Inspection on 12/10/05 for Marley Court Nursing & Residential Home

This inspection was carried out on 12th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Marley Court Nursing &... 13/10/09

Marley Court Nursing &... 06/11/08

Marley Court Nursing &... 15/04/08

Marley Court Nursing &... 16/07/07

Marley Court Nursing &... 27/02/06

Marley Court Nursing &... 17/01/05

Marley Court Nursing &... 17/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Marley Court Nursing & Residential Home Bolton Road Heath Charnock Chorley, Lancashire PR7 4AZ Lead Inspector Della Lovell Announced 12 October 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Marley Court Nursing & Residential Home Address Bolton Road Heath Charnock Chorley Lancashire PR7 4AZ 01257 226700 01257 234407 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Marley Court Nursing Home Limited Care Home with Nursing 49 Category(ies) of OP - Old age (49) registration, with number of places Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the overall total of 49 a maximum of 34 service users requiring personal care who fall into the category of OP. 2. Within the overall total of 49 a maximum of 25 service users requiring nursing care who falls into the category of OP. 3. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 4. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. Date of last inspection 17 January 2005 Brief Description of the Service: Marley Court is a purpose built home, which is registered to care for service users needing both personal or nursing care. The accommodation at Marley Court is offered on two floors, the first floor being accessed by stairs or passenger lift. The home has a range of single rooms some with en suite facilities and double or companion rooms, some of which also have en suite facilities. There are two lounge/dining rooms, one on each floor and a range of W.C’s and bathing facilities throughout, there is also a fully equipped laundry. The home has a large patio area at the front, furnished with hardwood garden furniture and set around a central fountain. This area, along with the side gardens is fully accessible to service users, regardless of mobility. As Marley Court is situated on the main A6 road from Chorley to Adlington it is well provided by public transport. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over one day in October 2005. Information regarding to standards not assessed at this inspection can be located in the previous inspection report. During the inspection discussions took place with the manager, staff and service users. A number of records were examined as part of the inspection process. Since the last inspection the registered manager has left and a new manager appointed. The new manager is currently going through the registration process with The Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? There have been a number of improvements since the last inspection. The new manager has identified training needs for staff in the home and a programme put in place to ensure ALL staff have completed mandatory training. The laundry has instructions for staff to follow, which ensures there is a good infection control system in place and the complaints record has been amended to ensure it is in accordance with data protection. One of the main improvements in the home was an activity coordinator had been appointed and service users told the inspection how much they were enjoying the weekly programme. Service users had been consulted and a variety of different activities were available. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The pre admission process was not thorough enough to ensure that individual needs were fully assessed. EVIDENCE: The pre admission assessment tool used by the home was mainly an indicator of dependency and not a detailed assessment of need. Pre admission assessments varied in content and did not always give a clear picture of identified needs. There was no evidence to confirm that pre admission assessments carried out by the home involved prospective residents and or their relatives. This meant that residents might not know what sort of care they should expect to receive when they came to live at the home or if the home could meet their needs. The manager said that she or another experienced nurse usually carried out pre admission assessments for prospective residents. This meant that both the home and any prospective resident could be sure that an appropriately trained person had done the assessments. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 Care plans did not reflect the care given and were not detailed enough to support the care process. The approach to health care was good so that needs were generally well managed. EVIDENCE: Care records seen showed that each resident had a plan of care but there was no evidence to show that the plan had been agreed with him or her or a relative. This meant that residents or their relatives had night not know what care they should expect to receive whilst living at the home and that they might not have been given the opportunity to discuss any concerns and identify any specific needs or preferences. Although staff were able to discuss individual needs and how the home met those needs this was not reflected in the care records. Care plans were sometimes too brief, not all health care needs had been included and instructions for staff were not specific enough to help the care process and promote the welfare of residents. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 10 Residents were settled, appropriately dressed and well cared for. Discussion with the manager and staff showed that the home had a positive approach to health care so that residents’ needs were generally well managed. Records showed that people living at the home had access to health care services according to individual need so that specialist advice and treatment could be provided. Residents were generally satisfied with the care they received, comments included “It’s always been alright here, and we’re well looked after”. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Dietary needs of the service users are well catered for with various menus and a choice of meals available to meet individual tastes. The home provides service users with choice and flexibility, which ensures service users, have control over their lives. EVIDENCE: Since the last inspection the home had employed an activity coordinator who works in the home every afternoon from 1pm to 5pm. Two service users told the inspector that they really enjoyed the session. There is a weekly planned programme and both service users where able to tell the inspector what was available each day. One service user said that their favourite session in the week was the “exercise to music”. The manager told the inspector that the activity coordinator had sought information from each service user on likes and dislikes. Service users spoken too were very happy with the current programme being offered. However the inspector noted that a number of service users are cared for in their bed. One service user told the inspector that she misses speaking to people and one comment card received by the Commission said that they felt service users confined to their rooms would benefit from some stimulation. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 12 The home should ensure that the needs and disabilities are taken into consideration and individual one to one time is provided for service users who are unable to participate in-group sessions. Service users told the inspector that the food was very good and that they were always offered a choice. The inspector was able to sit with service users over their lunchtime period. Choices were offered, the tables were set properly both tea and cold drinks were provided and the atmosphere was relaxed and enjoyable. Service users said that they had no complaints and that they were very happy living at Marley Court. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a complaints procedure, which ensures that all complaints would be acknowledged and investigated. The homes procedure for the protection of vulnerable adults does not ensure the protection of service users. EVIDENCE: The home had a complaints policy and procedure in place and this is made available to all service users and their relatives in the service users guide. The procedure is also available in the home for any visitors. Service users spoken too told the inspector they had no complaints but knew who they could speak to if they had any concerns. A policy was available for protecting vulnerable adults from abuse, however there was no clear procedure for reporting and recording allegations. Not all staff had received training and not all staff had received checks with the Criminal Records Bureau, this does not ensure the protection of service users. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 26 The premises were clean and tidy which ensured service users live in a comfortable environment. EVIDENCE: On the day of the visit the home was clean and tidy and the manager was able to discuss with the inspector the homes systems and procedures to control the spread of infection. The laundry was suitable for the purpose, clean and tidy and there were clear instructions for staff to follow with regards to temperatures to wash infected linen. Service users told the inspector that the home was always nice and clean and that their rooms were kept tidy by the staff. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The procedures for the recruitment of staff did not safeguard service users. Staff at the home are provided with some training, however a number of staff are awaiting up dates to ensure they are fully competent in the job they do. Staffing number ensure that service users needs are met. EVIDENCE: On the day of the visit a number of staff files were examined. Since the last inspection the home had developed a checklist to ensure that staff files contained all the appropriate documentation and checks required by law. However the inspector noted that a number of new staff had started employment prior to CRB disclosures being obtained, the inspector discussed the seriousness of this matter with the manager and the provider. One new staff file did not have any information in relation to the home’s recruitment and selection decision and another new carers file did not contain references. The inspector noted that a number of documents were absent from files. There was no information on new staff files to explore previous and past employment history with regards to overseas carers. The current manager is new to the position and informed the inspector that these matters would be dealt with as a priority. Staff files contained information in relation to induction training. Training was available for all existing staff and certificates were seen on some staff files. Since the new manager has come into post all staff have been put forward for moving and handling training. Although the new manager had identified some training needs, a training programme for the home has not been fully developed, the manager is currently looking at this. The home should ensure Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 16 that the training programme is in line with the needs of the service users. Only one care staff had completed an NVQ qualification, this will need to be addressed. Staffing levels in the home were sufficient for the number of service users living in the home. However the inspector noted that over the lunch period two service users required assistance, both staff members on the floor were busy attending to another service user. This was discussed with the staff on duty and the inspector was told that two staff had gone for their lunch-break. The manager was advised of this situation and consideration should be given to the management of staff breaks. Staff spoken too said that they felt they had enough staff on duty to meet the needs of the current service users, however some periods were particularly busy especially with the current level of service users dependency needs being high. There was a rota available in the home showing staff on duty. Staff said that they felt supported by the management team. