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Inspection on 20/06/07 for Markfield Court Care Centre

Also see our care home review for Markfield Court Care Centre for more information

This inspection was carried out on 20th June 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is well run, the management style of the acting manager is open and inclusive resulting in residents and staff feeling supported. Care plans and assessment records clearly detailed the needs and preferences of residents. A comprehensive quality assurance system was in place. Staff training is ongoing and ensures that staff are competent to meet the needs and maintain the safety of residents. The quality of meals provided was good. A varied and nutritious diet was being provided.A wide range of social activities was on offer. Frequent opportunity was provided for residents to go on trips out of the home.

What has improved since the last inspection?

Since the last inspection the heating and hot water systems have been repaired and are now in working order. Staff have worked hard to improve care planning and assessment records and this work was ongoing.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Markfield Court Care Centre Ratby Lane Markfield Leicestershire LE67 9RN Lead Inspector Debbie Williams Key Unannounced Inspection 20th June 2007 10:00 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.V339509.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Markfield Court Care Centre DS0000001917.V339509.R01.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 Vacant 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.V339509.R01.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. Key inspection 16th November 2006. Random inspection 31st of January 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. The home 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. The home has forty-five single bedrooms and twenty double bedrooms many are en-suite and some open directly onto the garden. The home offers numerous lounges and dining rooms and specialised bathing facilities are available throughout the three floors of the home. At the time of the inspection there were forty-nine residents living at the home. The fees ranged from £311 to £800 per week depending on the level of support required. A copy of the last inspection report was available at the home. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and was facilitated by the acting manager. The focus of inspections is upon outcomes for residents living at the home and obtaining their views of the service provided. The main method of inspection used was ‘case tracking’ which meant selecting four residents and tracking the quality of their care by checking records, discussion with them, discussion with visitors to the home and with staff. Information provided within an annual quality assurance assessment which is completed by the provider was also used to gather evidence for this inspection. This inspection was unannounced, staff and on duty were helpful and professional at all times. Four requirements and one recommendation was made. What the service does well: The home is well run, the management style of the acting manager is open and inclusive resulting in residents and staff feeling supported. Care plans and assessment records clearly detailed the needs and preferences of residents. A comprehensive quality assurance system was in place. Staff training is ongoing and ensures that staff are competent to meet the needs and maintain the safety of residents. The quality of meals provided was good. A varied and nutritious diet was being provided. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 6 A wide range of social activities was on offer. Frequent opportunity was provided for residents to go on trips out of the home. 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 Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 7 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.V339509.R01.S.doc Version 5.2 Page 8 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.V339509.R01.S.doc Version 5.2 Page 9 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): Standards 1 and 3. (Standard 6 is not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Prospective residents are provided with the information they require prior to moving into the home and can be assured that their needs are fully assessed. EVIDENCE: A copy of the information provided to prospective residents was seen and this included the service users guide, a copy of this is also provided to each resident on admission. One resident spoken with confirmed they had received this information. The care records for four case tracked residents were inspected and found to contain a full needs assessment which included risk assessments and social worker assessments were applicable. One resident spoken with confirmed they had been given the opportunity to visit the home prior to moving in. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 10 A needs assessment is carried out for each prospective resident prior to moving in, this is undertaken by the acting manager or by the assistant manager. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 11 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): Standards 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans indicated that resident’s health and personal care needs were being met. EVIDENCE: Care plans for four case tracked residents were inspected. Care plans were comprehensive and included risk assessments and life histories. Care plans were reviewed at least monthly. A six monthly review is also held; residents and their families are invited to participate in this review. Daily records provided a summary of daily events, care provided and resident’s wellbeing. There was evidence of staff seeking the advice of and liaising with healthcare professionals such as tissue viability nurses, community nurses and GP’s. Social work care plans and reviews were seen within care records where applicable. Wound assessments were ongoing and also comprehensive. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 12 Medication administration charts and storage areas were seen for one area, medication was being stored correctly and records appeared accurate. Qualified nurses or senior carers who have received training, order and administer medication. Once training is provided staff are then supervised and their competency assessed. Medication is reviewed by the residents GP at least six monthly. The acting manager regularly audits medication administration and storage. Interaction observed between staff and residents appeared friendly and respectful. Residents spoken with felt that staff were respectful and maintained their privacy and dignity. Staff received training regarding privacy and dignity and treating residents with respect as part of their induction training. Further staff training in customer care was also being provided. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 13 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): Standards 12 – 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Policies and practices in place promote choice and autonomy for residents and lifestyle expectations are usually met, however, staffing numbers were not always adequate to meet the needs of residents causing choice and autonomy to become limited. EVIDENCE: Residents spoken with felt the service met their lifestyle expectations, residents were aware of the social activities on offer and these included regular trips outside of the home. Residents also confirmed that they could choose how to spend their day, when to get up and when to go to bed, however, three residents spoken with said that on some occasions they had to wait for staff to attend to their needs, one resident and their visitors said that during mealtimes staff were too busy to help with other daily living activities and so they had to wait until the mealtime was over before staff could attend to them One resident said that they did not always get their morning cup of tea if staff were too busy. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 14 Two activities organisers are employed on a part time basis. A wide range of activities was on offer, these included monthly trips out, coffee mornings, dominoes, a weekly shop, library and puzzle morning, arts and crafts, mystery tours in the mini bus with flasks of tea and entertainers coming into the home. The activities organiser spoken with said she used every opportunity to get residents out of the home even if it’s a quick trip out to the shop. The activities organisers provide one to one time for residents who are unable to participate in the outings. The wide and varied range of activities offered is commended as good practice. Fortnightly church services and a monthly ‘songs of praise’ afternoon are provided. At the time of this inspection there were no residents from ethnic minority communities living in the home. Residents and visitors spoken with confirmed that visitors were made welcome by staff and could visit at anytime. Residents spoken with praised the quality of meals provided and said they were always offered a choice. The lunchtime meal was served during this inspection, the meal appeared appetizing and nutritious and the dining areas congenial. One resident was feeling tired during lunchtime and decided to take their meal later, staff spoken with said that this wasn’t a problem and that kitchen staff were very helpful. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents felt confident that complaints were listened to and acted upon. Policies and procedures promote protection from abuse. EVIDENCE: A record of all complaints received is maintained. The acting manager was able to demonstrate a good understanding and awareness or complaints and adult protection policies and procedures. Staff spoken with were also aware of complaints and safeguarding policies and procedures and had received training in this area. Further adult protection training was also planned in for staff. Residents and visitors spoken with said they were aware of how to make a complaint and would feel comfortable speaking to staff about any complaints. The complaints procedure was displayed in the reception area. Information provided within the pre inspection quality assurance assessment confirmed that all complaints would be responded to within twenty-eight days and that a weekly managers surgery was held. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 16 Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 17 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): Standards 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents live in a clean and comfortable environment but some attention to décor and maintenance is required in order to ensure the environment is also safe and pleasant in all areas. EVIDENCE: All areas of the home appeared very clean. Residents own rooms were personalised and appeared comfortable and homely. Residents spoken with were happy with their rooms. The décor on the corridors throughout the home appeared a little shabby with ripped wallpaper and peeling paint. Communal bathrooms lacked any homely decoration or furnishings and so were ‘institutional’ in appearance. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 18 The flooring in one bathroom was uneven and was causing a trip hazard. The carpet in the ‘smoking lounge’ was covered in cigarette burns and needed replacing. Information provided within the pre inspection quality assurance assessment confirmed that further redecoration and replacement of some carpets was being planned. Policies and procedures were in place for the control of infection. One staff member spoken with was able to demonstrate a good awareness and understanding of infection control policies. The acting manager confirmed that all hot water and heating in the home was in good working order. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 19 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): Standards 27 – 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Staffing numbers did not meet the needs of residents. Staff were trained and competent to do their jobs and recruitment procedures promoted protection for residents. EVIDENCE: Staffing rosters were inspected for the previous three weeks prior to this inspection; there were ten staff on duty during daytime hours and six at night. Residents spoken with felt that staff worked hard but there were not enough staff on duty and that on some occasions they had to wait for staff to attend to them. One resident and their visitors said that if they needed attention during a meal time they had to wait until the meal time was over before staff could attend to them. Staff spoken with also felt staffing levels were too low to meet the needs of residents. The personnel file for one staff member was seen and found to contain all relevant references and checks. Copies of training certificates were also seen. All staff receive induction training, each new staff member is assigned a Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 20 mentor and provided with an induction booklet and checklist. A copy of the training matrix was seen, training is ongoing, a list of training available for staff was seen on the staff notice board. Residents spoken with felt that staff were competent and well trained. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 21 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): Standards 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home was well run in the best interests of residents. EVIDENCE: At the time of this inspection the manager post was vacant and an acting manager was in place. The company were in the process of recruiting a registered manager. All staff and residents spoken with felt the acting manager was approachable and supportive. A programme of quality assurance was in place. Audits were undertaken by the acting manager and by a senior manager, copies of these were seen. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 22 Secure storage was available for small amounts of resident’s personal money. Records were maintained and two signatures obtained for each transaction. All mandatory health and safety training was provided. Records seen and staff spoken with confirmed this. All accidents are recorded and these records audited. Health and safety polices and procedures were in place, staff were aware of these and had received training in this area. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 23 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 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.V339509.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP27 OP19 Regulation 18 23 Requirement Timescale for action 31/07/07 3. 4 OP19 OP19 23 23 Ensure staffing levels are appropriate to the needs of residents at all times. The décor in the corridors of the 30/08/07 home requires attention in order to bring it up to an acceptable standard. The carpet in the smoking 30/08/07 lounge requires replacing. The uneven floor in the 31/07/07 communal bathroom (third floor) requires repair in order to maintain the health and safety of staff and residents. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 25 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 OP19 Good Practice Recommendations Communal bathrooms should be decorated and furnished a domestic manner in order to provide a homely environment for residents. Markfield Court Care Centre DS0000001917.V339509.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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.V339509.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!