Inspection on 27/01/06 for Marden Court

This inspection was carried out on 27th January 2006.

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

Marden Court 19/03/09

Marden Court 12/03/07

Marden Court 15/08/05

Marden Court 01/02/05

Marden Court 25/10/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 Marden Court Quarr Barton Calne Wiltshire SN11 0EE Lead Inspector Thomas Webber Unannounced Inspection 27th January 2006 09:25 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 Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Marden Court Address Quarr Barton Calne Wiltshire SN11 0EE 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) 01249 813494 manager.mardencourt@osjctwilts.co.uk The Orders Of St John Care Trust Ms Jane Ridgwell Care Home 28 Category(ies) of Dementia - over 65 years of age (2), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (28) Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of services who may be accommodated at any one time is 28 No more than 4 services users over the age of 65 years with a mental disorder MD(E) may be admitted at any one time No more than 2 service users with Dementia (DE(E)) Date of last inspection 15th August 2005 Brief Description of the Service: Marden Court was built in the 1960s as a purpose built residential home offering accommodation and personal care to a total of 28 residents over the age of 65 who require care primarily through old age, although the home is also registered to accommodate 4 residents who have mental health needs and 2 with dementia needs. Two of the 28 beds are used for respite care. The home also provides day care facilities for up to 16 residents. The home is set in its own delightful gardens, in a quiet residential area close to the centre and facilities of the market town of Calne. The home was originally opened in the 1960s as a local authority home and was taken over by the Order of St Johns Care Trust in 2000. The registered manager is Ms Jane Ridgwell. Residents are provided with their own bedrooms and these are located on the ground and first floor levels and are accessed by the use of a passenger lift. A call bell system is installed in each room, which can be used by residents to call for staff assistance. The home provides suitable communal space together with adequate bath and toilet facilities. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, undertaken during the course of one day from 09:25 to 14:00. The main purpose of this inspection was to obtain the views of the residents regarding the care and services provided by the home and to assess the core standards not checked at the last inspection. Standards assessed included residents’ care plans, medication, residents’ dignity, privacy, and choice, food menus, complaints, staffing levels, staff training, residents’ finances and health and safety. A tour of the premises was undertaken and the views of eleven residents were sought on an individual and group basis. What the service does well: The home is run and managed by a manager who is appropriately qualified and has considerable experience in the care setting she manages. The home continues to provide sufficient numbers of staff on duty at all times to meet the needs of the residents as well as working towards achieving a trained workforce. Residents spoken to commented very favourably about the care provided by the staff stating that the staff are wonderful, patient, very kind and they are treated very well by them. One resident also stated that he was made to feel very comfortable. Staff were observed to undertake their duties in a caring and attentative manner. The home provides a safe, accessible and suitably maintained environment to meet the residents’ individual and collective needs. Residents are provided with individual bedrooms which they have personalised to their individual wishes. Residents have access to a sufficient number of toilet and bathroom facilities. The home is maintained to a good standard being clean, tidy and comfortable and provides suitable laundry facilities. Residents spoken to commented very favourably about the standard and cleanliness of the accommodation provided, stating that their bedrooms are kept clean and tidy. Residents also commented that they were happy with the laundry arrangements in place, stating that their clothing is suitably returned in good condition. However, a few residents did comment that some of their clothing took some time to be returned. Residents receive a varied, appealing and balanced diet with meals being eaten in a congenial and relaxed setting. Residents spoken to commented very favourably about the quality and quantity of food provided. They confirmed that they receive a choice and are provided with plenty of food. Mealtimes are conducted in a relaxed and congenial atmosphere and seconds were offered. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 6 Residents can, within their capabilities, exercise personal autonomy and choice and their privacy and dignity are respected at all times. Information is provided to residents on how to complain should they wish to and the residents felt that any concerns would be listened to and acted upon. Residents’ financial interests are being suitably maintained. The health, safety and welfare of the residents and staff are promoted and protected. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were not assessed during this inspection, as the core Standards had been satisfactorily assessed or deemed not applicable at the last inspection. