Inspection on 15/10/05 for Marlstones Care Home

This inspection was carried out on 15th 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

Marlstones Care Home 16/07/07

Marlstones Care Home 24/07/06

Marlstones Care Home 22/02/06

Marlstones Care Home 18/03/05

Marlstones Care Home 01/06/04

Marlstones Care Home 17/02/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Marlstones Care Home Adgate Close off Rock Street Bulwell Nottingham NG6 8QU Lead Inspector Rob Cooper Unannounced Inspection 15th October 2005 10:20 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 Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 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. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Marlstones Care Home Address Adgate Close off Rock Street Bulwell Nottingham NG6 8QU 0115 9270629 0115 9760452 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) Nottingham City Council Mrs Cecilia Broughton Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 8 service users may be under the age of 65 years, but over 55 years 18th March 2005 Date of last inspection Brief Description of the Service: Marlstones is residential care home for older people, owned and managed by Nottingham City Council. It is located to the north west of the city centre in the Bulwell area. The building covers two floors, with the upper floor being accessed either via a staircase or a passenger lift; as a result people with restricted mobility can be accommodated. Marlstones is currently registered for forty-eight places of which four might be emergency/ short term care beds. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection took place through the middle of the day with one Inspector present and lasted approximately three and a half hours. The Registered Manager – Cecilia Broughton was present throughout, and facilitated the Inspection. The methodology used was to visually inspect the premises, speak with a number of residents, some of the staff and to case track three residents which involves looking at specific care records, talking to the individual residents, and their carers, in order to make a judgement regarding the quality of care that they receive. Marlstones was found to be well organised, and well run, and provide a good service. What the service does well: What has improved since the last inspection? What they could do better: The Service User Guide needs amending to include details of the Commission for Social Care Inspection. Staff training around the Protection of Vulnerable Adults needs to be organised. Resident’s care plans and risk assessments need to be formally reviewed on a monthly basis. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 6 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. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 123&5 Prospective residents would have most of the information they would need to make an informed choice regarding coming to live at Marlstones. Not every resident has a written copy of the terms and conditions of residence or a contract. Every resident has their needs assessed prior to moving into Marlstones. Trial visits are part of the Marlstones admission procedure. EVIDENCE: The ‘welcome pack’ for Marlstones, which incorporates the Statement of Purpose and the Service User Guide was seen. There is no reference to the Commission for Social Care inspection within this pack, or the role undertaken by the Commission. Three resident’s files were seen, and a statement of terms and conditions of residence and or a written contract were not present within the files. There was a copy of the Extended Community Care Assessment in each file, together with a range of internal Marlstones assessment tools. Trial visits were discussed with the manager, and there was documentary evidence within one file that an introductory visit had taken place. In addition one resident said when asked, that before moving in, she had visited with her family, and had then come for a day, to “see how she liked it.” Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 & 11 Resident’s health, personal and social care needs are set out in a plan of care within their file. Resident’s health care needs are potentially not being met, as care plans are not being reviewed on a regular or current basis. Resident’s safety is being protected in relation to medication by Marlstones’ policies and procedures. Residents are assured that at the time of their death, staff will treat them and their families with respect, dignity and care. EVIDENCE: Three resident’s files were seen, and these all contained a plan of care, covering health, personal care and social needs. However one plan had not been reviewed since November 2004, while another had last been reviewed in May 2005. The National Minimum Standards state: “The Service User’s plan is reviewed by care staff in the home at least once a month ….” (Standard 7.4). Currently no residents self-medicate, but a Monitored Dosage System (MDS) is used which is provided by Boots the Chemists. Medication records were seen and checked and found to be correct and in order. All three files that were seen had well documented plans for funeral arrangements, with all three people also having paid into pre-paid funeral plans. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15 Residents do have a lifestyle that matches their preferences, and satisfies their social, cultural, religious and recreational needs. Family contact for residents at Marlstones is encouraged and facilitated. There is an element of choice in many areas of daily life at Marlstones. Residents at Marlstones receive a wholesome appealing diet in comfortable surroundings. EVIDENCE: Six residents were spoken with during the Inspection and asked about different aspects of their life at Marlstones. One individual said they were: “Quite happy”, and another told me that: “There was a lot going on.” A member of staff said that there was not an activities co-ordinator, but activities are arranged in-house. There had recently been a trip to the Royal theatre – with pre-theatre drinks, and a fish and chip supper on the way home. There is an open visiting time at Marlstones, and during the Inspection two separate relatives were spoken with. Generally everyone was reasonably happy with the service their relative received, although one commented that: “They could do with some more entertainment, as there is not enough stimulation either mental or physical, and there is no encouragement to exercise.” Both sets of relatives thought that their particular relatives was well looked after, and treated with respect by the staff. There were numerous examples of choice Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 11 being offered to residents, with regard to drinks, activities and meals. Three residents when asked said that there was always a choice at mealtimes, and that the staff often asked them to make choices in other areas of their lives. The records kept in the kitchen were found to be correct and complete, and the cook was in the process of making a homemade birthday cake for one of the residents. The menu was displayed and there was ample choice, including a soft option for those who have difficulty chewing. Records of food eaten, and choices made were also kept. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 17 & 18 Residents and their relatives are confident that their complaints will be listened to, and acted upon. Resident’s legal rights at Marlstones are protected. Residents at Marlstones are potentially at risk of abuse. EVIDENCE: The complaints procedure at Marlstones is prominently displayed, and both relatives who were asked said that they knew how to complain, and who to complain to, although they also said that they had not had cause to complain. Two residents said that postal voting was arranged at the last election. Staff training records showed that not all staff had undertaken training in abuse, and the Protection of Vulnerable Adults (POVA). This leads on to residents being potentially at risk of abuse, due to the lack of staff training and awareness. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 22 24 25 & 26 Residents at Marlstones live in a safe well-maintained environment. Residents have easy access to safe and comfortable indoor and outdoor facilities. There are sufficient lavatories and washing facilities for residents. There is a range of specialist equipment to aid resident’s independence. Resident’s bedrooms are safe and comfortable, as are the communal areas. Marlstones is clean, pleasant and hygienic. EVIDENCE: A visual inspection of the premises showed Marlstones to be safe and well maintained. The repair log was seen, and this showed that there is a system in place for routine maintenance. The fixtures and fitting were seen to be in a sound condition. There is a small bar area where residents can relax, and enjoy an alcoholic or soft drink, and there was evidence of communal areas being made ‘homely’. There were several lavatories situated throughout the building, both on the upper and ground floor. The bathrooms had a range of features to assist with independence, with chair lifts and raised toilet seats among the features noted. The passenger lift is a ‘talking lift’, which informs Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 14 passengers of doors opening and closing, and the floor level that the lift has arrived at. This greatly enhances resident’s independence, as some residents are able to use the lift independently as a result of this feature. A number of resident’s bedrooms were seen, and these were all found to be comfortable, well personalised and well equipped. Two residents were asked about their bedrooms, and both said they liked them very much. The building that accommodates Marlstones is far from ideal, however it presents as clean, and welcoming and there is clear evidence of ‘home making.’ Two members of the domestic staff were spoken with, and cleaning schedules and routines were seen. On the day of the Inspection the building smelt fresh, and was tidy. A small spillage was observed in the dining room, but this was quickly dealt with by staff, who removed the spill, and made the area safe for residents to use. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 & 30 Resident’s needs are met by the skill mix of the staff on duty. There are sufficient numbers of staff on duty at all times to ensure resident safety. There is limited staff training on offer to team members at Marlstones. EVIDENCE: The staff rota covering a four-week period was seen, and this showed that there were sufficient numbers and levels (in terms of seniority) of staff on duty for all shifts throughout that period. The staffing rota showed a hierarchy within the staff team, so that ‘senior’ members of staff were always on duty, and able to take responsibility should the need arise. Staff training records were seen, these showed that a range of training particularly around induction and mandatory training for fire and first aid was available, and staff had taken part in this training. However some staff had not received training in Adult Abuse or Protection of Vulnerable Adults. Members of staff who were asked about their abuse training also said that they had not received any specific abuse training. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 36 & 38 Marlstones is run in a way that is in the best interests of the residents. Staff members at Marlstones are appropriately supervised. The health & safety, and welfare of the residents and staff is protected at Marlstones. EVIDENCE: Three residents were asked for their views about how Marlstones operates, and all three said they were quite happy, and they thought it was ‘pretty good’. Observations through the day supported this view, with staff seen to be polite and treating residents with dignity and respect. Daily routines were seen to be supportive of resident’s lifestyles rather than imposing on them. Two formal staff supervision records were seen, and these confirmed that formal staff supervision is taking place. Two members of staff were asked about their experiences of supervision, and they explained the procedure. Both members of staff independently said that on top of their formal supervision, the manager was readily available, and that she was very supportive of the staff team. A Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 17 range of health & safety records covering such areas as the Control of Substances Hazardous to Health (COSHH), Fire and water temperature testing were seen, and found to be correct and complete. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 4 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 3 X 3 Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 (1) f Requirement The Registered person shall produce a written guide to the care home which shall include: the address and telephone number of the Commission (CSCI) The Registered person shall produce a written guide to the care home which shall include: the terms and conditions in respect of accommodation to be provided for service users, including as to the amount and method of payment of fees. The Registered person shall keep the service users plan under review. The Registered person must ensure that all staff members receive training in abuse and the Protection of Vulnerable Adults (POVA) so that service users are safeguarded from physical, financial, or material, psychological or sexual abuse, neglect, discriminatory abuse or self-harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance, DS0000037295.V262271.R01.S.doc Timescale for action 28/02/06 2 OP2 5 (1) b 28/02/06 3 4 OP7 OP30OP18 15 (2) b 18 (1) c (i) 28/02/06 30/06/06 Marlstones Care Home Version 5.0 Page 20 in accordance with written policies. 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 OP12 OP7 Good Practice Recommendations The Registered person should consider the level of entertainment, and physical and mental stimulation available to residents. The Registered person should ensure that the resident’s Care Plans are reviewed by care staff in the home at least once a month. Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Marlstones Care Home DS0000037295.V262271.R01.S.doc Version 5.0 Page 22 - 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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