Inspection on 13/09/05 for Marbury House

This inspection was carried out on 13th September 2005.

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

Marbury House 12/06/07

Marbury House 24/01/06

Marbury House 09/11/04

Marbury House 09/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Marbury House Marbury Road Heaton Chapel Stockport SK4 5NU Lead Inspector Kath Oldham Unannounced 13 September 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Marbury House Address Marbury Road, Heaton Chapel, Stockport, SK4 5NU 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) 0161-432-2825 0161-947-9687 Borough Care Limited Mrs Y Nixon CRH - Care Home 40 Category(ies) of DE(E) Dementia over 65 (4) registration, with number OP Old Age (40) of places Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 40 OP and up to four DE(E). Date of last inspection 9 November 2004 Brief Description of the Service: Marbury House is owned and operated by Borough Care Limited. The home is purpose built and situated in a housing estate in the Heaton Chapel area of Stockport. Marbury House is registered for up to 40 service users. An extension to the care home has meant that all bedrooms are single, some with en-suite toilets.Yvonne Nixon is the manager of the care home. She has previous experience in care and was the deputy at another of the company’s homes prior to her appointment as Manager. The care home is registered to provide accommodation and care to service users who are within the category of old age and four service users who have dementia. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken in the day, commencing at 8:00am. The inspection included the examination of a sample of records maintained for the purpose of Regulation, a partial inspection of the premises, conversation with service users and observation of staff practice and routines. Comment cards were left at the home for service users, relatives and visitors. The comments made are included in this report. What the service does well: What has improved since the last inspection? The requirements identified on the last inspection, in relation to medication, have all been addressed by the home. The medication policy has been provided to the Commission for Social Care Inspection. The pharmacist inspector will feed back about its content to the home. Since the last inspection all staff who have the responsibility of administering medication have received training. Service users are identified prior to medication administration by the use of photographs attached to the medication administration records. Marbury House F54 F04 marbury house U s8565 v233690 130905 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. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 standard(s) 1 & 3 Information is provided to prospective service users so they can make an informed decision about whether the home can meet their needs and preferences. EVIDENCE: Marbury House has a statement of purpose and service user guide. The service user guide is routinely provided to prospective service users and forms part of the welcome pack produced by the home. There was evidence of an assessment being undertaken by the home prior to new service users being admitted. Service users said they were able to visit the home a couple of times before choosing whether to go into the home. On admission a trial period of six weeks is arranged to provide an opportunity to see if the service user settles and to continue the assessment of their needs and aspirations. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 Service users’ health, personal and social care needs are provided for at Marbury House. However, care plans in place do not always support the care practices observed. EVIDENCE: A short-term care plan is put in place on a service user’s admission to the home, which is built on and developed as the home gets to know the service user and their needs and abilities. Three care files were viewed and each contained a plan of care, which identified service users’ care needs. The care needs were not specific and, from reading the record, you could not get a sense of the care provided to service users. Examination of supplementary records and discussion with service users identified that the specifics of how the care was provided or the regularity of the interventions was not noted. The records did not include the regularity of when interventions should take place and, when they didn’t, why not. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 10 A record is maintained of visits by health care personnel and details the treatment or support provided. Service users are weighed regularly and a record is maintained of their weight. A risk assessment is undertaken to identify whether there are any risks and how these can be minimised by, for example, staff practice or aids and appliances. Examination of medication administration records identified them to be completed appropriately. A number of service users self-administer medication, a format is used to record this. The form does not include the need to review service users’ abilities to self-administer or to check whether they are managing and administering their medication appropriately. Requirements were made on the last inspection to alter the medication policy to include the storage, administration and recording of homely remedies. The manager stated that homely remedies are not used at the home and everything is on prescription. The medication policy was provided at the inspection and the pharmacist inspector is to examine this and provide feedback to the home regarding its content. The care supervisor gave out medication to service users at breakfast, her manner of administration was respectful to service users’ abilities. Time was taken to make sure service users took their medication in a discreet and patient manner. The care supervisor said she uses the contact with service users at this time to assess how they are and to ensure they have a good diet. Service users appeared confident that if they needed a doctor, staff would call one. One service user said she had a hospital appointment, which was arranged as a consequence of staff checking on her and asking the doctor to call. Staff were observed to promote service users’ privacy by being discreet when providing personal care. Their tone and manner was unobtrusive and respectful. Staff were observed to call out before entering bathrooms and bedrooms and knocking on the door. Service users were informed of staff actions without drawing attention to the purpose of the support. A number of service users have keys to their bedroom doors and this further promotes their privacy. The daily reports, used by the care home to record the support provided, contained very little information in some instances. Statements such as “fine”, “slept well”, “all care given” were examples of this. The daily reports should detail the actual care provided. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 standard(s) 12, 13 & 15 Service users are consulted about all aspects of the day to day running of the home and are assisted to maintain contact with family and friends. EVIDENCE: Service users are assisted and supported in some instances to take part and interact in the activities sessions. One service user said she enjoyed reading her paper and staff made sure she gets it once it has been collected. Activities are arranged within the home and some service users said they take part in whatever is going on. One service user said they were reliant on staff letting her know when things were on and to take them to the dining room. Other service users said they enjoyed sitting watching television and talking amongst themselves. A further service user said she was happy going out with her visitors and wasn’t interested in taking part in the activities arranged by the home. Service users said there is a notice to tell you what’s on and you can please yourself what you do. A note of the next service user meeting was displayed on the notice board. Service users said they can have their say at the meetings and their comments are listened to. They said that they talk about anything and everything and the staff write things down. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 12 Breakfast was shared with service users, who stated that they ate what they wanted. Fresh drinks were available and service users said they had enough to eat. Staff took time to ask what service users wanted to eat and gave them opportunity to have additional helpings. Service users were observed having breakfast from 8:00am, with others coming into the dining room when they got up. Staff support with feeding was appropriate with staff taking time to check the abilities of service users and providing support and guidance as needed. A record is not maintained at the home to record the actual meals served to individual service users. An assessment cannot be made whether the diet is sufficient. A service user said they were “looked after and fed” and “that was all they needed.” Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 standard(s) 16 & 18 Complaints were appropriately dealt with. Staff had not received sufficient training in the prevention and recognition of abuse. EVIDENCE: A number of comments were made with regard to clothing going missing or being delayed in finding its way back to service users. A visitor said they didn’t understand why nametapes were not purchased and sewn into clothes to remedy this. The manager stated that nametapes are purchased for longterm service users. A record is maintained of complaints and compliments received by the home. The record details the action taken and the outcome of the investigation. Service users said if they had complaints they knew who to speak to. Staff appeared aware of what constitutes abuse and were very clear what action they would take if they suspected abuse may be taking place. Some staff have been on adult protection training in the past. Others have not benefited from this type of training. This essential training needs to be arranged to safeguard service users and staff. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 23, 24 & 26 Marbury House is a safe and well-maintained home. EVIDENCE: Bedrooms were individualised and some service users had furnished their bedroom, in part, with furniture from their previous home. The accommodation is comfortably furnished and appears to meet the needs of all service users. A number of bedrooms have been updated recently. The home has six lounges which can be used for activities, quiet time, to receive visitors or conduct church services. There are two lounges for service users who choose to smoke. The remaining four lounges are smoke free. Lounge seating was observed to be of a design to suit the individual needs of service users with high and low back chairs available. Some of the lounges have been redecorated and service users said they helped to pick the colour scheme. The corridors are also scheduled to be redecorated. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 15 Outdoor space is available to service users which is accessible to wheelchair users or those using walking frames. Seating is available to service users who wish to sit outside. Marbury House has four bathrooms and one walk-in shower room. bathrooms contain assisted baths. All There are ten toilets within the care home for service users’ use. In addition, ten service users have en-suite toilets in their bedrooms. There are four toilets on the ground floor; the remaining six are on the first floor. The toilets and bathrooms were observed to be clean. The home is equipped with a passenger lift, which is serviced and maintained. The home has a stair-lift in addition to the passenger lift. Service users are offered a key to their bedroom on admission to the home; some service users use their keys independently. Other service users have their keys in their rooms, which are available for them to use when required. Emergency lighting was in place, which serves to illuminate the home in the event of a fire emergency. Inspection of records of emergency lighting identified that it was maintained correctly. