Inspection on 06/07/06 for Martin Hall Nursing Home

This inspection was carried out on 6th July 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

Martin Hall Nursing Home 27/10/05

Martin Hall Nursing Home 22/04/05

Martin Hall Nursing Home 19/08/04

Martin Hall Nursing Home 29/04/04

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

CARE HOMES FOR OLDER PEOPLE Martin Hall Nursing Home The Old Hall Martin Lincs LN4 3QY Lead Inspector Moya Dennis Key Unannounced Inspection 6th July 2006 09:45 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 Martin Hall Nursing Home DS0000002543.V303088.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. Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Martin Hall Nursing Home Address The Old Hall Martin Lincs LN4 3QY 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) 01526 378251 01526 378250 info@martinhall.co.uk Peck & Packer (Care Homes) Limited Ms Lesley Susan Layton Care Home with nursing 40 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (39), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (40) Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide care for service users of both sexes whose primary needs fall within the following categories: Mental Disorder, excluding learning disability or dementia -over 65 years of age (MD (E)) (40). Dementia - over 65 years of age (DE (E)) (39) Dementia - (DE) (2) for service users aged between 60 years and 65 years The maximum number of service users in the home with nursing needs does not exceed 29 and the maximum number of service users with personal care needs only does not exceed 11. 27th October 2005 2. Date of last inspection Brief Description of the Service: Martin Hall is purpose built nursing home in the centre of Martin-byTimberland. The home is on the main road, less than 5 minutes from Woodhall Spa. The local bus passes through the village every hour and runs between Boston and Lincoln; the nearest stop is just outside the home. Local amenities include village shop/post office, church, village hall and public house. The home can accommodate up to 40 service users with mental health needs, offering both nursing and personal care. Respite care is available. Bedrooms are on two floors and comprise 24 single rooms, 15 of which are en-suite and 8 shared rooms, all of which are en-suite. Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over five hours and used a review of all the information regarding Martin Hall, including a visit to the home. Many of the key standards were inspected at the last visit so were not assessed at this inspection. The home has complied with all requirements made at the previous inspection and none were made at this visit. The main method of inspection involved case tracking the care of selected residents by examining their records and discussing their experience of care received at Martin Hall. The inspector toured the building; spoke to seven residents, manager, staff, five visitors and observed general day-to-day practices within the home. Conversation with residents was limited because of the service user group involved. A wide range of documentation was also inspected. What the service does well: What has improved since the last inspection? Care plans are based on pre admission assessments and are completed soon after the resident moves to the home. Medication administration policies have been strengthened. Plans for documented staff supervision are complete and Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 6 regular supervision for all staff will commence shortly, in accordance with National Minimum Standards. Residents have more opportunities for recreational activity. 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. Martin Hall Nursing Home DS0000002543.V303088.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 Martin Hall Nursing Home DS0000002543.V303088.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 5. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s statement of purpose is comprehensive. Residents and/or their families are able to visit the home before deciding to move there. EVIDENCE: Thirteen service user surveys were returned to the Commission for Social Care Inspection, [CSCI]. Eleven people thought they had received enough information about the home before moving there. One thought they had not and one declined to answer. A copy of the home’s statement of purpose was made available for the inspector. This contains all the information required by National Minimum Standards. From the selected files examined it was evidenced that each resident, or a family member had been given a copy, plus a copy of the home’s terms and conditions. It was acknowledged that this amount of paper work Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 9 could be daunting at times of crisis so the home also provides a brochure, giving key points of information in a more readily understood format. Prospective residents are given the opportunity to visit the home and meet staff. One visitor told the inspector they had been given, “a conducted tour of the home and facilities” to help identify the most acceptable home for their relative. They are also able to speak to staff during the pre-admission assessment process and raise any questions or concerns they may have. The home does not offer intermediate care. Martin Hall Nursing Home DS0000002543.V303088.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 at least once during a 12 month period. 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. Care plans are based on pre admission assessments and completed very shortly after admission. Residents are treated with respect at all times. EVIDENCE: Files of the residents case tracked were found to include all the necessary information for staff to deliver appropriate care. Plans set out the actions needed by care staff to ensure that all aspects of health, personal and social care needs are met. All health appointments, including dentistry, and GP visits are recorded in residents notes. Risk assessments are completed for those residents most at risk of falls. Relatives told the inspector that they were contacted as soon as possible after any incident and were informed of the circumstances, any injuries sustained and the well being of their relative. They said they appreciated being able to remain involved in the care of their loved ones. Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 11 No resident currently has any pressure wounds and the manager is vigilant in monitoring skin integrity of vulnerable residents. The home’s policy regarding medication has been strengthened. A copy of a positive pharmacy report was made available for the inspector. Medication charts were signed as appropriate. Because of their specialist needs, residents are unable to self medicate. The home deals with a contractor for disposal of waste medicines, including controlled drugs. Few residents are able to use the phone but several visitors said they were able to ring at any time. One resident manages to use a mobile phone independently. Few resident manage their own personal affairs but any mail received is given to them unopened and later passed to relatives, if necessary. Staff were observed to treat residents with respect. Preferred terms of address were used and no carer was dismissive of those less able to communicate. Staff said they were instructed during induction that care must be delivered in ways that promoted residents’ personal esteem and dignity. Where residents chose to share room, privacy screens have been provided. All residents were clean and well dressed. One visitor remarked, “I appreciate the fact that she and her room are always kept clean”. Other remarks included, “The care and support at Martin Hall is second to none”. “Residents are kept clean and their clothing changed as soon as possible”. Martin Hall Nursing Home DS0000002543.V303088.