Inspection on 23/08/07 for Marray House

This inspection was carried out on 23rd August 2007.

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 20/11/06

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 Mandy Norton Unannounced Inspection 23rd August 2007 10:00 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.V343982.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.V343982.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 Position Vacant Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th November 2006 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 28 years. The fees range from £300.58 to £325. A brochure is provided for those wanting more information about the home and its facilities. The previous inspection report is available in the entrance foyer. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place from 10.25 am until 2.50 pm and was conducted with one of the two matrons. The registered person employs two senior carers to run the home who are known as ‘matrons’, they have worked at the home for many years and share the management responsibilities between them. Many of the people living in the home have also been there for many years and are familiar with the management arrangements. The registered provider visits the home regularly and is in regular contact with both ‘matrons’. A tour of the home was carried out and many of the people living in the home were spoken to during the visit. This report also contains information taken from the completed Annual quality assurance assessment and discussion with staff on the day of the inspection. There were 14 people living in the home at the time of the inspection. What the service does well: Marray House is homely and comfortable. People spoken to said that the staff are friendly and approachable. People who are thinking of living at the home are assessed in their current setting (where possible) to see if the home can meet their needs. In addition care plans are obtained from social and other health care professionals. Once admitted to the home peoples needs are set out in a care plan, the plans provide sufficient information for care staff to be able to meet the individuals’ health, social and psychological needs. People to said they are able to maintain contact with family and friends and exercise some choice and control over their lives. They can eat their meals where they like and spend time with others in communal areas or in their own rooms. People said that they can go to bed and get up when they like. The home presented as clean and hygienic with attractive lounges and outdoor space. People who live at the home benefit from the homes good relationships with the local GP practice, who carry out a weekly round at the home (as well as Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 6 visiting at other times as required) the District nurse, who provides any nursing care required. 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.V343982.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service or are planning to move into the home have information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. The home is not registered to provide intermediate care. EVIDENCE: The matron said that people who are intending to move into the home are assessed by one of the matrons. They go to visit the person in their current setting to make an assessment. They gather as much information as possible during the assessment and use it to inform the care plan once the person is Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 9 admitted. The information is complimented by the Social Services care plan if publicly funded. Anybody that makes enquiries about staying at the home can visit at any time and are given a brochure that also contains an ‘open invitation’ to visit the home. A number of people have lived at the home for a long time indicating that the pre admission process is used properly to ensure the home can meet the needs of the people that move in. A person who had recently moved in was happy with the home and what it has to offer. Each person is issued with a contract. The one examined had information about terms and conditions of occupancy and fees to be charged. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 10 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home receive consistent health and personal care as appropriate. The homes well managed medication systems protect the welfare of Service Users. People are treated with respect and their right to privacy is upheld. EVIDENCE: Five care plans were examined; in all of those seen there were assessments which provided information about skin integrity, moving and handling, safety and hobbies and interests. The information generates the plans of care, which provide the basis for the care to be delivered. There was some evidence that people are consulted about their care plans from time to time. It is recommended that all people who are admitted to the home (and /or their next Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 11 of kin) are asked to be involved with setting up their care plan and in future reviews of the plan. Records are maintained for all visits to the home by social or health care professionals. All residents are registered with a GP. The medication system is well managed; The pharmacist supplies medicines in blister packs that are kept in a locked cupboard. Disposal of unused/ out of date medication is safe, well recorded and collected by the pharmacist. During a tour of the home staff were overheard interacting with people appropriately. Joining them into conversations and talking with them individually. Doors were closed when personal care was being delivered. Staff were seen and heard knocking on doors before entering peoples rooms. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 12 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are happy with the amount of social activity that is offered and are content with their lifestyle within the home. People maintain good contact with family and friends and exercise choice and control over their lives. People receive a wholesome appealing diet and are not rushed. EVIDENCE: The brochure states that entertainments and outings are available and care plans examined had details of peoples interest and hobbies. The matron said that staff sometimes take people out to the shops or for a run in their car. Daily evaluation sheets seen in the care plans included information about any outings that have been taken and any visitors or activities the person had been involved in that day. The matron was advised to ensure that all staff using their car in work or their own time to transport Service Users have business cover on their insurance. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 13 Some people are able to go out with their friends and relatives and this is encouraged. During a tour of the home people were seen reading newspapers or magazines, talking with other residents and watching the TV, in their own rooms or in one of the two lounges. One person was able to go outside and have a cigarette. People spoken to said that the staff are able to spend time with them individually if they want to carry out a particular activity. Some said that they have decided how they like to spend their day and mix with others listening to the news of the day and discussing a variety of issues and then like to spend time in their own rooms later in the day. There were visitors seen coming and going during the inspection and the atmosphere in the home was homely and friendly. People can have their own TV, radio and/or telephone (they are responsible for the individual bill). People spoken to said they are asked daily what they would like to eat and alternatives are always available. A carer was seen around the home asking people what they would like during the inspection. Service Users spoken to said the meals were good and well presented. Two said they did not like minced beef and are therefore offered meals that don’t contain it. The matron said that tea, coffee and other hot drinks are served regularly and available 24 hours a day. A mealtime was not observed but staff were seen taking meals to the dining room or to peoples rooms if they had decided to eat there. An afternoon tea round was seen and people were being given choices about what drink they would like. