Inspection on 09/01/07 for Maryfield Convent

This inspection was carried out on 9th January 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

Maryfield Convent 08/01/09

Maryfield Convent 07/03/06

Maryfield Convent 18/10/05

Maryfield Convent 23/12/04

Maryfield Convent 01/09/04

Maryfield Convent 05/03/04

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 Maryfield Convent London Road Hook Hampshire RG27 9LA Lead Inspector Mr Rodney Martin Key Unannounced Inspection 9th January 2007 12:00 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 Maryfield Convent DS0000012262.V324479.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. Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maryfield Convent Address London Road Hook Hampshire RG27 9LA 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) 01256 762394 sisters@maryfieldhook.fsnet.co.uk Congregation of Dominican Sister Sister Celestina Cini Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a service user with the date of birth 12/08/1920 in the category MD(E). 7th March 2006 Date of last inspection Brief Description of the Service: Maryfield residential care home is registered to provide accommodation for 26 people who are within the category of old age. The home is owned and managed by the Congregation of Dominican Sisters of Malta. The home endeavours to provide a homely and relaxed environment for service users. Staffing is provided twenty-four hours a day. Visitors are welcome and service users families are encouraged to play an active part in their relative’s life where appropriate. The home has well-established links with local General Practitioners and nursing services to support and enhance the care provided. The home is situated in a small village of Hook and is set within the grounds of the convent, which is attached. The home is a three-storey building and accommodation is provided on the upper two floors. The home has restricted its admission numbers at present to thirteen on the first floor only. The current fees are a flat rate of £410 per week. This information was contained in the pre-inspection questionnaire received in the Commission’s office on 5 January 2007 and was confirmed on the day of the inspection. There are additional charges for hairdressing, chiropody, toiletries, newspapers/magazines and holidays. Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place between 9.45am and 2pm. The process included an examination of documents and records, observation of staff practices, where this was possible without being intrusive. The inspector also had the benefit of receiving a pre-inspection questionnaire from the home, although no comments cards were received from staff or residents. The majority of residents were interviewed, some in the privacy of their room, as well as two visitors and a volunteer. The inspector was also able to speak to staff. An opportunity was also taken to look around the home, including communal/shared areas, the home’s kitchen and laundry and a sample of bedrooms. The home’s registered manager was present throughout the visit and was available to provide assistance and information when required. On the day of the visit thirteen residents were accommodated and of these three were male and ten were female, whose ages ranged from 81 to 96 years. One resident has been in the home since 1996 and the rest were admitted from 2000 onwards. The stated aims and objectives of Maryfield are that “the management pride themselves on offering a highly professional care service for the elderly, with a personal touch. We are pleased to accept residents for long and short term. When people have worked hard throughout their life and have been committed to helping others, we think they deserve extra cherishing. They need a home where individuality is emphasised, with staff who have time to give attention to small detail, and where they have the choice of enjoying the company of likeminded fellow residents. The home subscribes to the six core values of privacy, dignity, independence, choice, rights and fulfilment”. The home was found to be meeting its stated aims and objectives, on the day of the inspection. In line with the Commission’s policy, all the key standards were inspected on this occasion. What the service does well: The home provides a good service and the needs of residents are met within Maryfield. There is a very relaxed and friendly atmosphere in the home. The home is well managed with the involvement of both staff and residents. There is a good staff team, who are suitably trained and supervised to provide a good standard of care for residents. Residents are listened to both in having their views sought through questionnaires, residents’ meetings and through Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 6 the daily involvement by staff. A visitor and residents said that the staff were very caring, helpful and there was also very positive comments from a questionnaire completed by residents and relatives in November 2006. The home provides a clean environment free from adverse smells. 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. Maryfield Convent DS0000012262.V324479.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 Maryfield Convent DS0000012262.V324479.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process is well managed with an assessment completed, to ensure that Maryfield can meet the prospective service user’s needs. Maryfield does not provide intermediate care. EVIDENCE: On the day of the inspection Maryfield was accommodating thirteen residents. Although Maryfield is registered for twenty-six residents the management have made a decision not to use the upper floor and so the home is currently full with thirteen residents. Since the last inspection, on 7 March 2006, two new residents were admitted. The inspector was able to speak to these residents as well as view their files. Three visitors were also spoken to. One visitor said, “It’s lovely here, there’s plenty of TLC [tender loving care]”. A resident told the inspector, “It’s a lovely place to live in”. Other residents spoken to echoed this sentiment. Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 9 Maryfield has been operating as a care home for over forty years and referrals come mainly through the home’s reputation. Prospective service users do not have to belong to the Catholic faith as the home has an open policy regarding the admission of residents. As noted above the home is currently full and there is a waiting list for a vacant place. Following an initial inquiry, when basic details are obtained, if the manager feels they can meet the residents’ needs, the family are invited to come have a look around the home. The prospective service user is then invited to come and spend the day in Maryfield, which would include having a complimentary lunch with the residents. This enables the staff to assess the individual’s capabilities as well as give the prospective service user an opportunity to see if the home is what they are looking for. A comprehensive pre-admission assessment is completed, which includes sufficient information for the home to make an informed judgment regarding whether they could meet the perceived needs of the resident or not. There is a trail period of one month, which can be extended if required. A relative had completed a recent questionnaire and stated, “My mother is so happy and content in the caring and loving atmosphere of the home. All the sisters are patient and understanding, providing loving caring from their hearts. I am always made so welcome. Whenever we come and see mother it is like visiting family and makes X so happy. We always have a cup of tea”. Maryfield does not provide intermediate care, although prospective residents can come for a short respite stay, if there is a vacancy. Short stay residents are assessed in the same way as permanent residents. Maryfield Convent DS0000012262.V324479.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ physical and emotional needs are met, as set out in individual care plans and risk assessments, with evidence of good multi-disciplinary working taking place on a regular basis. Residents are protected by appropriately trained staff, who follow the home’s policies and procedures for dealing with medicines. Personal support within the home is offered in such a way as to promote and protect residents’ privacy and dignity. EVIDENCE: Each resident has a separate case file, which is includes the resident’s personal details and photograph, medical information, the resident’s abilities for activities of daily living, various risk assessments, the monthly review of care and their interests and hobbies. Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 11 Various files were seen and residents spoken to. There was evidence that needs were met. For example one resident told the inspector that they prefer to have a shower instead of a bath. Also they needed to see the chiropodist and this had been arranged for them. Care plans are reviewed monthly. The personal and oral hygiene of each service user is maintained and recorded. All residents are registered with a GP at Hook surgery in Reading Road. The GP visits weekly, or when required and residents can see the GP in the privacy of their own room. The manager reported that there is very good support from the GP and community nursing service. Residents have access to all other health professionals on an as needs basis and are supported by staff when necessary. The home has a relevant medication policy, which satisfactorily details the receipt, recording, storage, handling, administration and disposal of medicines. Although residents are able to self medicate within the home’s risk management framework, currently none are self-medicating, apart from one resident taking paracetamol when required. The home operates a monitored dosage system for administering medication. This is kept in a locked cupboard within a locked room. The home does not currently have any controlled drugs, apart from two residents who have been prescribed Temazepam. The drug administration sheets were satisfactorily recorded, with no omissions. Staff have received medication training through the home’s pharmacist. All residents spoken with confirmed they are well-supported, treated with dignity and respect, and that they receive a high quality, consistent level of care. Staff members knocked on residents’ doors before entering and referred respectively to residents by their name, without patronising them. An appropriate lock is provided on all bedroom, toilet and bathroom doors. Residents are free to make and receive telephone calls in private. A number of residents have their own telephone installed. One resident had written in their questionnaire, “Considering I am not a easy person to get on with I am very pleased with the care, help and friendliness of the staff”. Maryfield Convent DS0000012262.V324479.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ social, religious and recreational needs are met. Contact with family/friends/representatives and local community is encouraged as the individual wishes. Practices in the home demonstrate that the home promotes individual choices and encourages residents to have control over their lives. Dietary needs of residents are well catered for with a balance and varied selection of food available that meets residents taste and choices. EVIDENCE: The home provides various activities for residents to participate in, although there is no organised programme. One resident told the inspector, “There’s plenty to do here”. Staff ask the residents each day what they would like to do. The home has used a questionnaire to find out what service users would prefer to do. The majority of residents go to morning mass at 10am, for halfan-hour and then come back for the coffee club, which is run by a volunteer. The inspector had coffee with some of the residents