Inspection on 18/09/08 for Markfield Court Care Centre

This inspection was carried out on 18th September 2008.

CSCI found this care home to be providing an Adequate service.

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

Markfield Court Care Centre 20/06/07

Markfield Court Care Centre 16/11/06

Markfield Court Care Centre 29/09/05

Markfield Court Care Centre 23/06/05

Markfield Court Care Centre 14/02/05

Markfield Court Care Centre 27/07/04

Markfield Court Care Centre 17/12/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

CARE HOMES FOR OLDER PEOPLE Markfield Court Care Centre Ratby Lane Markfield Leicestershire LE67 9RN Lead Inspector Kathy Jones Unannounced Inspection 18th September 2008 08:10 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 Markfield Court Care Centre DS0000001917.V371367.R02.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. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Markfield Court Care Centre Address Ratby Lane Markfield Leicestershire LE67 9RN 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) 01530 242595 01530 244287 markfield.court@ashbourne.co.uk Ashbourne Life Ltd Sarah Stephens Care Home 85 Category(ies) of Old age, not falling within any other category registration, with number (85), Physical disability over 65 years of age of places (85) Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Markfield Court Care Home is registered to provide personal care to male and female service users who fall within the following categories:Old age, not falling within any other cateogry (OP) 85 Physical Disability - over the age of 65 years (PD(E)) 85 To accommodate the person in the category DE(E) named in variation no. 48891 To accommodate the person in the category DE(E) named in variation number V34893. The maximum number of persons to be accommodated at Markfield Court is 85. 20th June 2007 2. 3. 4. Date of last inspection Brief Description of the Service: Markfield Court is a care centre with provision for nursing and personal care. It is registered to accommodate up to eighty-five residents falling within Older Persons (OP) or Physical Disability (PD) Category over 65 years of age. Ashbourne Life Ltd are the registered providers of Markfield Court and are owned by Southern Cross Healthcare a large national care home provider. Markfield Court is a traditional building which was formerly the nurses’ accommodation for the old Markfield hospital. It is located close to Junction 22 of the M1 on the outskirts of Ratby and Markfield, and is close to the town of Coalville. It is easily accessed by public transport from the City of Leicester. The Care centre is an attractive and distinctive centre set in very large, attractive woodland, in which there are walks for residents that are mobile. Accommodation is located on three floors, which can be accessed by a shaft lift. There are forty-five single bedrooms and twenty double bedrooms many are en-suite and some open directly onto the garden. There are numerous lounges and dining rooms and specialised bathing facilities are available throughout the three floors of the home. The information below about fees was provided by the registered manager as being current at the time of the inspection: Nursing Care fees range from £550 per week for a single room without an ensuite to £700 for a double room with single occupancy. The above rates Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 5 incorporate personal care and accommodation only. Any RNCC (nursing contribution) payable is paid in addition to these rates directly to Markfield Court Care Centre. For residential care fees range from £500 for a single room with no en suite to £650 for a double room for single occupancy with an en suite. Social services funding for nursing and residential placements is accepted without a top up for standard single rooms without en suite only. A copy of the last inspection report was available at the home. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Standards identified as ‘key’ standards and highlighted through the report were inspected. The key standards are those considered by the Commission to have a particular impact on outcomes for residents. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the service, collating information received in surveys received from relatives, people who use the service and staff and drawing together all of the evidence gathered. The pre-inspection planning was carried out over the period of half a day and involved reviewing the service history, which details all contact and correspondence with the home and previous inspection reports. The last full inspection (this is called a key inspection) took place in June 2007. Information from this inspection was taken into account as part of the planning. This unannounced inspection visit was carried out over a period of a day and involved two inspectors. The inspection was carried out by ‘case tracking’, which involves selecting samples of residents’ records and tracking their care and experiences. Observations of the homes routines and care provided were made and views on the care provided were sought from people who use the service, visitors and staff. We sent out surveys to a random sample of people to gather their views on the service provided. We received completed surveys from six people who use the service, one relative and three staff. None were received from health professionals on this occasion. Their views and the views of people spoken with during the inspection have been considered as part of the inspection and some comments incorporated within the report. The management of residents’ medication was checked through reviewing prescribed medication for a sample of people. A sample of staff files were reviewed to check the adequacy of the recruitment procedures in protecting people who use the service. Communal areas and a sample of bedrooms were viewed and observations were made of people’s general well being, daily routines and interactions between staff and people who use the service. