Inspection on 23/06/09 for Marlyn House

This inspection was carried out on 23rd June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Marlyn House 29/08/07

Marlyn House 16/06/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Marlyn House 41 Cannock Road Blackfords Cannock Staffordshire WS11 5BU     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kathryn Marks     Date: 2 3 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Marlyn House 41 Cannock Road Blackfords Cannock Staffordshire WS11 5BU 01543504009 01543465750 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Renu Ghai care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 18 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 18 Dementia - over 65 years of age - (DE(E)) 2 Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) 4 Physical Disability - over 65 years of age - (PD(E)) 2 Date of last inspection 0 0 0 0 Over 65 2 4 18 2 Care Homes for Older People Page 4 of 26 Brief description of the care home Marlyn House is a detached residential home about a mile from the centre of Cannock, where all services, shops, entertainment, hospital, and transport can be found. It is a two-storey brick rendered building facing onto Cannock Road, but with ample car parking and domestic garden to the rear. The Home provides 24-hour permanent care for up to 18 older people of both sexes. The home offers one shared bedroom, all remaining rooms are for single occupancy. Most bedrooms have en-suite facilities and several bedrooms are available on the ground floor. A vertical lift is provided for people using the service and appropriate toileting and bathing facilities. A large lounge is available with television, and a separate dining area. A loop system has been fitted in the lounge to improve the quality of life for hearing aid users. At the rear of the home patio doors open onto a level garden area where appropriate garden seating and a summerhouse is available. Individual Service Users Guide identifies the fees which are between £362 to £394 per week, dependent on need. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced Key Inspection was carried out on Monday 22nd June 2009 by one inspector who used the National Minimum Standards for Older People as the basis for the inspection. The last Key Inspection was 29th August 2007. On arrival for this inspection the care manager, senior care, care assistant, cook and two domestics were on duty. The responsible individual joined us later. The hairdresser was also on site. The care manager provided written information regarding staffing, staff training, menu and dietary provision, that was observed to be in place at the home. We discussed with the care manager the arrangements for the day, to avoid disruption to people using the service, staff, and routines in the home. Care Homes for Older People Page 6 of 26 We spoke to people using the service in lounges and bedroom areas. Three peoples care records were checked, and the records of three members of staff, including recruitment and training records. We discussed the food with people living in the home, talked to the cook and observed her offering choices to people using the service. We also looked at the Annual Quality Assurance Assessment (AQAA) this is a self assessment tool, and had been well completed with a lot of detail, and sent to us prior to the key inspection. Completion of the AQAA is a legal requirement and it enables the service to undertake a self assessment, which focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use the service have the information they need to make an informed choice about living at the home. Evidence: The AQAA we received prior to the inspection told us that The service provide detailed information about the home. People receive a contract and statement of their terms and conditions. The service ensures that prospective people have their needs assessed before a decision is made on admission to the home. The service demonstrate to people on admission to the home that they are confident that the home can meet their needs. The service offer trial visits to people to avoid unplanned admissions. The service give advanced notice of any changes regarding payments. The service offers a six week settling in period, and both parties are able to re-assess the placement. We saw the homes Statement of Purpose and Service Users Guide that have been Care Homes for Older People Page 10 of 26 Evidence: updated, and provide detailed information for people who may wish to use the service. We saw records that told us people and their relatives had visited the home prior to admission. There were no relatives visiting the service at the time of this inspection. We saw the care records of three people and examined them in detail. Peoples records contained information collected by the Care manager, who carried out the assessment. We saw that general risk assessments were in place on peoples records including manual handling, fire, and health and safety. This means that peoples needs had been assessed and the home was satisfied it could meet those needs. The manager was reminded of the need to review risk assessments on a regular basis. The home does not provide intermediate care. