Inspection on 11/03/09 for Masson House

This inspection was carried out on 11th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 17 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Masson House 24/07/06

Masson House 05/01/06

Masson House 02/03/05

Masson House 02/09/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Masson House 86 Derby Road Matlock Bath Derbyshire DE4 3PY The quality rating for this care home is: zero star poor service A quality rating is our assessment of how well a care home 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 full assessment a ‘key’ inspection. Lead inspector: Nancy Bradley Date: 1 1 0 3 2 0 0 9 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 older people 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. Care Homes for Older People Page 2 of 26 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 Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Masson House 86 Derby Road Matlock Derbyshire DE4 3PY 01629 55740 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Brian Richard Boam Mrs Hazel Teresa Boam Mrs Hazel Teresa Boam Care Home 17 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): old age, not falling within any other category Additional conditions: Date of last inspection: Brief description of the care home: Number of places (if applicable): Under 65 0 Over 65 17 2 4 0 7 2 0 0 6 Masson House is a listed building and is approximately 250 years old. The care home is situated opposite Masson Mill on the outskirts of Matlock Bath. Set within woodland grounds, only the frontage of the building is accessed by residents and visitors. The care home provides residential care for up to 17 older people with a wide range of personal care needs. Accommodation is provided on three floors, with access to all floors by shaft lift or staircase. Care Homes for Older People Page 4 of 26 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: zero star poor service How we did our inspection: The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This was an unannounced key inspection and took place over a total of eight hours. We spoke with the owner who is also the registered manager and people living at the home. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since the last key inspection. This included the following: The annual quality assurance assessment (AQAA) that was sent to us by the home. Care Homes for Older People Page 5 of 26 The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the home. Two people living at the home were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the person. Additionally, time was spent in preparation for the visit, looking at the service history and the previous inspection report. Records were examined relating to the people living there and the general running of the home. We sent out ten Have Your Say questionnaires to people living at the home and their relatives and have received none back. At the time of this site visit the home had ten people in residence. We received one completed questionnaires from care staff. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: 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 on page 4. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 the service experience quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are not in place to ensure that peoples potential needs are fully assessed and can be met prior to admission. Inconsistencies in recording may affect the level of care people receive. Evidence: During the site visit the care details of two people who live at the home were seen. The majority of the people who are admitted to the home have their needs assessed through the care management system, which highlights their additional needs, and the need for any additional staffing hours. The care records of the one-person case tracked had a care needs assessment from the adults Social Services Department; they had lived at the home for a number of years. The second person case tracked was a recent admission and was admitted for respite care. The local Health Authority provided the care needs assessment. One of the people case tracked had mental health issues, which were not recorded in the homes records, also this person was under sixty five. The local Social Services Department have been made aware of this admission. The registered manager stated the person was moving to an alternative placement at the end of the month. Care Homes for Older People Page 9 of 26 The local adult Social Services are currently re assessing peoples’ care needs following an anonymous complaint raised with them. Care Homes for Older People Page 10 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 the service experience quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Inconsistencies in the care planning system, recording and risk assessments may compromise service delivery and may leave people at risk. Evidence: The care plans of two people were viewed in depth. The registered manager stated that she was compiling new care plans for all of the people living at the home. The new care plans provided insufficient detail for staff on how they could meet the needs of the people they were looking after. There were a number of inconsistencies in the care plans and the terminology used was at times inappropriate. This was discussed with the registered manager. Risk assessments were in place however strategies on how to eliminate the identified risk were not fully completed The registered manager stated that she had full knowledge of the peoples care needs. We discussed with the registered manager how she would inform staff of changes to peoples care in the event of her not being available. From care records seen people living at the home or their relatives