Inspection on 25/11/05 for Maryland

This inspection was carried out on 25th November 2005.

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

Maryland 05/03/09

Maryland 13/12/06

Maryland 05/08/05

Maryland 13/01/05

Maryland 02/09/04

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

CARE HOMES FOR OLDER PEOPLE Maryland 29 Townsend Drive St Albans Hertfordshire AL3 5RF Lead Inspector Marian Byrne Unannounced Inspection 25th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Maryland DS0000019461.V266603.R01.S.doc Version 5.0 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. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Maryland Address 29 Townsend Drive St Albans Hertfordshire AL3 5RF 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) 01727 853601 01727 848385 marylandcarehome@aol.com Union of Sisters of Mercy Marcia Tonkin Care Home 32 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (32), of places Physical disability over 65 years of age (32) Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th August 2005 Brief Description of the Service: Maryland Residential Home is set in its own attractive and well maintained grounds in a quiet residential area of St Albans, to the north of the city and close to the City Hospital. Accommodation is offered on three floors served by a passenger lift and four stair-lifts. All thirty-two bedrooms, of which many are of a sufficient size that they are set out as bed/sitting rooms, are for single occupancy. There are spacious communal areas comprising two dining rooms, a lounge on the ground floor, a library, a hair dressing salon and various small sitting areas. The home has a ground floor, eight bedded self-contained unit complete with a new conservatory and an enclosed garden. Residents have access to the convents chapel Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a positive inspection. The unannounced inspection was carried out on the 25/11/05 by one inspector. The requirements of the last inspection were met and the home has improved the environment of the home through the addition of an conservatory and the rearranging of the communal area on the ground floor. New floor covering has been laid in the dementia unit giving it a clean fresh appearance. What the service does well: 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. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 6 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 Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 7 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): 1,2,3. The home provides an up to date Statement of Purpose and Service Users Guide. Prospective service users are fully assessed prior to them being offered a home at Maryland. EVIDENCE: The Statement of Purpose has been updated to include the changes in the environment. All prespective service users are assessed prior to admission and are reviewed appropriately at six weeks to ensure they are having their needs met. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 8 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): 7,8,9,10,11. Care plans reflect the needs of service users. Service users have access to health professionals. Medication recording must be more accurate. All service users were treated with respect and dignity. EVIDENCE: The home has reviewed care plans and risk assessments. They contain good easily assessable detail of service user’s care needs. All contain photographs and assessment details. They are updated regularly to reflect changing needs. Health professionals are contacted appropriately and the Registered Manager ensures that all service users receive their mandatory visits from their registered General Practitioner. The home endeavours to offer a home for life to service users. Staff are skilled in caring for those who are in the final stages of life. A visitor whose mother had died the previous evening asked to speak to the inspector. She expressed her gratitude to the staff of the home who were constantly with her mother until her life had passed. She said that she couldn’t fault the care given to her mother. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 9 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): 12,13,14,15. Service users where possible live as full and independent a life as possible with good contact with family and friends. The food served was of good quality. EVIDENCE: On the day of the inspection, a good number of the service users were in the sitting room being entertained by an outside entertainer ‘Sylvia’. Sylvia plays the electric organ. She is a frequent visitor to the home. Service users and visitors spoken with were happy with the quality of care provided to them and their relatives. There was no limitation on visiting the home at reasonable times. Lunch was sampled by the inspector, who found it to be very tasty and of good appearance and colour. There was a very good supply of fresh fruit and vegetables and good quality dry stores. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 10 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): 16,18. The home has a complaints procedure, which it follows. Service users are protected from abuse. EVIDENCE: The home follows its comprehensive complaints procedure. The home had received many complements on the care given to service users. Staff have completed training on protection of vulnerable adults. The Registered Manger manages in a manner that protects service users. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 11 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): 19,26. The home is well maintained. It is clean, fresh, hygienic and odour free. EVIDENCE: The environment was clean fresh and odour free. A new conservatory has been built at the back of the house overlooking the garden. Service users spoken with reported that they were very happy with it. The library has been re-sited next to the conservatory this is a quiet area in the home offering a very comfortable area to sit quietly or to read. New floor covering has been laid in the conservatory giving it a fresh, clean odour free environment. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 12 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): 27,28,29,30. Service users needs are met by current staffing levels who provide an environment where they are protected. The home follows a robust recruitment policy. EVIDENCE: The home has a core of well-trained dedicated staff who provide a safe environment for service users to live their lives to the full. Staff receive all mandatory training. Staff cannot work with service users until they have completed moving and handling training. The home has a robust recruitment policy and does not employ staff until all the statutory identity and security checks have been carried out. The three staffing files inspected reflected this. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 13 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): 31,32,33,36,38, The Registered Manger provides strong leadership in a home that is run in the best interest of the service users. The health and safety and welfare of the service users is protected at all times. EVIDENCE: The Registered Manager provides strong leadership and management that protects the welfare of the service users. She is proactive in ensuring staff are aware of their duties and is fully aware of the extent of her responsibilities within the home. The home is run in the best interest of the service users and the manager is available to the service users and their families and representatives. Formal supervision has yet to become part of the management of the home, however the manager is aware of this and has plans to address it. The home ensures all equipment is serviced regularly fire fighting equipment is serviced annually and the home has a plan in place in the event of a fire. Fire drills are held regularly. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 14 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 2 X x Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 15 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. 1. Standard OP26 Regulation 23(2)(d) Requirement The Registered manager must ensure that the dementia unit within the home is free from odours that could be associated with incontinence. This standard has been met. The Registered Manager must ensure that all reference supplied to the home have been authenticated. This standard has been met. The Registered Manager must ensure that all staff receive regular formal supervision. The Registered Manager must ensure that all records of medicines administered are accurate. Timescale for action 05/08/05 2. OP29 19(4)(c ) 18/08/05 3 4 OP36 OP9 18 13(2) 31/01/06 25/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 16 No. Refer to Standard Good Practice Recommendations Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Maryland DS0000019461.V266603.R01.S.doc Version 5.0 Page 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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