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 36 Service users live in a home that is managed by a person fit to be in charge. Staff are supervised to ensure that they are competent and confident to do the job. However more attention is needed to documenting information in relation to staff performance and care practise. EVIDENCE: The manager is new to the post and had made an application to The Commission for Social Care Inspection to be registered. The manager is a qualified registered nurse with many years experience of working in care homes. The registered provider meets with the manager on a regular basis and the manager feels supported in her new role. The registered person should ensure that the manager is provided with a job description. Since taking over as the new manager appraisals for all staff have commenced and these were seen documented on staff files. However formal supervision Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 18 has not yet commenced. The inspector discussed with the manager the need to introduce supervision formally at least 6 times a year. It came to the inspectors attention that one new care worker had recently been spoken too with regards their conduct. This had not been documented on the care workers file. Any discussion held with staff regarding concerns or disciplinary matters must be fully documented on the individual staff file. The manager must ensure that all new staff are supervised as a part of their induction which should include direct observation of their care practises. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x x x x 2 x x Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 20 yes 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. Standard OP3 Regulation 14(1) Requirement The registered person must ensure that a thorough assessment of needs is undertaken for each service user. The registered person must ensure that service users and or their relatives are provided with the opportunity to be involved in the assessment and care planning process. The registered person must ensure that the care plans provide written instructions on how the assessed needs are to be met by the staff. The registered person must deveop further the homes policy for protecting vulnerable adults to include a clear procedure for reporting allegations of abuse in accordance with the Lancashire document no secrets in lancashire. The registered person must ensure that staff left in charge are provided with training on the protection and reporting of allegations of Abuse of Vulnerable Adults. (Timescale not met (30/6/05). Timescale for action 30/12/05 2. OP3 OP7 (14(1)(C) 30/12/05 3. OP7 OP8 15(1) 30/12/05 4. OP18 12(1) 13(6) 30/12/05 5. OP18 13(6) 30/12/05 Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 21 6. op29 19(1) 7. op29 19(1) Schedule 2 8. op36 18(2) The registered person must 30/12/05 ensure that information and documentation listed in Schedule 2 of the Care Homes Regulation 2001 in respect of persons working in the home are obtained.(Timescale31/3/05 not met) The registered person must 13/10/05 ensure that all staff have a satisfactory check with the Criminal Record Bureau.(Timescale of 31/3/05 not met) The registered person must 30/12/05 ensure that all new staff are appropriately supervised and this is documented on the individual staff file. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 12 12 Good Practice Recommendations The registered person should ensure that service users social and lesuire interests are recorded at the point of admission. The home should ensure that the activities provided take in to consideration the needs and disabilities of the current service users and individual one to one time is provided for service users who are unable to participate in group sessions. The registered provider should ensure that locks are fitted to the doors of service users rooms and that keys are made available to those service users who want them, following a risk assessment. The registered person should consider the management of staff breaks to ensure that staff are on duty in adeqaute numbers at peak times during the day. The registered person should make appropriate arrangements to ensure staff are qualified to NVQ Level 2 in Care. The registered person should ensure that the manager is F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 22 3. 24 4. 5. 6. 27 28 31 Marley Court Nursing & Residential Home 7. 8. 9. 36 3 provided with a job description. The registered person should ensure that staff formal supervision 6 times a year. The registered person should ensure that the home assessment covers the list in Standard 3.3 of The National Minimum Standards. Marley Court Nursing & Residential Home F57 F08 S25550 Marley Court V251900 121005 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road, Chorley Lancashire, PR7 1NW 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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