and the volunteer and a Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 13 visitor. There was a friendly banter of conversation over coffee. One resident had written on their questionnaire, “The coffee club is excellent”. Apart from the usual activities, within residential care, such as reading, watching television, bingo, exercises, residents can participate in reminiscence activities and enjoy walking around the home and in the extensive garden. Staff take residents out shopping and some residents prefer to go into Hook village on their own. On 6 November 2006 a trio from The Anvil, Basingstoke came to give a concert, which was enjoyed by the residents and friends attending. There are outdoor activities during the summer months as well as picnics in the garden. Contact with family and friends are maintained. Visitors can visit at any reasonable time and residents can see their visitors in the privacy of their bedroom, in the communal areas in the home or have refreshments in the tearoom. This was confirmed by the visitors spoken to as well as the information recorded in the statement of purpose and service users guide. On the day of the visit the inspector met two visitors and a volunteer. They were very complimentary about the home, stating they were made welcome and that there was a very relaxed and friendly atmosphere in the home. The home has residents’ meetings every three months and they are generally planned to coincide with major events. Minutes of these meetings are maintained and topics included celebrations, activities and menu planning. Residents are supported and encouraged to manage their own finances. The home does not manage or retain money for service users. Residents have brought their own furniture and possessions into the home and have arranged their rooms to meet their own requirements. The home operates a four-week menu. Generally, residents are not offered a choice for the midday meal unless they do not like what is on the menu, although occasionally there is a choice available, for example, lamb or pork chops, quiche Lorraine or chicken and ham pie. Residents’ likes and dislikes are recorded. The meal is taken into the dining room on a heated trolley and residents can help themselves and take what they want. On the day of the inspection residents had chicken in a tomato sauce, with boiled potato, broccoli, peas and carrots followed by ice cream for dessert. Residents were due to have a choice of soup, cheese or egg on toast for tea. Residents spoken to said how much they enjoyed the meals in Maryfield. This was also confirmed in a recent questionnaire completed by residents and relatives. The kitchen was clean and tidy. The record of food provided to residents, including alternatives to the menu, was satisfactorily maintained. An environmental health officer visited the home on 8 December 2006 and stated, “excellent standards of food safety and cleanliness”. Maryfield Convent DS0000012262.V324479.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints policy in place that is accessible to residents, their friends and relatives and members of staff. The home has an adult protection procedure, which protects and safeguards residents from abuse, although this would be further improved with staff receiving training in the various aspects of abuse. EVIDENCE: Maryfield has a detailed and relevant complaints procedure, which is contained in the home’s statement of purpose and service users guide. Residents, spoken to, were aware of whom to complain should they have a need to. One resident told the inspector, “I’m happy here and have no complaints”. From the selection of questionnaire recently completed by residents, comments such as, “Have not had to make any [complaints]” and “No complaints made”, were typical of the replies. The home has a complaints log and no complaints were recorded, since the last inspection. The home has all the relevant documentation relating to adult protection, including a whistle blowing and the adult protection policy. In discussion with the manager and staff it was confirmed that staff have not had any abuse training during 2006. It was agreed that the manager would either obtain a training video on abuse or access adult protection training. There have been no incidents of abuse notified to the Commission. Maryfield Convent DS0000012262.V324479.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, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A very good standard of accommodation is provided ensuring that residents live in a homely, safe and comfortable environment. Residents have individualised their bedrooms, to meet their needs. EVIDENCE: A tour of the building was undertaken. Maryfield is a three-storey building, with facilities and services on the ground floor and bedrooms on the first and second floor, although the second floor is not currently in use. A chapel is attached to the home and the main Catholic Church is adjacent to Maryfield. The home has a large well-maintained garden, which is greatly appreciated by residents. There is paved access around the building for residents to walk securely. Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 16 Maryfield has twenty-six single bedrooms, none provided with en suite toilet facilities. Although the home is currently registered for twenty-six residents, the management have made a decision not to use the second floor, which has thirteen bedrooms. The home has two-day lounges, two dining rooms [one is used by staff] a hairdressing/activity room and a tea/coffee room. There is also a private chapel that is open for residents to use. Since the last inspection a more secure doorbell system has been installed and a refurbishment of the ground floor, bathroom and toilets. The inspector spoke in private with several residents who were very complimentary about the home’s facilities and said, “I like my room and am very comfortable”, although, one resident added that they would appreciate an en suite toilet. A resident had written in the recent questionnaire, that Maryfield was a “very good home to be living in”. There was evidence of residents’ personal belongings in the rooms. There were no adverse smells noted. The home has a separate large laundry room, which is situated away from food preparation. The laundry room has two commercial washing machines and a commercial dryer and the room was clean and tidy. There was evidence of COSHH [control of substances hazardous to health] policies and procedures in place and staff were observed to be complying with infection control procedures and practices. Maryfield Convent DS0000012262.V324479.