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 7 Verbal feedback was given to the Registered Manager throughout the inspection. The term ‘people who use the service’ has been used to describe the people living and receiving care at the Griffin Centre in the report. However the terms ‘residents’ and ‘service users’ have been used where people have referred to them as such. What the service does well: What has improved since the last inspection? There is now a registered manager in post who holds legal responsibilities for the management of the home. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 8 Requirements made at the previous inspection about replacement flooring and re-decoration have been met. People felt that standards of care had improved and views were summed up by the following comment from a relative “The Manager and Deputy manager have really improved the home tremendously. Not only in arranging for improvements but the friendliness and atmosphere is much improved. 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. The summary of this inspection report can be made available in other formats on request. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 9 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 Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3. Standard 6 is not applicable, as intermediate care is not provided. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process provides assurances that the needs of people admitted to the home can be met. EVIDENCE: The annual quality assurance self assessment submitted by the registered manager confirms that information is available about the service and what is provided in the form of a statement of purpose and a service user guide. During the inspection we found that a copies of these documents were available with a copy of the most recent inspection report. Copies of the documents were provided to us to be reviewed after the inspection visit. Six surveys were received from people who use the service, which in some cases had been completed with the assistance of a relative or supporter. All confirmed that they had received information about the home before moving Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 11 in. This is important in helping people to make decisions about their care and to help ensure that their expectations can be met. The majority of people were happy with the information that they received and their comments about the service indicated that their expectations have been met. One relative described how they were invited to visit the home, were shown around and time was taken to talk to them about Markfield Court and the services provided. Two people already had information, either through previous experiences or from friends. The service user guide while having some information about Markfield Court is a corporate document and is fairly general. Following the inspection the registered manager has forwarded another document, which is provided, to new people which contains information which is more specific such as laundry arrangements and how post is dealt with. Reference is made to the fees in the service user guide however the actual costs are not included. It is important that this information is available to ensure transparency and also to help people make choices and decisions and plan their finances. The manager has also confirmed that she is in the process of reviewing the service user guide and will include this information. Care files were reviewed for two people who have recently been admitted to Markfield Court. These showed that an assessment of people’s needs had been carried out prior to admission, which helps to ensure that their needs can be met. The assessment covered people’s health and personal care needs and also their social and religious needs. The assessments appeared to be thorough and information and contact numbers for health professionals already involved with people’s care was available. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The overall care provided appears to be good and the care plans which support people receiving nursing care are good, but the lack of up to date care plans for other people puts them at risk of their needs and preferences not being met. EVIDENCE: People we spoke with during the inspection and who completed surveys were happy with the care that they receive. Comments included “It is only the love and care and nursing care that has pulled him through”. We also met with someone who we had seen during the inspection last year and noted that they looked much better and brighter. We looked at a sample of care files to see how the needs of people with different needs were being met. We found that care plans for people receiving nursing care were reflective of peoples assessed needs and that the care plans Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 13 were reviewed at least once a month. We also looked at the care file for someone who had only been admitted to Markfield Court the previous evening. There was a draft care plan in place, which provided staff with good basic information about the care they needed to give based on their assessed needs. In contrast care plans on the residential unit were not fully reflective of people’s needs. For example there was no care plan in place for someone who was identified as being at high risk of pressure ulcers. This creates a risk of their care needs not being fully met. These care plans were also not being reviewed regularly. An entry in someone’s daily notes indicated that they did not like large groups of people. This had not been included in their ‘socialising care plan’ which created a risk of them being placed in an uncomfortable position repeatedly. A note on the office wall identified that someone had preferences as to the people who provided their care; again this had not been included within their care plan. Care plans are considered important documents, which are there to provide staff with information