level prior to their starting work. There are three people resident and the staff and resident spoken to reported that there are always two staff on duty with the manager on call. Also that at times there can be an additional staff member shared by Mappleton House 2, which is on the same site. This is now covered in the homes staffing policy and statement of purpose indicating how many staff will be on which rota for each shift and how the staff from the other house will be used. There is a night awake shift providing a staff member awake in the building each night. There is also a night awake in Mappleton House 1 and there is an intercom between the two houses. The current staffing appears to meet the needs of the residents. There is a rota which is kept in the office and is available to staff. The staff were friendly and warm towards the residents and reported a high commitment to their jobs, they were highly motivated to provide a good service and clearly enjoyed being with the residents. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The home is well managed with clear lines of accountability; the manager is well respected by staff. EVIDENCE: The manager demonstrates a clear style of leadership and staff commented that they are clear regarding what she expects from them. Also that she is supportive in her approach and highly committed to the needs of the service users. Some staff said that this was the best home they had ever worked at and that part of the reason for this was down to the manager. On the day of the inspection her style was that of openness and a desire to develop the service to ensure that it is of the highest quality. In the absence of the manager there are now two deputies who participate in management duties and run the home during the manager’s holidays and free time. Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 4 x 3 x Standard No 31 32 33 34 35 36 Score x x 4 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mappleton House Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x 4 x x x x x C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 22 yes-1 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 9 20 Regulation 13(4) 13(2) Timescale for action There should be documented risk 1/10/05 assessments for individual residents at the home. Records of any medicins which 1/10/05 have been administered should be improved to include reasons for non administration. The use of the private room for 1/10/05 service users in the other building (Mappleton House 2) must be outlined in the homes Statement of purpose This is outstanding from the last inspection. Requirement 3. 28 23 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 Good Practice Recommendations Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Edgeley House Riverside Business Park TottleRoad Nottingham NG2 1RT 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 Mappleton House C53 C03 S55194 Mappleton Hse V245516 230805 Stage 4.doc Version 1.40 Page 24 - 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. 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