were not always signing care plans. Although the registered manager reported that relatives were asked but declined. People spoken with and from records seen confirmed that they have access to general care professionals when needed. All of the people at the home are registered with the local GP surgery. The care records of one person were seen and discussions with the Care Homes for Older People Page 11 of 26 registered manager confirmed that the podiatrist services had not been sought by the home since 2007. However general foot care is provided in house. People at the home have access to the local optician and outside eye clinic. The home had purchased a chair for one person. A full moving and handling assessment has been undertaken by adult Social Services. The medication administration practices of the home were viewed. The home has recently contracted with Boots The Chemists. They have not undertaken any audits as the contract only commenced in January 2009. The registered manager stated only staff who have undertaken medication training administer medication. The Medication Administration Records (MAR sheets) viewed were satisfactory. Specimen signatures of staff authorised to administer medication and photographs’ were not with the MAR sheets. One of the people case tracked was not able to fully express themselves verbally and to contribute directly to the visit. We did speak with two other people who stated they get up at 6.30am and go to bed at 9.30pm. They liked to read the paper and watched TV. During a tour of the home and through direct observation we noted the majority of the people appeared to be relaxed and were watching T V. The registered manager confirmed that eight of the ten people who live at the home required some assistance with personal support, with several of them having a high level of need and support. During the visit it was clear that the majority of peoples’ privacy and dignity were respected, where supervision during personal care is required. However there is an issue with one person’s privacy and dignity when they are being transferred to the commode. As the instructions in the care plan did not fully explain how this person’s privacy and dignity was to be maintained. This was discussed with the registered manager. Section Care Homes for Older People Page 12 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using the 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 planned activities and contact with families and friends enables people living at the home to have choice in their lives, and assists in their wellbeing. Evidence: The visitor’s book showed that the home has flexible visiting hours and people living at the home are able to receive their visitors within the communal areas or within their privacy of their own room which ever they preferred. The home uses a local organisation to provide in house activities such as art and craft, music movement and card making. This is on a sectional basis. From records seen people and from direct observation the majority of the day is spent watching TV. We arrived at 8.30am and people were watching the TV. The home has not been able to arrange any church services for the people living there. Previous arrangement had been cancelled. The registered mangers stated she would like church services to be monthly. Peoples’ religious preferences are recorded in their care needs assessment and care plan. The home organises trips out and photographs of these were displayed around the home. Care Homes for Older People Page 13 of 26 The home operates a three weekly menu. At time of this site visit the home is not maintaining a full record of all meals provided. The records seen indicated they were only recording lunch and tea Care Homes for Older People Page 14 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are arrangements in place to safeguard peoples welfare, which enables their concerns and complaints to be listened to and acted upon. However current practice and the lack of up to date training leaves people vulnerable. Evidence: People living at the home are made aware of the home’s complaints procedure through the Service User Guide and the Statement of Purpose. A copy of the complaints procedure is also displayed in the main foyer. Any concerns and complaints made are investigated within the agreed time scales of twenty-eight days. The registered manager states a record is maintained of all complaints made this includes details of the investigation, action and outcome. Records maintained by the home indicated that no complaints had been received from people who live there or their representatives about their care since the last site visit. The policy informs the complainants that they are able to contact the Commission at any stage of the complaints process. However the policy did not show the correct contact details for the Care Quality Commission. We have not received any concerns about this home. However the local adults Social Services Department are currently investigating a complaint under safeguarding of vulnerable adults. The present policy did not meet current practice, nor was any reference made to any local procedures, which were in place. The policy seen did not make reference to the different of safeguarding people can be subject to and need protecting from. No reference was made to whistle blowing. Records seen indicated that four staff required training on the safeguarding of vulnerable adults. We have received information from the registered manger which indicates training in safeguarding has been arranged and will take place in 2009. Care Homes for Older People Page 15 of 26 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, 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. This is what