about the actions they need to take to ensure people, receive consistent care according to their needs. Records showed that health professionals such as the General Practitioner and the chiropodist were involved with people’s care and contacted as and when necessary. While the health care needs of people receiving nursing care appeared to being monitored there was no evidence that this was the case for people on the residential unit. For example a care plan dated March 2007 identified that someone was at risk of constipation. The plan had not been reviewed since February 2008 and up to that time there was nothing in the evaluation to indicate if this had been a problem or not, records contained general statements such as continue medication. Failure to monitor issues such as constipation can lead to serious health care problems, particularly with someone with dementia who is not always able to easily express and explain discomfort. The management of medication again varied between the floors. A sample check on the nursing floor indicated that medication was well managed and accurate records were in place to support this. A survey received talked about times where medication had run out and eye drops were given as an example. As we did not know who this was we were unable to check if this person had eye drops at the time of the inspection, however we checked a sample of people’s medication and found that it was available. We found that the date of opening had not always been recorded on eye drops, which have a short shelf life. In all cases checked the date of dispensing meant that these were within the expiry dates, however advice was given not to use beyond the dispensing date as the opening date was not known. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 14 There were no signatures for two consecutive days prior to the inspection on the one persons medication administration records for warfarin, which was prescribed to be given daily. Taking account of the number of tablets recorded as being received, those signed as given and those left, there was one more tablet than there should have been. This meant that the medication had not been given as prescribed which could have serious consequences for the person’s health. Further checking of medication administration records identified that there were some other gaps in the medication administration records for the same dates. Other records appeared to have been completed appropriately. Discussion with the registered manager identified that a senior member of staff from another Southern Cross Care home had been responsible for medication administration on the dates identified. The General Practitioner was contacted regarding the missed medication and we have been informed since the inspection that an investigation is to be carried out. People were well groomed and during the inspection we observed and heard people being spoken to and treated with dignity and respect. Staff were seen to knock on people’s doors before entering the room and to respond to requests for assistance appropriately. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good range of outings and activities, the atmosphere is relaxed, visiting arrangements are flexible and the meals are of a good standard. EVIDENCE: The annual quality assurance self assessment submitted by the registered manager identifies that a wide range of activities and outings are provided and that special dates and celebrations are acknowledged. This is supported by comments received in surveys from people who use the service and their relatives. For example: “Varied selection of activities ranging from day trips out, bingo, board games, art work, library delivery service with large print books, charity fund raising days and more. This gives towards a happy, welcoming atmosphere.” “Lots of activities on offer, ------------- chooses not to partake but goes out in the grounds in his wheelchair on warmer days”. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 16 “Spent the whole of Christmas day at the home, lunch and tea provided, staff all dressed up and the atmosphere was great.” We were also told during the inspection that there is unrestricted visiting and that staff had arranged a special lunch for a wedding anniversary. One relative commented that there are sometimes difficulties when there are staff shortages, particularly for people who are in bed who need “a little extra time to be spent with them in company and everyday conversation”. However overall the comments received indicate that people are treated as individuals and that things that are important to them are acknowledged and celebrated. A staff member responded to a question in a survey about what the service does well “it interacts well with the needs of people from various backgrounds and different religions”, which indicates an understanding of the importance of this. On the afternoon of the inspection some people were going out on the minibus for a drive through a local park. As people were being assisted onto the bus, there was lots of conversation between staff and people who use the service and also laughter which was clearly as important as the actual trip. During the inspection staff were seen and heard to hold conversations with people who use the service and there was a relaxed and cheerful atmosphere. Positive comments were also received about the meals. “Food is amazing, always a choice, 3 courses.”, “‘------ has put weight on”, “Good choice of breakfast including a cooked option”, “we think the meals are very good, two three course meals a day”. People confirmed that they are offered a choice of meals and the breakfast and lunch served on the day of the inspection looked appetising. People have the choice of eating in the dining room or in their own rooms. Staff were observed to assist people where necessary with their meals and to take account of individual preferences. A record in the dining room clearly detailed different dietary requirements and comments from someone who uses the service confirmed that meals are liquidised when necessary and ‘build up’ drinks given. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures for dealing with concerns and complaints, they are dealt with appropriately and people are listened to. EVIDENCE: Details of how to make a complaint are detailed within the service user guide. Contact details are provided for senior managers within the company for anyone who does not wish to make a complaint directly to the manager or is not satisfied with how their complaint has been dealt with. People told us that they can speak to staff about any concerns and that staff take appropriate action promptly. Someone who uses the service told us that the manager is “always ready to listen”. There is no record of any complaints being received by the Commission for Social Care Inspection (CSCI) since the last inspection. A sample check of the complaint record at Markfield Court identifies that complaints are taken seriously, investigated and that action is taken to address the concerns. Information received in notifications to CSCI confirms that referrals to social services and/or the police through safeguarding vulnerable adults procedures are made as required. Three such referrals have been made since the last Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 18 inspection; information received from Markfield Court and social services indicates that the registered manager has taken appropriate action to report concerns and to safeguard people. A senior staff member spoken with during the inspection was clear about their responsibilities for helping to safeguard the people in their care and the need to report any concerns. However the staff training statistics identify that not all staff have received training in safeguarding of vulnerable adults. Following the inspection the registered manager has advised that some external safeguarding training provided by the local authority has been booked. Training which ensures that staff are able to recognise abusive practices, understand their responsibilities and the procedures for reporting any concerns is considered to be an important part of safeguarding people who use the service. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises were clean and comfortable and there is an ongoing redecoration and refurbishment plan, which provides a pleasant environment for people who use the service. EVIDENCE: The annual quality assurance self assessment submitted by the registered manager identifies that there is an ongoing plan for re-decoration and refurbishment. A sample check of the premises confirmed this. Requirements made at the previous inspection about replacement flooring and re-decoration have been met. There is an ongoing plan for improvement, which includes replacing all the windows with double glazed ones over the next twelve months, re-decoration, Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 20 replacing carpets and updating equipment. Bathrooms are identified for redecoration and refurbishment; currently some of them are rather bare and institutional looking. The registered manager confirmed that part of the redecoration plan would be to improve the visual appearance of the bathrooms. The annual quality assurance self assessment identifies that some staff have received training in infection control. The training matrix identifies that more staff training is required in this area. A staff member confirmed that disposable gloves and aprons are available and are used as part of helping to reduce the risk of infection. There were no unpleasant odours during the inspection and surveys from people who use the service confirmed that Markfield Court is usually fresh and clean. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff selection and recruitment procedures are good helping to safeguard people. Some further training is required to ensure staff have up to date knowledge to meet their responsibilities and the needs of people. EVIDENCE: Positive comments were received about the staff team and included; “Care staff very good, helpful and more importantly – kind”, “staff interact well with all the residents and staff are always cheerful”. We also observed good interactions between staff and people who use the service during the inspection. Out of six surveys received from people who use the service, three said that staff are always available when they need them and three said they usually are. Staff were observed to be responding to call bells in a timely manner during the inspection. One person said they sometimes have to wait a while for assistance and a relative commented, “Occasionally more staff are needed”. Discussion with people who use the service and relatives indicated that people’s needs were being met but that staff were sometimes rushed if they were short usually Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 22 through staff sickness. The comments indicate the need for regular monitoring and discussion with people who use the service about how their needs are being met. Discussion with the registered manager and staff identified that some staff including senior carers had recently left which created a problem with staffing and keeping care plans up to date on the residential unit. The manager confirmed that people had now been recruited to these posts and that staff sickness levels were monitored. The difficulties where staff call in sick at short notice was discussed and assurances given that everything is done to try and find a replacement to ensure that people’s needs are met. At the time of the inspection one person requiring nursing care had been admitted to the floor referred to as the residential floor. We saw that a registered nurse working on the floor below was overseeing this person’s care. The registered manager confirmed that this arrangement would be kept under review and as numbers increase there would be additional nursing staff on duty. Surveys from three staff members confirm that they received