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people using the service are met, personal care is delivered in the way the individual wishes. The administration of medication must protect the people using the service. Evidence: The AQAA we received prior to the inspection told us that Each person using the service is supported to make their own decisions. With agreement of the person the service works with individuals, their relatives and carers in order to provide the best support for the individual. The care workers are trained in giving choice to people and ways in which to facilitate users to make decisions. We received two surveys from health care professionals that told us that: The care services assessment arrangements ensure accurate information is gathered Peoples social and health care needs are properly monitored Care Homes for Older People Page 12 of 26 Evidence: The service always seeks advice and acts on it to meet peoples social and health care needs The services manager and staff have the right skills to support people I feel the service provided at Marlyn House is at a very high standard A good all round service is being provided We received two surveys from relatives of people using the service that told us that: Service looks after all aspects of my relatives care They look after everybody We checked the care records of three people during this inspection. We saw that records contained information regarding health care, personal care and socialisation that are reviewed on a monthly basis. We saw health care records that identified people are registered with the local health care practice. Appropriate referals are made to professionals as necessary. We observed that medication is administered from a blister pack monitored dosage system, with the exception of medication not compatable with the system. We observed that medication was being decanted into pots from the blister pack, and taken around to people in the lounge in a pot with name in. These practices place people at risk. The appropriate administration of medication will be a requirement of this report. We saw throughout this inspection courtesy being shown to individuals, with privacy and dignity being promoted. Induction for staff includes the promotion of privacy and dignity, the Care Manager and responsible individual for the service have attended privacy and dignity course. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service make choices about their daily lifestyle. The food provided is of a high standard, with a varied and nutritional diet being offered. Evidence: The AQAA we received prior to the inspection told us that The service have strong links with the community so that people using the service can access local activities. The home recognises the importance of personal and social relationships that people have and are respectful of peoples privacy. The home has areas where people can meet with relatives, friends, professionals and not be disturbed. People are able to have their own private phone line into their rooms. People can bring in personal possessions and not be disturbed. Three meals a day are offered, snacks and drinks are available 24 hours, special diets are catered for. We received surveys from three people using the service that told us: I am happy enough here If I want anything I only have to ask One person thought more entertainment could be provided Care Homes for Older People Page 14 of 26 Evidence: Three people told us I always get the medical care I need Three people told us always like the meals very satisfied with the care I receive Make me feel safe and looked after well We looked at the care records of three people using the service, social contacts and daily activities are recorded along with outings into the community. Some people go out with relatives. We observed that peoples privacy was promoted with staff telling people what they were doing, and asking permission to enter their personal space. Discussions with people identified a relaxed atmosphere where the needs of people were respected. We saw a small private area with seating where people using the service can meet with their relatives, or any person they wish to see and not be disturbed. One person currently has their own private telephone line. We saw that people had brought favourite items with them to personalise their bedrooms, including some furniture. Lots of pictures, photographs and familiar possessions. We saw a varied nutritional menu in place that people told us is discussed with them. We saw the cook talking to people and offering them choices at mealtimes. Special diets are catered for as necessary. If someone wants to have a meal in their bedroom then they are able to do so. People told us they thoroughly enjoyed their food at Marlyn House. This means that people using the service are able to make choices and live fulfilling lifestyles. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make complaints and are safeguarded by the homes procedures. Evidence: The AQAA we received prior to the inspection told us that The service has a clear and accessible complaints procedure illustrating timescales and how complaints are dealt with. All people using the service are informed of the complaints procedure and would be fully supported by staff in making their complaint. The care home keeps records of all complaints received and the action taken. All staff are trained in the Protection Of Vulnerable Adults and work to these regulations. Procedures are in place to respond to evidence or suspicion of neglect. The home ensures that people are safeguarded from physical, financial, or sexual abuse, neglect discriminatory abuse or self harm, inhuman or degrading treatment. The home adopts the opinion that each person has the capacity to make all their decisions unless proved otherwise. Staff are also aware that peoples capacity may change. We saw the home has in place a complaints book, no entries have been made since the last inspection. There have been no complaints made to the home or the commission. We talked to people in the home using the service. People told us that they would talk to staff if they were unhappy about something and they would sort it out. Care Homes for Older People Page 16 of 26 Evidence: We saw that peoples rights are protected by systems in place at the home, including their contract, ongoing assessments, policies and procedures in place. We saw that peoples finances are managed by themselves and their relatives. We saw staff training records that identified staff have received training in Protection Of Vulnerable Adults. We saw that equality and diversity is promoted at the home via policies and procedures in place. The service has a mixed workforce with team members coming from various backgrounds. We saw all people using the service offered the same choices. We saw on staff files that Criminal Records Bureau and Protection of Vulnerable Adults checks are carried out, and two written references are taken up prior to employment. This means that people are cared for by appropriately recruited staff. