Inspection on 24/08/05 for Marston Court

This inspection was carried out on 24th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Marston Court 08/10/07

Marston Court 08/05/06

Marston Court 24/01/06

Marston Court 28/02/05

Marston Court 19/08/04

Marston Court 18/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Marston Court Marston Road Oxford Oxfordshire OX1 1ND Lead Inspector Jane Handscombe Unannounced 24 August 2005 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 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. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Marston Court Address Marston Road, Oxford, Oxfordshire, OX1 1ND Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01865 241526 01865 722290 manager.marstoncourt@osjctoxon.co.uk The Orders of St John Care Trust Mrs Theresa Whitford Care Home 39 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (3), Dementia - over 65 years of of places age (20), Learning disability over 65 years of age (3), Old age, not falling within any other category (39), Physical disability over 65 years of age (20). Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 February 2005 Brief Description of the Service: Marston Court is a care home providing personal care and accommodation for 39 older people and Day care facilities for 10 from the local community. There is provision for 6 service users who need help with rehabilitation (intermediate care). The care home is managed by The Orders of St John Care Trust who are responsible for many care homes throughout the county of Oxfordshire. Marston Court is located in a residential area of Oxford approximately a mile from the city centre. Local shops, churches, pubs and other amenities are accessible to service users. Marston Court is a two storey building served by a lift. With the exception of one double room, all rooms are single with shared bathroom facilities. The care home is divided into four wings, each having a lounge and dining area. The grounds are shared with the county office of The Orders of St John Care Trust providing some lawn and a secluded patio area with a water feature. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced, which took place on 24th August 2005. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved speaking to residents in order to ascertain their views upon the care they receive at the home, staff members and the manager, viewing care plans and assessments, whilst also observing the general day to day operations of the home. The home presented as clean and tidy throughout, with residents going about their daily activities in a calm relaxed atmosphere. Staff were observed to provide care and support to the residents in an unhurried manner and respecting their individuality and dignity at all times. Comments received from residents and staff during the inspection included: ‘I have all I need in here’ ‘here I am quite satisfied’ ‘the meals are very good here’ ‘I think the staff are absolutely wonderful’ ‘Its spotlessly clean here’ ‘I am very content with the way it is run’ ‘It’s a nice place to work’ The inspector would like to thank the residents and staff for their assistance during the inspection. What the service does well: Residents spoken to during the inspection were complimentary of the staff and the care they receive at the home. Likewise they spoke positively with regard Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 6 to the way in which the home was managed and both the residents and staff felt the manager runs the home in an open and inclusive manner. The home offers a varied programme of activities to suit all abilities and liaises with residents regarding their likes and dislikes on both a one to one basis and through regular resident meetings. What has improved since the last inspection? What they could do better: There are a number of things that Marston Court needs to address in order to improve upon the health, safety and welfare of those in their care. Issues around the assessment of care needs and risk assessments were evident during the last inspection in February 2005, for which requirements were made. During this inspection, it was evident that those requirements had not been addressed, and the poor practices continue, which in the inspector’s opinion places the service users at risk of not having their needs met fully. All residents receiving care must have a care plan showing a full assessment of needs and the actions to be taken in order to meet these needs. This was clearly not the case in one such case; the inspector viewed a resident’s file which did not contain any information regarding the needs of the resident or the care to be given. Further residents’ care plans viewed on the day of inspection were incomplete, with one file suggesting that the resident had no review of his/her care needs since December 2004, some 8 months previously. Assessments and Care Planning were generally inconsistent, incomplete and of poor quality. However, it is envisaged that with the new care plan format that has now been drawn up and training to be undertaken, this should allow for a clearer, comprehensive system of recording the resident’s needs to ensure that staff are clear in knowing what the resident’s needs are and what to do for each individual person living at the home. A recommendation that care plans Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 7 should be reviewed once a month, with the involvement of the resident and or their representative, has been made. In order to ensure the health, safety and welfare of the residents in care at Marston Court, the manager must ensure that all residents have a care plan and that risk assessments and reviews of residents’ care needs are undertaken regularly and documented in the care plans for staff to refer to in order that they address the residents’ needs fully. 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. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 6 The system of assessing prospective residents was of poor quality, inconsistent and incomplete. The absence of important information and thorough assessments potentially places residents using the service at risk and does not ensure their needs are being met. EVIDENCE: The inspector was informed that the manager of the home visits prospective residents in their own home or hospital in order to assess their care needs before they are admitted to the home, to allow for both the resident and the manager to be confident that the home meets their needs. However, the inspector asked for 4 named residents’ files, picked randomly, 3 of which were produced. It became evident that the 4th resident had no such assessment or a plan of care in the file, thereby placing the service user of not having his needs met fully. The inspector required that this be drawn up during the inspection with the involvement of the service user. Wherever possible, prospective residents, family and friends are given the opportunity to visit the home and join fellow residents, in order to gain a ‘feel’ of the home and meet staff before making a decision as to whether the home is suitable. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 10 Residents who have been assessed and referred solely for Intermediate Care are provided with dedicated accommodation together with equipment and staff to deliver short-term intensive rehabilitation, enabling the resident to return home. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 10 Assessing the residents’ needs and reviewing these needs is paramount to ensure that the health and social care needs of residents are identified and met. Assessments and Care Planning were inconsistent, incomplete and of poor quality. It is the inspector’s opinion that residents are at risk of not having their health care needs met fully. Residents experience a sense of privacy at all times and a good rapport was seen to exist between the care staff and the residents. EVIDENCE: During the inspection, staff were observed to demonstrate particular sensitivity upon entering bedrooms, bathrooms and WCs and addressed residents in an appropriate manner. Individual care plans are available for most of the residents, although of the 4 residents’ files viewed, one did not contain any assessment of needs, risk assessments or a plan of care (see choice of home section). The care plans viewed on the day of inspection were of poor quality, incomplete and failed to contain recent reviews of care needs, which in the inspector’s opinion failed to Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 12 ensure that all aspects of the residents’ health, personal and social care needs were being met. Two of the files failed to contain the residents’/representatives’ signature to indicate they had in fact taken part in the assessment process, one of which failed to contain the signature of the person undertaking the assessment evidencing that they were qualified to do so. One resident’s file informed the inspector that a hoist was to be used, and a wheelchair although no risk factors had been noted. The same file showed that the last review of needs was undertaken in December and the monthly recording of weight was also last undertaken in December. A further resident’s file informed that there had been a review undertaken in which there were changes to the continence care, yet this was not noted on the care plan to inform those caring for the resident. Whilst the care planning was seen to be of a poor standard, the inspector was informed that a new system of care planning was to be undertaken for which the manager and care leader are to be attending a care plan training session the following week. This training will be cascaded to all care staff members and should allow for a clearer, comprehensive system of recording residents’ needs to ensure that staff are clear in knowing what the residents’ needs are and what to do for each individual person living at the home. A recommendation that care plans should be reviewed once a month, with the involvement of the resident and or their representative has been made and requirements to address the shortfalls mentioned. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Contact with family, friends and the local community is encouraged and support is given where required. A varied programme of activities satisfies the recreational interests of the residents. EVIDENCE: The home welcomes all visitors and residents informed the inspector that they were welcome to visit at any time. There are few routines at Marston Court and these are centred around meals and mealtimes. On the day of inspection, residents were seen to be enjoying a Roast chicken lunch followed by a milk jelly pudding. Where a resident does not wish to take the main meal offered, further options are available. Residents on Evenlode informed the inspector that the food is very good with plenty of choice, although on this occasion they did comment on it not being served up very warm; this was fed back to the care services manager. Wherever possible the service users are enabled to follow their social, cultural, religious and recreational interest and needs. There is the opportunity for residents to attend monthly church services, enjoy the services of a visiting Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 14 hairdresser and enjoy a variety of activities, which are posted on notice boards throughout the home. Residents and staff enjoyed a recent barbeque, held in July, and a summer fun day was held in Bicester for those who wished to partake. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 17 The home has a complaints procedure, which service users are aware of, as are their families, and feel confident in placing a complaint should the need arise. Residents’ legal rights are protected and they are all on the electoral role, whereby they can choose to vote in person or by postal vote EVIDENCE: Speaking with residents on the day, it was apparent that they were aware of the complaints procedure and were confident that any concerns they may have would be acted upon appropriately. All residents spoken to were aware of who to take any concerns to if the need should arise. The home has a complaints procedure, which is on view in the home and may also be found in the residents’ handbook. An independent advocacy service is available for residents to access if the need arises. The service is provided by Age Concern Oxfordshire, at no cost to the resident, details of which were observed to be on display on notice boards within the home. There are regular residents meetings held in the home to which all residents are invited. These meetings are an open discussion in which residents can voice any concerns and make any suggestions and the management can address their issues and discuss points of interest relating to the home. The Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 16 meetings are minuted and displayed within the home to keep all residents informed. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 26 The home presents as clean and tidy throughout with suitable facilities to maximise the service users’ independence. EVIDENCE: On the day of inspection the home was well maintained, clean and tidy throughout. The residents have access to all their communal and private space, through the provision of specialist equipment such as ramps and a passenger lift. The home also provides grab rails in corridors, bathrooms and toilets and hoists and assisted toilets and baths to meet the residents’ needs. A call system with an accessible alarm facility is provided in all rooms, in order that residents can call staff in the case of an emergency. Residents are provided with a key to their bedrooms within a risk management process. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The home is staffed in accordance with the needs of the residents and the staff undergo the appropriate training to meet the residents’ needs. EVIDENCE: The home maintains a recorded staff rota showing which staff are on duty at any time of the day and night and in what capacity. On the day of inspection there were sufficient staff to meet the residents’ overall needs. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38 In view of the findings during the inspection around assessment of needs, risk assessments and care planning, the inspector is of the view that the home is not presently protecting the health, safety and welfare of the residents appropriately. EVIDENCE: Whilst the registered manager has many years of experience of working with older people and has more than two years management experience and regularly updates her knowledge and skills, there are shortfalls around the issues of assessing residents’ needs and the care planning process, which were also evident during the last inspection and for which requirements were made. In discussion with the care services manager, it was reported to the inspector that a new care planning format has been introduced and training is to be undertaken by both the manager and a senior members of staff, who will be cascading the training to other staff members, which it is hoped will ensure Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 20 that assessments and individual plans of care and reviews will be comprehensive and address the needs of the residents appropriately. There are clear lines of accountability within the home and within The Orders of St John Care Trust. There are policies and procedures in place to protect the residents’ health and safety and all staff receive mandatory training in moving and handling and fire safety. The manager initiates fire drills thus ensuring the safety of residents. Further records in relation to health and safety will be looked at during the next inspection. Residents and members of staff reported that the manager runs the home in an open, positive inclusive way and they would have no worries approaching her if they had any concerns and were confident that they would be listened to and dealt with appropriately. Regular residents meetings are held which keep the residents informed and allows for any concerns to be discussed. These meetings are minuted and distributed around the home. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 2 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x 3 x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 2 x 2 x x x x 2 Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 22 YES 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. 1. Standard OP3 Regulation 17(1)a Schedule 3 Requirement The Registered Manager must ensure that a photograph of each service user be kept on file. Note this is an outstanding requirement from previous inspection in February 2005. The Registered Manager must ensure the needs of a service user have been assessed by a suitably qualified person. Note this is an outstanding requirement from previous inspection in February 2005. The Registered Manager must ensure that all risk assessments are undertaken and kept up to date to reflect the needs of the service users, and to provide staff with clear information as to the management of those needs. Note this is an oustanding requirement from previous inspection in February 2005. Timescale for action Immediate and henceforth 2. OP3 14(1)a Immediate and henceforth 3. OP7 24(1)a Immediate and henceforth RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 23 No. 1. Refer to Standard 7 Good Practice Recommendations It is reccommended that all care plans be updated and transferred to the new care plan format within 3 months and further reccommended that care plans be reviewed once a month, with the involvement of the resident and or their representative. Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Burgner House, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Cowley, Oxford OX4 2SU 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. Extracts may not be used or reproduced without the express permission of CSCI Marston Court H57-H08 S13159 Marston Court V245375 240805 Stage 4.doc Version 1.40 Page 25 - 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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