induction training, two said it covered what they needed to know very well and one said it mostly did. They also said that they receive training relevant to their role. The training matrix identifies that staff are receiving training; however there are staff who require training or training updates in some areas to ensure that they have the necessary knowledge and skills to meet people’s needs and their responsibilities. Examples of this include infection control. Safeguarding vulnerable adults and nutrition. The annual quality assurance self assessment acknowledges the need to manage staff training more effectively and provide more training. The registered manager advised that some staff are going to do a trainer for trainers course to enable them to carry out some training. Surveys from three staff members confirmed that criminal record bureau checks and references were taken up before they started work. Two staff files were looked at to check the adequacy of the recruitment process. This confirmed that checks including criminal record bureau clearances and references are taken up and that a check of the protection of vulnerable adults is made as part of the recruitment process. In one case a criminal record bureau clearance had not been received, however the registered manager confirmed that the staff member would work under supervision until it was received and deemed as satisfactory. The interview record confirmed that any gaps in the employment history were explored helping to safeguard people who use the service. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an experienced and competent manager who promotes and safeguards the health, safety and welfare of the people living in the home. EVIDENCE: The registered manager has worked at Markfield Court for two years and has become registered as manager with the Commission for Social Care Inspection since the last inspection. This means that she has been assessed as having the necessary qualifications and skills to meet the responsibilities of this role. As the current manager is not a registered nurse, part of this responsibility is ensuring that she has staff in place to oversee the clinical care. The findings of Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 24 this inspection in relation to the nursing care confirm that the arrangements are appropriate. Staff and relatives told us that there have been marked improvements in standards of care in the time that the registered manager has been in post. An example of the comments made to us came from a relative “Sarah has supported us and has never let us down, its so well run”’. A survey received from a relative stated, “The Manager and Deputy manager have really improved the home tremendously. Not only in arranging for improvements but the friendliness and atmosphere is much improved. Long may these two be in charge!” Staff also confirmed that they feel supported in their roles. As part of the quality assurance system, the organisation has internal systems where various audits are carried out to measure compliance with regulations and identify shortfalls. The Operations Manager also carries out unannounced visits at least once a month to check on and report to the organisation on standards of care. Questionnaires are sent out to relatives as part of the quality assurance process on a rotational basis. The improvements in the standards of care indicate that there is an effective system in place. Some people leave small amounts of money for safekeeping to assist with paying for services such as hairdressing and chiropody. This is kept in a central bank account, which accrues interest and is added to each individual account. A sample check confirmed that records are kept of all transactions and receipts kept to verify these. This helps to safeguard people. In a small minority of cases other valuables are kept. There is a system where these are signed in and out. Observations during the inspection were that staff were carrying out safe practice in relation to the movement and handling of people who needed assistance. Training records identify that staff do receive training in safe working practices, however the training matrix identifies some staff who require training updates in some areas including movement and handling. Discussion with the registered manager indicated that some of the training might have been done but not recorded, which she was going to check. This training is important to ensure that staff have the necessary knowledge and skills to reduce the risk for people who use the service. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 25 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 26 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 OP1 Regulation 5 Requirement Timescale for action 30/11/08 2. OP7 15 (1) 3. OP8 12 (1) (a) 4. OP30 18 (1) (c) (i) The Service User Guide must contain all information detailed in Regulation 5, including clear information about all charges. This would help prospective and current people who use the service and their families make informed decisions. Care plans must be reflective of 30/11/08 people’s needs with sufficient information to guide staff in the care to be provided. People’s health and well being 30/11/08 must be monitored in accordance with the assessed risk. This must include the risk of constipation for those people unable to express a problem. Staff must receive training 30/01/09 appropriate to their role and to meeting the needs of the people they care for. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 27 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 OP27 Good Practice Recommendations The sufficiency of staff at different times of the day should be kept under review through discussion with people who use the service. Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Markfield Court Care Centre DS0000001917.V371367.R02.S.doc Version 5.2 Page 29 - 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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