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people to live in a safe, clean, well maintained and comfortable environment. Evidence: The AQAA we received prior to the inspection told us that The service ensures the environment is maintained and offer people a homely place to live. The home is maintained appropriately to reduce the risk of infection and cross infection. The home provides infection control training to all staff so that they are aware of the importance of prevention. A programme of routine maintenance works is kept within the home. The home complies with the requirements from the fire service. Communal space is available outside the home for people to access. Toilet and bathing facilities are available to meet the needs of people using the service as set out in the national minimum standards. The home has a call system with an accessible alarm facility in every room. The home provides private accommodation for people, it is furnished to a comfortable standard. We saw that the design and layout of the home meets the needs of the people using the service. The communal areas are comfortable and homely, people were relaxed and moving freely around the home. We saw the home was clean and well maintained, individual bedrooms were Care Homes for Older People Page 18 of 26 Evidence: personalised with favourite items of the person occupying the room. We saw that Health and Safety checks and services are carried out, with hazardous substances securely stored. We saw staff training records that identify staff have received infection control training. Policies and procedures are in place for the control of infection. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well trained and consistent staff team support the people using the service. Evidence: The AQAA we received prior to the inspection told us that The home ensures that all staff operate in a manner which promotes liberty, we enable people to feel safe and secure whilst promoting independence. As an organisation the service recruit in a fair and open way ensuring they employ the right people. The service carry out various checks on possible employees for example, Criminal Records Bureau checks, references employment history. All staff receive a job description and handbook. The care home has an appropriately qualified workforce with at least 85 of staff holding NVQ Level 2 or above. We saw staff records of the last three people employed by the home. Records told us staff have received appropriate pre-employment checks prior to commencing work at the home. We saw staff training records in staff files, that identified staff are trained to National Vocational Level 2. Four staff are currently doing NVQ Level 3, four staff have NVQ Level 3. The Care Manager told us she is developing a training matrex to easily identify the staff training requirements. Care Homes for Older People Page 20 of 26 Evidence: We were told by the Care Manager that staff are being trained to do risk assessments. Records told us senior staff and four care staff have done dementia care training, this is planned for rest of the staff team. We saw that senior staff and the Care Manager have completed Foot Care Course. We talked to the Care Manager who told us that she is able to discuss issues with the proprietor and generally feels well supported. We talked to members of staff who told us they receive training opportunities, and that mandatory training is carried out. We talked to the cook who told us provisions are ample and that fresh produce is used. We talked to the Care Manager who told us recruitment is via the local newspaper or word of mouth recommendations. There is a nucleus of long standing staff at the home caring for people using the service. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service are safeguarded by an experienced manager. Evidence: The AQAA we received prior to the inspection told us that The service has up to date policies and procedures. The service arrange meetings for people using the service and staff meetings on a regular basis, and act on the issues raised. The registered manager and the proprietor are working side by side to improve the peoples quality of life. All staff have induction training and then regular meetings and appraisals to identify their learning needs. The Care Manager has 13 years experience in caring for the elderly. Four years at this home as Deputy Manager and two years as Care Manager. She is currently registering to do the Managers Award. We saw records that told us the Care Manager and the Responsible Individual have attended training on the Mental Capacity Act. The Care Manager and Senior Care have Care Homes for Older People Page 22 of 26 Evidence: attended training in Privacy and Dignity In Care. We saw that good leadership was in place, and observed the manager to be competent. The manager attends all training with staff to keep herself up to date with current practice and guidelines. We saw quality monitoring systems in place, a sample of questionnaires that had been sent out to people and an analysis of the results had been completed. We observed safe working practices to be in place, staff records show that health and safety training has been completed. We saw that a fire risk inspection had been completed in April 2009. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person shall 02/07/2009 make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. To ensure medication is administered safely. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!