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The procedures for the recruitment and training of staff safeguards service users living at the home. EVIDENCE: At 8:00am there were four care staff on duty plus the care supervisor and two housekeeping staff. This being due to holidays. The manager was scheduled on duty at about 9:00am. Staff said they get on with their job and are aware of their responsibilities and roles. It was said that staff do not always respond promptly at night to the call bell, which leads to discomfort and inconvenience. At night time there are two staff on waking duty. Due to the layout of the home and the needs of service users, this could lead to service users having to wait longer for support. The manager stated that she had undertaken an audit of the time of the call bell and the response time. This was reported to be in one to three minutes of the call bell sounding. A number of service users need two staff to assist them with transfers. One staff member is on sleep-in duty. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 17 The routines in the home appeared unhurried, with staff taking their time to assist and speak to service users whilst carrying out their duties. Staff were aware of individual service users’ likes and requests in relation to rising routines and service users said they got up when they were ready. One service user said they liked having a bath in the morning which freshened them up. Staff showed patience and sensitivity to the needs of service users, some of who needed reminding where they were or what they were doing. Staff meetings are arranged and notes made of the meetings, these provide an opportunity for staff to discuss any developments in the home. Examination of staff files identified that staff complete an application form prior to attending for interview, references are requested and Criminal Record Bureau checks are undertaken. Staff attend induction training and a rolling programme of training in care related matters are arranged. Staff said they had received moving and handling training. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 & 36 The manager has an open style and focuses on meeting the needs of service users. Practices within the home ensure that the health and safety of service users are promoted and protected. EVIDENCE: The registered manager has NVQ Level 4 in management and care and has significant experience of management in a care home. Staff meetings are arranged which give opportunities to enable staff to affect the way in which the service is provided. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 19 Service user meetings are used as a further opportunity of enabling service users to affect the way in which the service is delivered. The care home uses both formal and informal methods to assess the quality of the service provided. The registered manager and senior staff team encourage feedback from service users during their daily contact and care staff’s comments are collated in the same way. Policies, procedures and practice are regularly reviewed in light of changing legislation and good practice from the Department of Health, local authorities and specialist organisations. Formal supervision is provided to care staff at least six times a year. The senior staff team are allocated specific staff to supervise. Service users have access to their records and information about them held by the care home. Records are maintained securely. Examination of the finances kept on behalf of service users identified that numbered receipts were in place for all purchases made on behalf of service users. A company auditor visits the home to check the accounting procedures approximately every six months. Records showed that staff had taken part in fire drills and training. The home has had fire inspections and environmental health inspections, the requirements and recommendations identified were reported as having been addressed by the home. Maintenance and servicing of equipment was undertaken to ensure all the equipment was safe for service users’ use. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 3 x x 3 x x Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 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. 1. Standard OP18 Regulation 13 Requirement The registered person must arrange for all staff to attend the adult protection training to local authority specifications. Timescale for action 30/04/06 2. 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 OP1 OP7 Good Practice Recommendations The statement of purpose should be revised to provide information pertinent to Marbury House, rather than being a corporate document. The registered person should provide staff with supervision, direction and training in the necessary content to be recorded in care plans; develop the recording systems to comply with the identified standards. The registered person should further develop the staff team to assist in their completion of the daily reports, ensuring the detail is a record of the care provided and is not making staff judgements. The registered person should include in the medication risk assessment the need to review service users abilities to self-administer or to check whether they are managing and administering their medication appropriately. The registered person should amend the recording of the F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 22 3. OP7 4. OP9 5. OP15 Marbury House 6. OP16 food served to ensure that the record can be used to assess whether individual service users diet is satisfactory in terms of nutrition and otherwise. The registered person should review the laundry service at the home, ensuring service users receive their clothes back in a timely manner. Marbury House F54 F04 marbury house U s8565 v233690 130905 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, OL7 0QD 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 Marbury House F54 F04 marbury house U s8565 v233690 130905 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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