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 and 10 Residents’ personal, social and health care needs are identified in their care plans, with regular reviews being held. The home has a clear policy for the safe handling of medicines, however there are areas where residents are potentially at risk from shortfalls in the home’s procedures. Residents’ privacy and dignity are respected at all times. EVIDENCE: Long term assessment/care plans have been established for all residents and evidence was available to show that the quality of content in relation to the three case tracked were informative and well written. The goals/needs of the residents’ long term care plans are reviewed where changes occur or at least on a six monthly basis whereas their short term goals/needs are reviewed at least monthly. Evidence was available to confirm that residents have been involved in this process. In addition, manual handling and risk assessments are also completed in respect to all residents. All residents’ placements are also reviewed by the home initially after four weeks and thereafter six monthly. The manager reported that all interested parties are invited to attend at least one review a year. The manager reported that residents’ funded by social services are reviewed yearly after the initial review, although this is not always being achieved. However, social services have recently Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 10 reviewed a large number of residents and all relevant parties were invited to attend. The home uses the Boots monitored dosage system and appropriate storage facilities are in place for residents’ medication. Examination of the residents’ medication record sheets showed that they are being suitably recorded for medication administered. In addition a drugs register has been established for controlled drugs. Residents, who have been assessed as being capable, are encouraged and supported to self-medicate and this is supported in the home’s drugs policy. On the day of inspection, none of the residents were totally selfmedicating, although some were applying their own creams and eye drops. The manager reported that a new medication policy has been introduced by the Trust although this has not yet been fully implemented by the home. The Trust must ensure that the change within the medication policy is reflected within the home’s admission procedure. The Trust must also ensure that the revised medication procedure itemised under ‘Receipt of medicine from resident/carer/hospital’ is further amended to read “1) Medication being received via the resident or a carer must (as opposed to should) be checked with the resident’s GP”. This change is to avoid any possible ambiguity by staff. Residents are provided with lockable facilities within their bedrooms for the safe storage of their medication. Staff only administer medication to residents once the manager or care leaders have deemed them competent. However, care leaders tend to undertake the large medication rounds. Staff have received some training in the administration of medication from Boots. The pharmacist last visited and assessed the receipt, recording, storage, handling administration and disposal of medicines on 10th October 2005 and found them to be satisfactorily maintained. Observations and discussions with residents confirmed that they are provided with their own bedroom where they can conduct all their personal affairs in complete privacy, including medical examinations and any treatment. Residents confirmed that they can choose who and where to see any visitors. The home provides a payphone for residents’ use, which is located by the front entrance, although this facility can be moved to the hairdressing salon for complete privacy when being used. The home also has a hand set phone, which residents can use in the privacy of their bedrooms. In addition, residents can have a telephone installed in their bedrooms and a number of them have availed themselves of this facility. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 and 15 Residents, within their capabilities, can exercise personal autonomy and choice and residents receive a varied, appealing and balanced diet with meals being eaten in a congenial and relaxed setting. EVIDENCE: Observations and discussions with residents confirmed that they can, within their various capabilities, exercise personal autonomy and choice. Residents can and have brought items of furniture and personal possessions to make their bedrooms more homely, they can choose where to spend their time, where to eat, and what activities to participate in. A satisfactory and varied five weekly rotating menu is in operation, which provides a choice at breakfast and lunchtime, except when a roast is provided on a Sunday. A set meal tends to be offered at teatime. Drinks and snacks are also available at other set times of the day. Residents can choose where to eat their meals, either in the dining room or their bedrooms. Residents spoken to commented very favourably about the quality and quantity of food provided. They confirmed that they receive a choice and are provided with plenty of food. Mealtimes are conducted in a relaxed and congenial atmosphere and seconds were offered to those who wished to have more. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 12 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 Information is provided to residents on how to complain should they wish to and the residents felt that any concerns would be listened to and acted upon. EVIDENCE: Each resident is provided with a copy of the home’s complaints procedure and a copy of this document is also on display on one of the home’s notice boards. Since the last inspection the home has received one complaint, which related to one resident entering another’s bedroom. This complaint was promptly investigated, upheld and suitably resolved. The home now ensures that the outcome is recorded in respect to any complaints received. Residents spoken to commented that they had no complaints but felt that if they had any these would be suitably dealt with by the home. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 13 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): 20, 21, 24 and 26 The home provides a safe, accessible and suitably maintained environment to meet the residents’ individual and collective needs. Residents are provided with individual bedrooms which they have personalised to their individual wishes. Residents have access to a sufficient number of toilet and bathroom facilities. The home is maintained to a good standard being clean, tidy and comfortable and provides suitable laundry facilities. EVIDENCE: The home provides a range of communal areas which include a large dining room with a small sitting area, an additional small sitting area by the shop/bar, a lounge and a conservatory which is designated as the smoking area for the home, thus providing a smoking free zone to the other communal areas and to residents’ bedrooms. Residents can also access the facilities in the day centre. There is also a bar/shop and a hairdressing salon located within the premises and these are situated on the ground floor. The home has a spacious and well maintained rear garden which is used by residents weather permitting. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 14 The home provides sufficient bathroom and toilet facilities, although the manager reported that consideration is being given to converting an unused bathroom to a shower room. Residents’ bedrooms are suitably furnished and equipped to ensure comfort and privacy. Although the standard of decoration to these varies, some are decorated to a good standard. Residents can and have brought items of furniture and personal possessions to make them homely and residents have personalised their bedrooms to their individual wishes. Locks have been fitted to residents’ bedroom doors and keys have been provided to those residents who have requested them. Residents’ bedrooms have also been provided with a lockable storage space. Residents spoken to commented very favourably about the standard and cleanliness of the accommodation provided, stating that their bedrooms are kept clean and tidy. The home is maintained to a good standard being clean and tidy. The laundry facilities are located in a variety of places within the home: on the ground and first floor levels and these could still benefit from being situated in one room which provides sufficient space to accommodate all the required facilities. Residents’ clothing is labelled to ensure that their garments are appropriately returned. Residents spoken to commented very favourably about the laundry arrangements in place, stating that their clothing is suitably returned in good condition. However, a few residents did comment that some of their clothing takes some time to be returned. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 15 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 and 30 The home continues to provide sufficient numbers of staff on duty at all times to meet the needs of the residents as well as working towards achieving a trained workforce in line with the National Minimum Standards. EVIDENCE: The deployment of staff continues to ensure that there are four care staff on duty in the mornings with three on in the afternoons and evenings. The home also provides three members of waking night staff on duty each night. There are two members of staff on duty in the day centre at any one time. The above staffing levels include the care leaders but exclude the manager and the ancillary staff employed. Residents spoken to commented very favourably about the care provided by the staff stating that the staff are wonderful, patient, very kind and they are treated very well by them. One resident also stated that he was made to feel very comfortable. Staff were observed to undertake their duties in a caring and attentative manner. All new staff receive an induction programme and staff continue to be supported to undertake a variety of mandatory and NVQ training to equip them to perform their duties. In addition evidence was available to confirm that staff have attended other relevant training. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 16 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, 35 and 38 The home is run and managed by a manager who is appropriately qualified and has considerable experience in the care setting she manages. Residents’ financial interests are being suitably maintained. The health, safety and welfare of the residents and staff are promoted and protected. EVIDENCE: The manager has considerable management and supervisory experience in the relevant care setting she manages. She has satisfactorily achieved the Certificate in Social Service, the NVQ 4 Registered Managers’ Award and the NVQ Assessor’s Award. The manager continues to undertake ongoing training to update her knowledge and skills. Residents’ meetings continue to be held approximately every two months which provides them with a forum where they can comment and contribute to aspects of the running of the home. Copies of these minutes are suitably displayed on the various notice boards within the home. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 17 The home has secure facilities for the storage of residents’ monies. A spot check of the system of money held by the home on behalf of the residents was carried out and found to be satisfactorily maintained. Safe working practices have been established within the home, which comply with the relevant legislation. Full health and safety policies and procedures are in place to ensure a safe working environment and staff attend the various mandatory training courses. Window restrictors have been fitted to all windows and radiator covers have also been fitted to radiators in all residents’ areas for their protection. Various testing and servicing of equipment in respect to electrical and fire prevention are being carried out at the required intervals. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 19 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 OP9 Regulation 12(1)(b) Timescale for action The responsible individuals must 13/02/06 ensure that the Trust’s new medication policy is fully implemented by the home and the Trust makes changes to the home’s admission procedure to reflect the new medication policy. The responsible individuals must 13/02/06 ensure that the revised medication procedure itemised under ‘Receipt of medicine from resident/carer/hospital’ is further amended to read “1) Medication being received via the resident or a carer must (as opposed to should) be checked with the resident’s GP”. This change is to avoid any possible ambiguity by staff. Requirement 2. OP9 12(1)(b) Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 20 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 OP29 Good Practice Recommendations The responsible individuals should strongly consider obtaining a full employment history as opposed to a ten year one currently used. Marden Court DS0000028292.V275580.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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. 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