Inspection on 20/11/06 for Marray House

This inspection was carried out on 20th November 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

Marray House 16/08/10

Marray House 03/08/10

Marray House 02/07/10

Marray House 15/04/10

Marray House 07/12/09

Marray House 28/07/09

Marray House 23/08/07

Marray House 08/11/05

Marray House 16/06/05

Marray House 24/11/04

Marray House 06/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Marray House 12-14 Essa Road Saltash Cornwall PL12 4ED Lead Inspector Mike Stokes Key Unannounced Inspection 20th November 2006 11:30 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 Marray House DS0000009195.V318570.R01.S.doc Version 5.2 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. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Marray House Address 12-14 Essa Road Saltash Cornwall PL12 4ED 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) 01752 844488 Mrs Enid Robertson Crofts Mr Peter William Crofts Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2005 Brief Description of the Service: Marray House is registered to provide personal care and accommodation for up to 23 older persons. It is a detached house situated near the centre of Saltash, close to the shops, public transport and community facilities. Service users bedroom accommodation is provided on the ground and first floors. Stair lifts are provided to assist service users. Communal lounge, dining room, kitchen and laundry areas are provided on the ground floor. Mrs Crofts has been registered as a care provider for 27 years. The fees range from £293.25 to £315.00. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection to review the standards of care provided at the home when the registered persons were unaware it was planned. I arrived at 11:30am and left at 3.00 pm. During this time I met service users, care staff and the senior carers managing the home. The senior carers assisted me in looking at records kept to monitor the welfare of service users and discussed developments at the home. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 6 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 Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. Quality in this outcome area is good. The registered person has provided a statement of purpose and service users guide that details the facilities and services available within the home. The registered provider will assess all prospective service users prior to admission to ensure that the home can meet their care needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A statement of purpose is available within the home and a service users guide has been issued to each service user and made available to relatives. These documents explain the services and facilities available within the home as part of the contract and that hairdressing, toiletries, transport, chiropody and newspapers can be provided at the home and are at the service users expense. The range of fees are £293.25 to £350.00. The registered provider or a senior carer will visit the prospective service users at their own home or in hospital prior to admission to complete an assessment process. These records include information received from other agencies to assist in appropriate admissions to the home. Service users have the opportunity to visit the home for meals and a trial period to assist in the pre admission assessment procedures. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. The health needs of service users are met with evidence of multi disciplinary work occurring to provide for service users welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The existing care plans and weekly summary sheets for service users were reviewed with the senior carer on duty. The plans highlight the needs of service users; details of the action staff must take to meet these needs and demonstrate a monthly review of these plans with the involvement of service users. A discussion occurred regarding the arrangements to provide for a service user presenting behaviours due to a recent infection. A requirement is made to ensure that accurate and detailed records of liaison and treatment plans are maintained. A range of pressure relieving equipment, hoist, aids and adaptations is provided and appropriate liaison occurs with the community nursing service to provide for the welfare of service users. The senior carers maintain accurate records and appropriate procedures for the administration of medication to service users. The Pharmacist has reviewed the system and the report dated 03/11/06 was available for inspection. The Service users are registered with local GP’s in Port View Surgery and Saltash Health Centre; service users were observed to receive house calls on the day of inspection. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 9 Service users spoken to expressed approval of the care received at the home and that they can access all support services as required. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. Service users exercise their choice to enjoy the privacy of their own rooms or join other service users in communal areas for company or meals. Service users are predominantly dependent on relatives to access community facilities and the registered provider will organise visiting entertainers and group activities at the home. The meals provided in the home are good with special diets catered for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users were met in communal areas or their own rooms to discuss aspects of living at the home. Service users bring furniture and possessions such as televisions, radios and CD players to personalise their rooms. Service users expressed approval that regular visits are received from relatives. Service users are enabled to maintain contact with activities independently, although the majority of service users are dependent on relatives to access community facilities. A discussion occurred with service users and cook on duty to discuss the catering arrangements and the main midday meal was observed. The main meal is at lunchtime and a choice is provided for the evening meal, with snacks and beverages also provided during the day. The menu was inspected and a range of nutritious meals is provided, including special diets. Service users expressed their approval of the traditional catering arrangements at the home that provides 3 roast meals during the week. The Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 11 main meal provided on this visit was cottage pie with vegetables and apple pie and custard. It was observed that 2 service users were given an alternative of their preference and the senior carer on duty explained that each service is consulted individually regarding the meals to be provided each day; appropriate records are maintained regarding this consultation. I observed that this was acceptable to the majority but received comments from 3 service users that they did not enjoy minced meat; a service user stated,’ I do not like to complain that I do not like it. The Sunday roast pork and meringue was very nice’. The communication process was discussed with service users and the senior carer. A recommendation is made to continue the development of the consultation processes at the home to ensure that service users who may be confused or unsure of their rights are receiving meals of their choice. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. The registered provider uses the policy and procedures at the home to assist in the protection of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure containing the Commissions contact number and address was displayed in the home and is detailed in the service users guide. The registered provider maintains a record of complaints received and how these have been dealt with appropriately at the home. The senior carer stated that day-to-day control and regular contact with service users provided the opportunity to monitor standards. The registered person has provided appropriate ‘Protection’ policy and procedures. A recommendation that staff attend the ‘Protection of Vulnerable Adults’ training provided by social services has been achieved. There is a policy regarding staff accepting gifts from service users and precluding staff involvement in the making or benefiting from service users wills. The homes insurance provides for service users to make claims on personal items and for public liability. The home provides appropriate records regarding finances and items held on behalf of service users. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is adequate. The registered provider is providing a reasonable standard of décor and maintenance to ensure service users live in a safe and comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: I met service users in the communal lounge areas and in their bedrooms. Service users can choose to use the communal areas of the home or enjoy the privacy of their bedroom accommodation at any time. Service users expressed approval of the home and a service user stated,’ I am very comfortable and the home is kept very clean’. There are sufficient and suitable bathroom, shower and toilet facilities. The home provides a call bell system, 4 stair lifts, bath hoist, mobile hoist, grab rails and various pressure relieving equipment is available within the home. Radiator covers have been provided in 9 rooms and this work should be completed for the remaining areas. Appropriate lighting and ventilation is provided, the windows have restrictive opening devices. The baths at the home have mixing valves to control the supply of hot water and the registered provider is currently providing safety valves to sinks to prevent the risk of Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 14 scalding to service users. The home presented as clean, pleasant and hygienic. The registered provider has recently redecorated 2 bedrooms and a discussion occurred regarding the repair of a tear in a carpet and the cleaning of the hallway and stairs carpets to improve their appearance. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. The registered provider is ensuring that staff have appropriate training opportunities and service users expressed approval of the care received. Various staff records that are a requirement to be kept have not been maintained appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of this unannounced inspection there were appropriate numbers of senior staff, carers and ancillary staff to present an organised home, providing for the welfare of service users. There is a minimum of 2 carers at all times with 3 carers at peak times of activity and supported by ancillary staff. A waker and sleeping night carer are provided for service users that require attention at night. The records regarding the recruitment of staff were inspected and a discussion occurred to clarify that CRB checks are not transferable when recruiting staff. A requirement is made regarding the completion of CRB and POVA First checks on each new appointment. Induction training has been developed concerning ‘principles of care’ and the introduction of the 12-week ‘skills for care’ induction process must be used. Staff training opportunities are provided at NVQ level 2, Medication, First Aid, Basic Food and Hygiene, Fire Precautions and Manual Handling. A requirement is made regarding the cook on duty to complete the Basic Food and Hygiene training. The 2 senior carers who are NVQ Assessors continue to develop and oversee these responsibilities and have developed the individual staff files to record training completed. These records must be maintained to demonstrate that the home is providing competent staff and will assist in the staff supervision Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 16 process. Staff were observed to exhibit appropriate skills and attitudes during their interactions with service users. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 36 and 38. Quality in this outcome area is good. The registered person is providing clear and effective leadership and management to maintain a safe and comfortable home for service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered person has provided services at the home for 27 years and the 2 senior carers and other staff have also worked there for many years. The schedules 3 and 4 listing all records to be kept were reviewed and appropriate records are generally maintained at the home. A requirement is made regarding the provision of staff supervision meetings and the maintenance of records. The registered provider is completing risk assessments and the appropriate maintenance of health and safety precautions, training and equipment is occurring. Records regarding the maintenance of stair lifts in July 2006, hoists on 09/11/06, gas and electrical equipment are available. An electrical wiring check occurred on 18/05/06. The Fire Safety Officer also Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 18 visited the home 02/08/05 to review the fire precautions and the log book shows a record of fire precautions and alarm checks by the homes staff. The public liability insurance is displayed and valid until September 2007. Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 2 X 3 Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 20 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. 1. Standard OP29 Regulation 19 Requirement The registered person must operate a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. The registered person must ensure that there is a staff induction, training and development programme. The registered person must ensure that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice. Timescale for action 31/01/07 2. OP30 18 31/01/07 3. OP36 18 31/01/07 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. Refer to Standard OP7 Good Practice Recommendations The registered person should develop the care plans to expand on the needs of service users regarding health, DS0000009195.V318570.R01.S.doc Version 5.2 Page 21 Marray House social and personal care. The management should provide details of the action staff should take to meet these needs and demonstrate a monthly review of these plans with the involvement of service users. 2. OP15 The registered person should ensure that service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual, assessed and recorded requirements. The registered person should complete a programme of providing radiator covers and safety valves on hot water outlets for the remaining areas in the home. 3. OP25 Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Marray House DS0000009195.V318570.R01.S.doc Version 5.2 Page 23 - 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. 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