Inspection on 16/09/05 for Marmion Nursing Home

This inspection was carried out on 16th September 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 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 16/02/06

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 16 September 2005 1:30 Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 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.V249601.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 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.V249601.R01.S.doc Version 5.0 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.V249601.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd March 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.V249601.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a three-hour period and during the inspection discussions took place with nurse in charge as well as the two staff members on duty. There were 23 residents in the home receiving nursing care with one vacancy. Relatives and visitors felt welcomed at the home and were satisfied with the care provided. The service operates a person centred approach to care. Staffing levels were found to be adequate to meet the needs of residents. Staff know the residents well and support them to meet their needs and make choices about their lives. Residents have full lives. They attend a range of occupational and leisure activities and go out most days. Communal space was adequate for the needs of residents; all areas were comfortable and pleasantly decorated. Resident’s health and personal care needs were appropriately met. Records showed that residents were supported to attend appointments with G.P’s and other health professionals. Medication records were appropriately maintained. All residents had a healthy choice of food and stocks and supplies were plentiful. Staff are well trained and the home ensures that staff provide two references and have a satisfactory police check prior to commencing employment. The managers support staff and there are individual supervision sessions and staff meetings. Staff morale was high and it was evident by direct observation that staff get on well with the residents. What the service does well: The home provides the residents with a good service and meets nearly all of standards that were inspected. The home is well decorated and has a good standard of furniture and fittings. The home has two well-furnished lounges where residents can spend their time, one is a smoking lounge. The home has a large garden and patio area. The home develops care plans that show what support residents need. The home ensures that staff provide two written references and have a satisfactory police check prior to commencing employment. The care manager Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 6 and other trained nursing staff support care staff and there are individual supervision sessions and staff meetings. It was pleasing to note that care staff know the residents well and support them to meet their needs and help them make choices about their lifestyles. Each individual receives the health care treatment they require. Staff appear happy and content with their duties and get on well with the residents. Staff stated that the home ‘had a relaxed atmosphere and was warm and friendly’ another said ‘we are all like one big happy family’. Residents informed the inspector that they liked the staff and feel they are well cared for. 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.V249601.R01.S.doc Version 5.0 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.V249601.R01.S.doc Version 5.0 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: Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 9 Following discussions with staff and examination of care plans it was determined that full assessments were undertaken prior to a decision being made over admission. This was completed both by the local authority (where applicable) and by the home itself. 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. 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 could include referral to specialist services such as psychology, behavioural services and psychiatry. All the residents were supported to access educational, (where requested) occupational and leisure activities. Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 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 The home had clear care plans in place that ensured that staff had the relevant information to meet the needs of the residents. The home encouraged decision-making and participation, providing residents with choice and 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: Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 11 Care plans were examined and contained all the relevant information required. The care plans detailed where residents needed support including health, personal care and social activities. Reviews of plans were undertaken monthly and the residents and families were encouraged to take part in the care planning activity. Residents that could be aggressive had procedures in place that focussed on positive behaviours. No service users had specific cultural needs. The home also assisted residents with financial management where requested. Residents were encouraged to take decisions over their lives and over issues relating to the running of the home. A resident 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. Residents were supported to go shopping including any assistance needed buying their own clothes. Advocates would be involved when required to support residents in the decision making process. One of the owners confirmed that formal resident meetingsand discussions take place regularly on an ad hoc basis both as a group and individually. Minutes of planned meetings are maintained. Staff were observed asking residents what they wanted to do. Staff spoken to were aware of individual residents abilities to make decisions and different strategies that they could use to encourage choice. Resident’s individual differences and wishes were respected. A range of individual relevant risk assessments were on file and showed evidence of being reviewed regularly. Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 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): Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 13 12,13,14,15 Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 14 The regular access to the community and the opportunities for 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: Some of the residents attended external organised occupational activities. They attended day services where some residents worked two days a week. This was paid activity and transport and meals were provided. Most of the residents regularly accessed the community on a daily basis being involved in a range of activities including shopping, using health care services and a range of social activities. Residents were involved in a range of leisure activities including attending a local day centre. Within the home the residents engaged in a range of board games, jigsaws and arts and crafts. The residents had access to public transport or walked to local venues. There was an activity programme on display in the office which one of the owners stated ‘relects the residents inclinations and well being.’ There was felixibility in the homes leisure persuits, which was discussed at residents meetings. Qualified nurses administer all medication and they follow the homes robust procedure in line with NMC requirements. A pharmacy at Stonedelph delivers the homes supplies on a monthly basis and uses a bottle to resident approach. However, when residents go on leave their medication is made up in dossette form for ease. There were no residents receiving controlled drugs or oxygen in the home on the day of the inspection. There were two diabetics in the home but neither required Insulin injections. The home provided a varied menu that considered the likes and dislikes of the residents. The main meal was held at lunchtime and an alternative meal was available of the meal was not wanted by a resident. A smaller meal was held at teatime such as soup and sandwiches. Supper and snacks were provided. The home monitored residents weight and diet. Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 15 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): Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 16 18,19,20 The home supported the residents to maintain their personal care needs in a manner that considered their dignity and preferences. The health care needs of the residents were being met through the home supporting residents to access a range of relevant health care services. 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. A full record of each resident’s 24-hour care needs and their preferences was in the plans. A resident confirmed that staff provided any help and support needed and that staff were always there to help. The home operates a key worker system but all staff are expected to be fully involved with all residents. The health care needs of the residents were being met. Residents accessed the GP, the chiropodist, the dentist and the optician as well as specialist health care staff such as Consultant Psychiatrists. Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 17 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 home had a robust complaints system on display including all CSCI details. The home’s procedures and the staff’s knowledge provide residents with an environment whereby residents’ finances are safeguarded and issues of adult protection would be responded to. EVIDENCE: The home had a complaints procedure in place that was displayed in the entrance foyer. A resident spoken was able to explain how they would make a complaint and was confidant staff would respond to any concerns promptly. No complaints have been received by the CSCI since the last inspection. The home had an adult protection and whistle blowing procedure in place and these were accessible to all staff. Staff confirmed that that they were familiar with different forms of abuse. One of the owners confirmed that in house POVA training is undertaken on induction. Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 18 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): 24,28,30 The residents benefited from a well maintained home that was suitably located to access the community and was furnished and decorated in a domestic style. The home provided communal areas that provided residents with a range of comfortable and accessible spaces that were clean throughout. EVIDENCE: Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 19 The home was well maintained. Accommodation was on two floors with a passenger life access. The home’s decoration and furnishings were all of a domestic type and were of a good standard. The home was clean and tidy throughout. Cleaning schedules were in place and domestic and laundry hours were sufficient. The home was suitable for the residents and was in walking distance of shops and on a bus route Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 20 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): 31,32,33,34,35,36 The home’s staff are 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. The residents are supported and protected by the home’s recruitment procedures that are robust and ensure that the necessary pre - employment checks are completed. The home provides sufficient staff to support to meet the personal, health and social care needs of the residents. EVIDENCE: Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 21 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. Staffing levels are based on the dependency levels of the service users in their care. Kitchen and domestic staff are adequate and care staff does the laundry. Maintenance/gardener as required The owners undertake administrative work No staff are employed under the age of 18 years. Staff confirmed that they were provided with a job description and a statement of terms and conditions. All pre employment checks had been completed. 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 interacted positively with residents and that they were aware of their needs and how to meet these. The home’s staffing levels were at a level to meet the needs of the residents. Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 22 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): Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 23 37,39, 42 A competent manager who ensures that the resident’s best interests are safeguarded leads the home. The Health and Safety policies and practices promote and protect the welfare of residents. EVIDENCE: The home continues to be well run under the care managers remit. Residents and staff all participate in the running of the home and staff morale was high. The home had Health and Safety procedures in place with regard to regular checking of hot water temperatures. All temperatures were in line with the HSE regulations. Staff had received annual fire safety training. One of the owners confirmed that all staff employed received adequate fire drills every year. One of the owners confirmed that appropriate manual handling training is provided every year. It is noted that a there are no hoists or bath chairs in the home and all residents are ambulant. Regular servicing took place including the fire alarm, fire equipment and emergency lighting. Weekly fire tests are maintained. Staff confirm that nurse call systems are fully operational. Individual risk assessments were also in place. The home has adequate insurance cover. All records and documentation relating to residents were kept safe and secure in line with the Data Protection Act. Marmion Nursing Home DS0000022350.V249601.R01.S.doc Version 5.0 Page 24 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Marmion Nursing Home Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000022350.V249601.R01.S.doc Version 5.0 Page 25 No 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. 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.V249601.R01.S.doc Version 5.0 Page 26 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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