people staying in this care home experience: Judgement: People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The implementation of the refurbishment programme will enhance the independence of the people who live there. Evidence: We carried out a full tour of the home accompanied by the registered manager All communal areas were viewed together with staff facilities. Peoples’ bedrooms were viewed with their agreement. Several of the rooms had been refurnished with new carpets having been fitted. However several areas within the home were starting to look worn with some furniture in one of the small lounges looking threadbare. There is a conservatory attached to the side and front of the house which the registered manager states is used as a storage area. The home has a dinning room and lounge with TV in each room. Two of the bedrooms had an adjoining window allowing visual access of the others peoples rooms. On the day of this site visit the curtains were not drawn across. The registered manager stated all staff had been trained and the home operated effective infection control procedures. The AQAA shows that only two care staff have received infection control training. There were unpleasant odours in two bedrooms and the main hallway on the day of our site visit. The bedroom door on the third floor room seven was damaged. The registered manager stated the fire officer was aware and had approved its use. Fire doors were open and people could use them however curtains are drawn across them. The date on the fire training certificates had been amended from 2002 to 2008. The computer generated fire training certificates had been amended to show training had taken place in 2008. The previous date was 2002. The registered manager stated the Environmental Health Officer had visited last year and they gave a satisfactory report. Care Homes for Older People Page 16 of 26 The home has small laundry area. Care Homes for Older People Page 17 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using the service experience quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of robust recruitment and selection procedures and the appointment of suitably experience staff may adversely affect the care people receive and leaves them vulnerable and at risk. Evidence: On the day of the site visit the staffing complement was the registered manager, a care assistant and a student who is supernumerary to the number ratio of care staff. Two staff are on over night one sleeping and one waking. The housekeeper starts work at 9am. Information in the AQAA indicates that the care hours are for the home are one hundred and fifty four per week. The registered manager stated they have used agency staff however there is no evidence to support this in the AQQA. The registered manager confirmed she has now recruited staff to cover the shortfall in staffing levels. Direct observations of care staff during the site visit indicated that personal care is undertaken through out the day as there is in sufficient numbers of staff to do this when people first get up. Information in the AQAA and discussions with registered manager confirmed the home currently has fifty percentage of its staff who hold a NVQ level 2. The AQAA indicates the full staff complement is total care staff is ten. The home has a recruitment and selection policy in place. Several staff records were examined and all the required information was on record. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance. However the homes’ application form does not indicate that a full employment history is required. The form is not requesting the days date, month and year. This was discussed with the registered manage. It was not clear from records seen if staff are subject to a probationary period. Care Homes for Older People Page 18 of 26 From records seen an individual staff member was appointed following an adverse Criminal Records Bureau (CRB) check and a statement from their previous employer which indicated they could not give a reference as this person had not been with them for a week. The registered manager stated she had spoke with the staff member concerned however there is no record of the interview. No risk assessment had been undertaken on the staff member following the outcome of the Criminal Records Bureau check. Also one member of staff was appointed following the registered manager providing a reference and interviewing her. The home is not routinely maintaining a record of staff interviews held. However all staff have completed an application from. Evidence seen indicates that very little staff training had been undertaken in the previous twelve months. The registered manager had recently complied a training matrix for 2009 which indicates the majority of staff require refresher training on a all of the of mandatory areas. The training matrix for 2008 was not available at this site visit. The registered manager stated she has an induction programme for new staff. The complete questionnaire we received stated they were an experience member of care staff and as such did not require an induction. Care Homes for Older People Page 19 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using the service experience quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of management systems and structure demonstrates the home is not being run in the best interest of the people who live there. Evidence: The registered manager is also one of the registered providers, is a qualified nurse and has many years of experience of the care of older people. She has completed a recognised manager award. The registered manager is involved in the day-to-day and personal care duties of people living at the home. The registered manager stated they have tried to carry