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Inspection on 13/11/08 for Martinmass Close Care Home

Also see our care home review for Martinmass Close Care Home for more information

This inspection was carried out on 13th November 2008.

CSCI found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Martinmass Close Care Home 6-8 Martinmass Close Lenton Nottingham NG7 2LN The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Meryl Bailey Date: 1 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 27 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Martinmass Close Care Home 6-8 Martinmass Close Lenton Nottingham NG7 2LN 01158443663 01159788182 mdebbieb@ncha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): NCHA Name of registered manager (if applicable) Debbie Booth Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 0 care home 5 learning disability Additional conditions: service users shall be within category LD Date of last inspection 1 4 1 1 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 27 A bit about the care home Martinmass Close Care Home provides care and support for up to five adults with a learning disability. The home is not far from Nottingham City centre. Four single bedrooms are on the first floor and one bedroom is on the ground floor. There are two shared bathrooms and downstairs a communal lounge and dining room. More information about the care home, including copies of inspection reports, is available on request at the home. The current fee for living at the home is £343.62 per week. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Care Homes for Adults (18-65 years) Page 6 of 27 Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 27 How we did our inspection: This is what the inspector did when they were at the care home We saw all four of the people who currently live there. We talked with some of them. We checked the care records of two people and looked at a sample of staff records. We had discussions with some of the staff. Information about a home that is collected before the site visit is also used as evidence to make judgements. We received a completed AQAA (Annual Quality Assurance Assessment) form from the manager. Care Homes for Adults (18-65 years) Page 8 of 27 What the care home does well People are supported to take part in activities and they can choose where to go for holidays. The Complaints Procedure is in Signs and Symbols to help people understand. The house is safe, comfortable and homely for people to live in. Care Homes for Adults (18-65 years) Page 9 of 27 There are enough trained staff to keep people safe. The home is managed responsibly. What has got better from the last inspection Staff have completed assessments of risks and know what to do so that people can do activities safely. Care Homes for Adults (18-65 years) Page 10 of 27 What the care home could do better Use more pictures and symbols so that people living at the home are given more opportunity to understand and be involved in their own support plan. Consider alternative places to store medication. Arrange for staff to have regular recorded supervision meetings at least six times a year. Care Homes for Adults (18-65 years) Page 11 of 27 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Meryl Bailey Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge, CB21 5XE Phone 01223 771300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 12 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 13 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Admission arrangements make sure the home is suitable to meeting peoples needs. Evidence: There has been one new admission to the home since the last inspection. This person moved in at short notice and there was a copy of the placing authoritys previous assessment on the file. This was sufficient to establish that needs identified could be met at Martinmass Close. Staff at the home were continually reassessing and had commenced a full support plan (see next section). Care Homes for Adults (18-65 years) Page 14 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Support is planned to meet needs, but people are not involved in developing their own individual plans. Evidence: We looked at the files of two people at the home. A support plan had been developed for one of these who had lived at the home for a long time. The file did not give full information as the most recently updated parts to the plan were recorded only electronically on the computer. Staff had commenced a plan for the other person and it was available by viewing it on the computer screen. The content of the file was limited to an old assessment and various letters and lists. The people living at the home were unable to access the updated content in either form, but staff were used to using the computer and each of the staff added daily notes. Some previous plans were more accessible with some pictures. Staff told us of a project that had commenced to provide a Circle of Support poster for each person, using pictures and photographs. This is to enable them to understand who people are and what roles people have to assist them. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: There were monthly house meetings and some previous minutes indicate people were consulted about trips out and future holidays. The minutes are not written and supported by Signs and Symbols, but the minutes of the most recent meeting were not yet available. The electronic support planning system included risk assessments. Some risk assessments were concerned with health and safety around the home and others were about activities and risks involved when going out. Care Homes for Adults (18-65 years) Page 16 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are supported to take part in activities and have a quality lifestyle. Evidence: Three of the people living in the home attended a day centre and the other person was at home. The manager and staff told us about regular trips out and that people can choose if they want to go or stay at home. Daily records and activity sheets confirmed these trips to Matlock, shopping centres and various parks. Holidays have been funded by the provider (Nottingham Community Housing Association). Two people went to Louth, near Skegness for a week in July and one person went to Matlock for a week. One person has planned to go to one of the Canary Islands next year with staff support. Staff members were observed interacting with people in a patient and respectful manner. Staff spoken with demonstrated an understanding of the needs of individuals. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: People who attend day centre usually had a main meal provided there. There were records of what evening meals people had eaten each day in the home and these showed some variation. Staff explained that they bought a range of food that they know people like and then offer a choice each day of what is available. The record for the previous evening was scrambled egg, stir fry and spaghetti, juice and tea. A roast dinner was provided on Sundays and one of the staff was developing a new menu. Staff said there was a picture book including choices of meals, but this could not be found during the inspection visit. Staff showed some concern about the money available to buy food, but the manager said that there was always enough to purchase food for the people who live at the home. Care Homes for Adults (18-65 years) Page 18 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Personal care is flexible and meets the needs and preferences of individuals. Medication is given safely, but storage arrangements present a risk that some medicines may not retain their quality. Evidence: Staff members spoken with were aware of individual preferences in daily routines and the support needed with personal care. There were records of when people had seen doctors and other health professionals. Medication was stored securely, but in a room where the temperature varied. One of the cupboards was above a sink and during the inspection some tablets fell into water in the sink. Temperatures had been taken in the room and written down, but not every day. Medication Administration Records (MAR) were completed to show that people were offered their medication as prescribed to them by a doctor. The manager told us that she randomly tests staff on their knowledge of the medication policy using questionnaires. Care Homes for Adults (18-65 years) Page 19 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are assured their concerns will be listened to and they are safeguarded from abuse. Evidence: The Complaints Procedure was displayed in a Signs and Symbols format in the care home and is also contained in the service user guide. Two of the people living at the home indicated that they knew how to make a complaint by telling the staff they know well. Others indicated on questionnaires that they knew about making complaints and that they had a Service User Guide. There had not been any new complaints since the last inspection. Staff members spoken with demonstrated an awareness and understanding of abusive practices and of their responsibility to alert the manager of all allegations or suspicions of abuse or. The manager told us that more training was planned for staff in March 2009 to ensure all staff have updated information and awareness. Care Homes for Adults (18-65 years) Page 20 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People at Martinmass Close live in a safe, comfortable, homely and hygienic environment. Evidence: We looked at most of the areas in the house and all were clean and fresh. The dining room was of a domestic design. People settled in the lounge after their evening meal and looked comfortable in the leather seats. A repair had just been completed in one of the bathrooms where there had been a leaking radiator. This had also caused damage to the ceiling below, which was due to be repainted after it had completely dried out. There were extra grab rails in a bathroom to encourage peoples Independence in getting in and out of the bath. Bedrooms were decorated in colours chosen by individuals and well furnished. One person had an individual lighting system and could choose which lights to relax with. Care Homes for Adults (18-65 years) Page 21 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staffing arrangements ensure people are in safe hands and supported by trained staff. Evidence: The manager and two support staff were present at the commencement of this inspection with one person who lived there. The three others arrived home during the inspection. The rota showed that there were always a minimum of two staff available. At night one of the staff slept on the premises and another was awake. There was an additional bedroom for sleep-in staff. At weekends, when no one was at day centre, there were three support staff during the day. Staff files selected for inspection both contained evidence that the staff each had two written satisfactory references and had been checked through the Criminal Records Bureau before they commenced work at the home. There was a new member of staff who had completed an induction. The manager told us that all other staff had attained at least National Vocational Qualification at level 2. Two had also attained level 3. There was also evidence on the staff files that these staff members had received health and safety training. There were also certificates for other courses attended, which included Equality and Diversity, Mental Capacity Act, Cultural Awareness and Communication. There were records of regular staff meetings and staff said they had opportunities to Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: discuss matters with the manager on an informal basis, but formal one to one supervision meetings had not been regular or frequent. Of the two staff files we looked at there were records of only one such meeting since the last inspection for one staff and three for the other. Care Homes for Adults (18-65 years) Page 23 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is managed responsibly in the interests of people that live there. Evidence: The manager, Debbie Booth, is registered with the Commission. She returned the completed Annual Quality Assurance Assessment to us when we asked for it. Quality audits in accordance with Nottinghamshire Community Housing Association (NCHA) policy involve a manager of another NCHA service visiting the home to audit different aspects of the service. As part of this, people who live at the home have been enabled to express their own views. There were also minutes of monthly house meetings in which individuals were encourage to express views about activities and trips out using the vehicle available for them at the home. Staffing files showed that support staff had received training in Health and safety. All fire safety tests were undertaken as required by law and fire equipment including emergency lighting had been serviced and checked since our last inspection. Portable electrical equipment was labelled as checked in January 2008. The central heating and gas appliances were serviced in June 2008. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 Print off updated plans and use more pictures and symbols so that people living at the home are given more opportunity to understand and be involved in their own support plan. Monitor the temperature of the room containing medication at different times each day and consider alternative sites for the safe storage of medication. Arrange for staff to have regular recorded supervision meetings at least six times a year. 2 20 3 36 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!