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good staffing levels and residents are supported by sufficiently trained staff, to ensure that their needs are met. Residents are protected by the home’s robust recruitment procedures. EVIDENCE: Maryfield employs seven staff members, including the registered manager, who are Dominican Sisters from Malta. They all live on the premises and work various shifts throughout the day from 8am to 8.30pm. Maryfield also employs an administrator, who was available, on the day of the inspection and the services of an agency domestic. The home employs agency staff for the night duties, although the sisters take it in turn to provide the ‘sleep-in’ staff member. The same agency staff have been coming for some time and a resident told the inspector that they like the two carers that come. The inspector was able to speak to staff. There was evidence that the staff team worked well together. A relative had written in a recent questionnaire, “The care could not be better nor the care and dedication of the sisters at Maryfield”. All the sisters have obtained NVQ [national vocational qualification] in care at level 3 or have a nursing qualification, and this is to be commended. The Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 18 agency staff used for night duties have been coming to the home for some time and are experienced. Since the last inspection two staff members left, returning to Malta. However two sisters have replaced them, both with nursing qualifications, in May and September 2006. The former had worked in Maryfield before and has returned to become deputy manager. There was evidence that the home had followed the necessary checks before staff commenced their duties. The home has a full complement of staff. The home ensures that staff receive training in the basic core subjects of manual handling, first aid, fire safety, food hygiene, health and safety and control of medicines. A system of supervision is in place. Maryfield Convent DS0000012262.V324479.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, 32, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is approachable and has an open style of management. She provides good leadership, which ensures staff are supported and residents’ health, safety and welfare promoted through the home’s practices. EVIDENCE: Sister Celestina Cini is suitably qualified to run Maryfield having obtained the registered managers award for NVQ level 4 in both management and care. There is an open, friendly and transparent atmosphere within the home, which was also confirmed by a visitor, a volunteer and a visiting relative as well as evidence obtained from the recent questionnaires completed by both residents and relatives. One relative had written, “My compliments to all concerned for running an excellent residential care home”. Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 20 The home has used questionnaires to further ensure a quality control within Maryfield [these have been referred to in various parts of this report]. The majority of residents were spoken to and they were able to voice their opinions. From the various discussions and a review of the questionnaires, completed in November 2006, the overwhelming sentiment was summed up by a resident, “I feel at home and happy here”. The manager is not appointee for any resident as well as not handling any service user’s money. Additional charges, such as chiropody and hairdressing are either paid for on the day or an invoice is given to the family, when they next visit the home. The manager can pay out of the home’s petty cash account when taking two or three residents out shopping. Again, the resident either pays directly for their purchase or an invoice is given to the family, when they next visit the home. The fire logbook was inspected and the records indicated that the fire safety equipment had been tested and serviced within the guidelines. Staff have received fire safety training from an outside agency on 17 January and 12 July 2006, which also included a fire drill. The manager ensures the safe working practices by planning courses on health and safety within Maryfield, including first aid, manual handling, food hygiene, fire and medication. Risk assessments are in place. There are current and up to date contracts on electrical equipment as well as kitchen and domestic appliances et cetera. COSHH [control of substances hazardous to health] policies and procedures are in place. Window restrictors are in place on the windows above ground level, to ensure safety for residents. From a check of the records and practices observed in the home during the inspection, the health and safety measures taken in the home ensure the welfare and safety of the residents. Maryfield Convent DS0000012262.V324479.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 X X 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 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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. Refer to Standard Good Practice Recommendations Maryfield Convent DS0000012262.V324479.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Maryfield Convent DS0000012262.V324479.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. 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