out annual quality assurance but with little success. The AQAA states “Not all residents are able to communicate fully and their representatives will not always complete the questionnaire.” The home has produced a newsletter dated February 2009, which gives families an update of what the home has done over the last year. The AQAA states “to continue with developing our quality audits and to use these to improve the service.” There is no annual development plan for the home and no outside consultation with stakeholders on the quality of service provided. The registered manager stated the home did not handle people personal monies, but confirmed she was an appointee for one-person finances. The records were seen Care Homes for Older People Page 20 of 26 however the quality of the recording was inaccurate and no clear audit trail. The balance of the cash in had did not correspond with the balance on the sheet. Records seen indicated that staff had not received any formal supervision within the last twelve months. Staff appraisals were also out of date. The AQAA indicated that that all the essential equipment in the home had been maintained and checked within the last twelve months. Records showed that portable electrical appliance tests, gas appliances and the heating certificates were in place. The information in the AQAA was brief and gave very little information about the home. There is minimal written evidence in the home to support statements in the AQAA. Care Homes for Older People Page 21 of 26 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 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 Requirement 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 Requirement Timescale for action 1 3 14 The home must complete an 30/04/2009 up to date assessment of the persons individual aspirations and needs. This must be completed by the home prior to admission. This is to ensure the home can meet the persons assessed care needs. 2 4 4 14 All assessments must be 30/04/2009 reviewed on a regular basis. This to ensure the home can still meet the persons on going care needs. 3 7 15 Comprehensive individual 30/04/2009 Page 22 of 26 Care Homes for Older People care plans must be developed for each person to demonstrate their assessed need. This is to ensure they will receive the appropriate level of care. 4 7 13 Risk assessment must provide sufficient information for staff and appropriate strategies for must be in place for the identified areas of risk. This is to ensure staff have the knowledge to care assist the person and minimize the hazards or risk. 5 7 15 All care plans for people living at the home must be kept under review. This is to ensure the quality of care and to ensure that changes in the persons care are recorded. 6 9 12 People privacy and dignity must be maintained at all times when personnel care is given. This is to ensure people feel respected and valued 30/04/2009 30/04/2009 30/04/2009 7 18 13 All staff must receive 30/04/2009 training on the protection of vulnerable adults. This is to ensure staff have the knowledge to skills to take the appropriate action when dealing with safeguarding vulnerable adults Care Homes for Older People Page 23 of 26 8 18 13 The homes policy on adult protection must include reference to local safeguarding procedures. This is to ensure people are fully protected. 30/04/2009 9 26 23 The home must ensure that 30/04/2009 systems are in place to keep the home free from odours. This is to ensure people live in a clean environment. 10 27 18 The home must risk assess 30/04/2009 and have strategies in place following an adverse CRB. This is to ensure people are fully protected 11 30 18 All staff must have up to date or refresher training 30required. This is to ensure staff are competent to do their jobs 29/05/2009 12 33 24 The home must undertake a 30/06/2009 review of the quality of care it provides by consulting with outside agencies, stakeholders and make its findings public. This is to ensure the home is run in the best interest of the people who live there. 13 35 16 The home ensures that the 30/06/2009 financial procedures in place are followed by all staff. This is to ensure peoples financially interest are fully protected 14 36 18 All staff must have formal supervision. This is to ensure the staff are appropriately supervised and peoples individual needs are met. 30/04/2009 Care Homes for Older People Page 24 of 26 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 9 The home should maintain an updated list of names of staff that are authorised to administer medication. This should be kept with the medication records at all times. 2 9 Medication records should include a photographic identity to ensure the correct people receive their medication. The home must ensure people have the opportunity to exercise their religious preference and beliefs. The home must maintain a full record of all meals provided. This should include any variations to the set the set menu. The complaints policy must show the current contact details for the Commission for Social Care Inspection. The home must have a routine maintenance and refurbishment programme. The manufacturer must approve the weight limit on the hoist. All staff should be made aware of the GSCC code of conduct The home should maintain a record of all staff interviews All staff must have an appraisal of their performance . 3 4 5 6 7 8 9 10 12 15 16 19 22 29 29 36 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@cqc.gsi.gov.uk Web: www.cqc.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. ©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. Care Homes for Older People Page 26 of 26 - 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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