Inspection on 16/02/06 for Marmion Nursing Home

This inspection was carried out on 16th February 2006.

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.

Other inspections for this house

Marmion Nursing Home 16/09/05

Marmion Nursing Home 03/03/05

Marmion Nursing Home 29/12/04

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

CARE HOME ADULTS 18-65 Marmion Nursing Home Stretton Street Glascote Tamworth Staffordshire B77 2BH Lead Inspector Mrs Sue Mullin Unannounced Inspection 16th February 2006 12:00 Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 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 Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 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 Adults 18-65. 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. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Marmion Nursing Home Address Stretton Street Glascote Tamworth Staffordshire B77 2BH 01827 67953 n/a 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) Grangemoor Care Homes Steve Bridges Care Home 24 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (24) of places Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th September 2005 Brief Description of the Service: Marmion care home with nursing accommodates residents suffering from with mental health disorders from the age of 18 years and over. The home caters for 24 service users in total. The home is built on two levels accessed by a passenger lift and has communal areas, two lounges and a dining room. There are three bathrooms, including a shower facility and five separate toilets throughout the home. Five single rooms have en suite facilities. The home is situated less than one mile from the centre of Tamworth and has a bus stop 400 yards away. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector conducted this unannounced inspection on the 16th February 2006. The home was in the charge of a trained nurse who assisted positively throughout the inspection. The home does not have registered care manager in position at the present time and the Commission are currently awaiting a completed application from the proposed care manager. A sample tour of the Home was undertaken, care plans examined and staff and residents were engaged in conversation, regarding the management of the home. All the residents approached were complimentary of the care, service and attention they received from a willing, attentive care team. There were 23 residents on the day of inspection, with one vacancy. The home appeared to be well run, comfortable with a ‘homely’ feel. Everyone appeared at ease with his or her surroundings. There were no poorly residents in the home on the day of the visit and no residents required the use of the hoist. Verbal feedback was given at the end of the inspection. The annual updates for Fire Safety and moving and handling training are planned for all staff during March 2006 and this will be checked on the next inspection. What the service does well: The home and its ethos strive to make sure that all residents have full lives. Some attend a range of educational, occupational and leisure activities and go out most days. Others are encouraged to choose the social activities they want to do. Staff know the residents well and support them to meet their needs help them to make choices about their lives. The staff ensure they receive the health care treatment they need. The staff team are united and get on well with the residents. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 6 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 contacting your local CSCI office. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 Residents were only admitted after a full assessment ensuring that the home was as far as possible aware of residents needs and the home therefore only admitted people whose needs they could meet. Staff’s training and knowledge, and the homes’ links with external agencies ensured that the residents’ holistic needs could be met. EVIDENCE: A sampling of files took place and following discussions it was evident that assessments were undertaken prior to a decision being made over admission. This was completed both by the local authority and a suitably qualified member of staff from the home. Assessments covered the areas of health and personal care, social and educational issues, family involvement and occupational needs. Copies of risk assessments were on file and care plans had been developed from the assessment. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 9 Staff confirmed, and records seen, identified that staff had undertaken relevant training and had the knowledge and skills to meet the needs of the residents. Staff spoken to were fully aware of the residents individual needs and this corresponded with the care plans. Records confirmed that the home arranged for the health care needs of the residents to be met. This included specialist services such as psychology, behavioural services and psychiatry. All the residents were supported to access educational, occupational and leisure activities and the home had developed positive links with the local colleges. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Several residents are involved in the planning of their lives in every aspect, enabling them to work to achieve their aspirations and goals at their own pace. The home encouraged decision-making and participation in household activities providing residents with choice, some control over their lives and the opportunity to influence aspects of the running the home. The risk assessments in place provided residents with the support to take reasonable risks as part of their lifestyle. EVIDENCE: The sample of resident documentation examined confirmed that appropriate care plans were in place. Plans covered the areas were residents needed support, including health and personal care, social and educational activities. No residents had specific cultural needs. Residents were encouraged to attend and care planning reviews. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 11 Residents were encouraged to take decisions over their lives and over issues relating to the running of the home. Two residents spoken to confirmed that they had choice over what to do and how and where to spend their time. They were able to choose whether to go out or to spend time in the home. Advocates were involved when required to support residents in the decision making process. Those that were able were involved in budgeting and managing their own money. Formal residents meetings/discussions are scheduled to take place regularly. Staff spoken to were aware of individual residents abilities to make decisions and different strategies that they could use to encourage choice. Residents were involved in a range of independent living and household tasks such as tidying their rooms, laying tables and so on. Resident’s individual differences and wishes were respected. A range of individual relevant risk assessments were on file, including smoking in the home and these showed evidence of being reviewed. All personal documentation was up to date and stored in line with The Data Protection Act 1998. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Residents lead a fulfilling life maintaining worthwhile relationships with others both in and outside the home. The regular access to the community and the opportunities for educational, social and leisure activities provided residents with a full and varied lifestyle. The meals provided the residents with variety and catered for special dietary needs. EVIDENCE: Several residents attended external organised educational and occupational activities. They attended day services, college and one resident worked four days a week. Activities included a variety of interests and promoted independent living skills. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 13 Some residents accessed the community regularly and enjoyed shopping, going to the pub and bowling. Within the home the residents engaged in a range of board games, jigsaws and arts and crafts. Staff were discreetly observed responding to the residents and enabling them to make their own choices throughout the day, including what to do with their time, meal choices and the like. Staff confirmed that residents were encouraged to enjoy a healthy diet. Choices were evidenced as there were several alternative meals provided at lunch during the inspection. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21 The home supported the residents to maintain their personal care needs in a manner that considered their dignity and preferences. All aspects of service users health needs are met. Their comfort and well-being are at the heart of the service. EVIDENCE: The personal and health care needs of the residents were identified in the care plans and discussions with staff showed them to be fully aware of residents’ needs. The majority of residents needed little physical support to maintain their personal care but required differing levels of support and encouragement. Discussion with the nurse in charge and inspection of records found that resident’s health needs were being addressed. Residents accessed the GP, the chiropodist, the dentist and the optician as well as specialist health care staff such as psychiatrists, and community mental health professionals. A record was kept of all appointments and outcomes. Records showed that residents had conditions such as epilepsy and diabetes were closely observed and regularly reviewed. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 15 The home is currently in the process of re introducing the primary nurse and key worker system and the progress on this will be checked on the next inspection. The arrangements in place for the storage and administration of medication were not checked on this occasion. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The views of residents are listened to and assistance is offered of how to complain if they are not happy with any aspect of the service. EVIDENCE: The home has an appropriate Complaints Procedure in place and this is available in the Statement of Purpose and Service User Guide. There have been no complaints received either by the home or to the Commission since the last inspection. Aspects of day-to-day life that may cause minor grumbles/concerns are discussed on an individual basis as they arise, and regular residents meetings regarding aspects of living at the home are held and documented. Training with regard to the Protection of Vulnerable adults was discussed at length and although most of the care staff have received this training through NVQ Level 2, the nurse in charge during the inspection, assured the inspector that this would be strengthened by further in house sessions. Progress on this will be checked at the next inspection. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The home is well designed and meets the needs of the client group in a homely, comfortable and safe way. EVIDENCE: The home was suitable for the residents and was within walking distance of shops and on a bus route. The home’s decoration and furnishings were all of a domestic type and were of a reasonable standard. He majority of resident are quite heavy smokers which tends to discolour some of the smoking areas. The home was well maintained accommodation was on two floors accessed by a passenger lift although several residents used the stairs. There was a patio area and a pleasant rear garden. Parking spaces were available at the front of the home. The home appeared clean and tidy throughout. Cleaning schedules were Undertaken by suitable levels of domestic staff. Only two residents suffered with incontinence and suitable aprons and gloves were available. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35 The home’s staff are well trained, well supported, motivated and are fully aware of the aims of the home and work positively with residents to provide them with a fulfilling lifestyle where choice is encouraged and residents are respected. EVIDENCE: As this is a care home with nursing registered prior to April 1st 2002 agreed staffing levels are maintained. There is always a qualified nurse on duty over a twenty-four hour period. Additionally there are: Early shift = 7.30 – 2.30 pm with two care assistants Late shift = 2.30 – 9.30 pm with two care assistants Night shift = 9.30 – 7.30 am with one care assistant There is also another carer five days a week who helps out during the busy hours of the day. Kitchen and domestic staff are adequate and care staff does the laundry. Maintenance/gardener as required The owners undertake administrative work. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 19 Staff spoken to were fully aware of their role in supporting residents to develop their skills and to be as independent as possible. Observation showed staff related positively with residents and that they were aware of their needs and how to meet these. The home had over 50 of care staff qualified to NVQ level 2. The home’s staffing levels were sufficient to meet the needs of the 23 residents in their care There was one vacancy. As this is a care home with nursing registered prior to April 1st 2002 agreed staffing levels are maintained. There is always a qualified nurse on duty over a twenty-four hour period. Additionally there are: Early shift = 7.30 – 2.30 pm with two care assistants Late shift = 2.30 – 9.30 pm with two care assistants Night shift = 9.30 – 7.30 am with one care assistant There is also another carer five days a week who helps out during the busy hours of the day. Kitchen and domestic staff are adequate and care staff does the laundry. Maintenance/gardener as required The owners undertake administrative work Staff spoken to were fully aware of their role in supporting residents to develop their skills and to be as independent as possible. Observation showed staff related positively with residents and that they were aware of their needs and how to meet these. The home had over 50 of care staff qualified to NVQ level 2. The home’s staffing levels were sufficient to meet the needs of the 23 residents in their care There was one vacancy. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The Health and Safety policies and practices promote and protect the welfare of residents. EVIDENCE: The home had Health and Safety procedures in place. Staff were required to read all policies for the maintenance of a safe environment. Regular checking of hot water temperatures took place. Individual risk assessments were in place for residents who smoke. All care and catering staff had received training in basic food hygiene. Two staff informed the inspector that they were hoping to undertake training in first aid. The annual updates for Fire Safety and moving and handling training are planned for all staff during March 2006 and this will be checked on the next inspection. Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X X X X X X 3 X Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Marmion Nursing Home DS0000022350.V280176.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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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