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Several visitors were present during inspection; all confirmed they are always made welcome and kept fully informed of any changes. Residents make choices about diet, smoking, activities, and outings. EVIDENCE: Visitors spoke to the inspector, giving their views of the quality of care. Many visit every day and their easy rapport with staff was evident. They said they were always asked if they wanted a tray of tea and one visitor who visits every day is able to have a meal there whenever they wish. Families are encouraged to celebrate birthdays or wedding anniversaries with residents. One resident is regularly able to attend a local social event with the help of staff. Residents are able to access Shop-Mobility and contact details are available in reception. Residents are involved in menu choices. Sample menus show a wide variety of meals, including soft diet, diabetic, vegetarian and gluten-free options. Bedrooms are kept locked when not occupied to prevent inappropriate wandering by confused residents. Some residents choose to have a key to their rooms. Others rely on staff to unlock their doors for them. Residents also have Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 13 the choice to smoke, if they wish. The home has a designated smoking lounge, away from the main lounge and does not affect the rights of those who choose not to smoke. Residents who wish to drink alcohol in moderation are able to do so if it does not conflict with medication or other health issues. Martin Hall Nursing Home DS0000002543.V303088.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. No complaints have been received since the last inspection. Family or legal representatives support residents without capacity. EVIDENCE: Of the returned surveys, ten relatives said they knew how to make a complaint, if necessary. Comments included, “Communication and the chain of command are very clearly defined and effective.” “Not necessary to complain – but always someone available”, and “After all these years there has never been a time when we could say we were not happy”. A copy of the complaints procedure is included in the home’s Statement of Purpose, which is given to every resident. The procedure is clear and robust. Any complaint received would be dealt with appropriately within prescribed time scales. Residents who are unable to deal with their financial affairs are supported by appointees or are subject to Power of Attorney. The home also has links with a local advocacy service, contact details of which are displayed in reception. Martin Hall Nursing Home DS0000002543.V303088.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 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 well maintained and residents have access to a pleasant, secure garden. EVIDENCE: The home employs a handyman to maintain the building. The home is comfortably furnished. The furniture in the larger dining room, mentioned in the last inspection report, is shabby but staff say the furniture is fit for purpose and tablecloths cover the marked tables at meal times. Residents are able to sit in the garden or conservatory if they wish. The home was clean at inspection. A relative commented, “A difficult task is performed very efficiently. Domestic staff never seem to stop working”. The main area of the home was odour free but there was a noticeable odour in areas of the corridor. The manager stated that although cleaned almost daily, Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 16 the carpets were old and the most effective solution would be to replace them. This is due to happen in the near future. The laundry is situated away from food preparation areas and lounges. Three laundry workers cover seven days per week. The laundry uses two industrial sized washing machines and one industrial dryer. During the inspection it was noted that no resident was wearing stained clothing. All clothing is marked with the resident’s name and put in their personal laundry box when clean to ensure it is returned to the right room. No resident ever wears clothing that is not their own. No relatives spoken to thought that items of clothing had gone missing. One said they appreciated the care workers took to ensure their relative’s woollens were in good condition and had not become matted or misshapen. Martin Hall Nursing Home DS0000002543.V303088.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28. Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Staff are well trained. Currently, only nine care staff have, or are training for, National Vocational Qualification (NVQ). EVIDENCE: All staff are given a copy of the home’s handbook when appointed. This covers terms and conditions, care of residents, drug administration, confidentiality, dress codes and policies concerning the non-acceptance of gifts or witnessing of wills. New staff ‘shadow’ more experienced workers and their progress is appraised daily. Staff files evidence that in addition to mandatory training, courses are available in dementia care, promotion of continence, stress and falls awareness, Parkinson’s disease and managing challenging behaviour. Staff say they feel equipped to do their job well. Five care assistants have National Vocational Qualification (NVQ), three are currently studying for the award and one is awaiting funding. Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The manager is well qualified. Residents’ personal allowances are well documented. EVIDENCE: The manager has many years experience. She has kept her knowledge up to date by attending relevant training courses and her National Vocational Qualification (NVQ) Assessor award is pending. She has a sound value base in care of vulnerable people and is very aware of the need to balance promoting residents’ rights with a duty of care. A member of staff remarked that one of the best things about working there was the fact that the manager was a carer, too. Visitors appreciated the ‘open door’ approach to speaking to the manager and several visitors called into the office informally during the Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 19 inspection. Staff meetings are held every eight weeks, providing a forum for the exchange of information and new ideas. The personal allowance accounts of four residents were sampled and all found to be correct. Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 20 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 X X X 3 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 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X X 3 X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X X Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 21 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. Refer to Standard OP28 Good Practice Recommendations As good practice, a minimum of 50 of care staff achieve National Vocational Qualification (NVQ) level 2 or equivalent as soon as practicable. Martin Hall Nursing Home DS0000002543.V303088.R01.S.doc Version 5.2 Page 22 Martin Hall Nursing Home DS0000002543.V303088.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. 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