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 14 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 & 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in the home and their relatives/friends know how to make a formal complaint. People are safe living in this home. EVIDENCE: The Annual quality assurance assessment states that there have been no complaints since the last inspection and no referrals to adult protection services. There have been no complaints made to the Commission. The complaints procedure is displayed within the home and is included in the brochure given to all people who move into the home. People spoken to said the matrons and care staff are very approachable and any concerns are discussed with them as they arise. One person said that a concern had arisen and had been ‘sorted out’ that day, so there would be no problem bringing something up again. Training records show that 3 care staff had protection of vulnerable adults training in June 2007 (provided by Cornwall County Council). Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 15 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, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe and well maintained and clean and hygienic ensuring the people living in the home live in a satisfactory environment. EVIDENCE: A tour of the home was carried out. It presented as clean and homely. One of the stair carpets was stained and looked in a poor condition. There are 2 lounges both on the ground floor, and a dining room all are well used by a number of the people. Access to the first floor is by means of a stair - lift. Peoples rooms seen contained personal items including furniture, ornaments and pictures that reflect their personality and interests. People were seen Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 16 moving freely about the home independently and some with the assistance of staff. People said that they liked their rooms but spent a lot of time in the lounges where there is good lighting and a nice bay window to sit inand others to talk to. Equipment examined during a tour of the home had recent servicing dates on it. A handyman is employed to carry out day to day maintenance. Environmental risk assessments are in place and generally reviewed annually or as necessary if anything changes. A number of these were in need of review at the time of the inspection. There is a call bell system fitted throughout the home. It was not heard being used during the inspection indicating that staff are predicting the needs of the people living in the home and there are enough staff on duty to meet those needs. The laundry is a suitable size for the amount of washing the home produces. Clean laundry was being delivered to peoples’ rooms during the inspection. People looked nicely dressed in clean clothing. The garden is well maintained and accessible to people living in the home. Seating is provided. It was hot on the day of the inspection and a number of people were seen using the outdoor space. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 17 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff with appropriate skills and knowledge to meet the needs of the people living at the home. The homes recruitment procedures protect people living at the home from being placed at risk of harm or abuse. EVIDENCE: The home has 2 matrons who work opposite shifts to each other. They do have some time during the week to meet and discuss any issues. They share the management responsibilities between them such as completing the duty rota, supervision, assessment of potential Service Users and ongoing day to day management. Their co-ordinated approach means that the responsibilities of the role are met. For 14 Service Users there is a matron supported by 2 –3 carers in the morning and 2 carers in the afternoon and early evening. Overnight there are 2 carers one of who sleeps between the hours of 10.30 pm – 6 am, but is on call overnight if needed. Any nursing care required is carried out by the local Community nurse team. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 18 Care staff are supported by a cook daily until 1.30 and a cleaner 3 days a week. The care staff do the laundry and ironing as part of their duties but this does not impact of the care people receive. People spoken to said that there are always staff available when they need them. The matron said that if people’s dependency changes they adapt the daily routing to ensure they receive the care they need at an appropriate time. The matron said that the home works well with local GP’s and district nursing services. The GP and District Nurse spoken to during the inspection confirmed this and both said that the staff report any concerns straight away and always act on the advice/ instructions given. Two (2) staff files were examined – they had all of the required documents in them including 2 written references, a CRB check, application form, contract of employment and job description. The staff files are stored securely. The file also included training certificates which confirmed that a variety of training is undertaken by staff , including fire safety, protection of vulnerable adults and manual handling and one had up to date supervision records Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 19 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, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by experienced people. The staff actively seek the views of people living in the home so that they can find ways of ensuring continual improvement of the service. Personal money held on behalf of Service Users is managed appropriately. The registered provider shows a responsible attitude toward promoting and protecting the health, safety and welfare of Service Users. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 20 EVIDENCE: The current matrons have several years experience of managing the home and are competent in their role. The owner lives locally and visits the home on a regular basis. People spoken to said that the matrons and staff are approachable and efficient. The matron said they don’t hold formal staff meetings but use the staff handover times to update staff on any changes or pass over important information. She said she has an ‘open door’ policy and due to a low staff turnover she knows her staff well and often recognises when there any problems or worries. There is desk diary that staff use to record information on a day to day basis. Staff spoken to said they were clear about the needs of the people living in the home and are happy to discuss any concerns with the matrons. The matron said that supervision takes place but it is not always formally recorded. Due to the designated responsibilities of the ‘matrons’ the one available during the inspection did not have distribution of satisfaction surveys as pert of her role but she was able to say that there is a formal process and an informal process of seeking the views of people that live in the home and their relatives on an ongoing basis to ensure that the home is always trying to improve to meet the changing needs of people. The matron said that fitting of radiator covers and safety valves on hand basins is an ongoing process. A handyman is available for ongoing maintenance tasks. The details how peoples money is managed were not discussed in detail but people spoken to said they were able to access money and were able to go out shopping and have newspapers if they wished. The fire log - book and accident books examined and were up to date and completed as required. The matron was advised to ensure that all staff taking Service Users out in their own cars whether on or of duty have business insurance cover. Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 21 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 X 3 2 X 3 Marray House DS0000009195.V343982.R01.S.doc Version 5.2 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. 1. 2. 3. 4. Refer to Standard OP7 Good Practice Recommendations The registered person should ensure that people are always involved in their initial care plan and ongoing reviews that take place. The registered person should ensure that the stair carpet that is stained and worn is replaced in the near future. The registered person should ensure that staff supervision sessions are carried out regularly and recorded consistently. The registered person should ensure that there is a policy about staff using their own cars to transport Service Users. The registered person should ensure that staff who use their own cars to transport Service Users either whilst they are on or off duty have business insurance cover. OP19 OP36 OP38 Marray House DS0000009195.V343982.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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.V343982.R01.S.doc Version 5.2 Page 24 - 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!