Inspection on 03/08/05 for Maun View

This inspection was carried out on 3rd August 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

Maun View 18/12/08

Maun View 02/11/06

Maun View 01/02/06

Maun View 07/03/05

Maun View 20/05/04

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

CARE HOMES FOR OLDER PEOPLE Maun View 261 Chesterfield Road south Mansfield Nottinghamshire NG19 7EL Lead Inspector Jayne Hilton Unannounced 3 August 2005 at 10:00 am rd 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 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. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Maun View Address 261 Chesterfield Road South Mansfield Nottinghamshire NG19 7EL 01623 423125 01623 412731 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Nottinghamshire County Council Janet Marshall Care Home 60 Category(ies) of 60 - Older People registration, with number 15 - Dementia over 65 of places Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7/3/05 Brief Description of the Service: Maun View is a Nottinghamshire County Council Social Services run home, situated a short bus ride away from the centre of Mansfield. The Home is purpose built to provide personal care for sixty older people over the age of 65 years, with up to fifteen service users who have a diagnosed dementia. Maun View offers forty-four long-stay placements, seven short-term placements, and has the facilities for nine intermediate (rehabilitation) placements. The ten intermediate beds are joint-funded by Mansfield Health Authority and Nottinghamshire County Council.Accommodation for service users is on two floors, with single bedrooms located in four separate units. Each bedroom has an en-suite toilet and shower. There is lift and stair access to accommodation on the first floor. Maun View is constructed around a courtyard, with an attractive and secure garden for service users to enjoy. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. This inspection was unannounced and undertaken by Jayne Hilton on 3rd August 2005. The duration of the inspection was five hours. Several of the key standards were assessed alongside some other standards, which were not covered at the previous inspection. The manager requested that the term residents be used in the report. Six residents were spoken with, four staff, the manager and three members of the intermediate Care Team. Records examined included three residents’ care plans and associated documentation, complaints records, training records, Quality Monitoring and associated records and terms and conditions. Medicines management was also assessed at this visit. The outcomes for residents is assessed, as positive. What the service does well: Residents have all of the information and required documentation they need in relation to the placement, and relatives and friends are welcomed to the home and invited to attend carer meetings. Six residents were able to confirm that their needs were being met and praised the staff team highly. Residents’ wishes and preferences are clearly identified within the care plans and they informed the inspector that they can go to bed and get up when they want to, and have a say in all of their daily routines and lifestyle wherever possible. Staff training is clearly provided to a good level and there are monitoring systems in place to ensure residents need are met and that the input of care is of a good quality. In appearance and demeanour residents presented as well cared for. Residents unanimously reported that staff treat them with respect at all times. Residents’ expectations and preferences are met, and they exercise control and choice over their lives and confirm they are happy with the food provision. Residents are very clear about how to make a complaint should they wish to do so and use their right to vote. From evidence gathered at the inspection, residents are protected from abuse and live in a safe, clean and well-maintained environment. Furniture and equipment meets required standards. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 6 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. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2-6 Residents have all of the information and required documentation they need in relation to the placement. Relatives and friends are welcomed to the home and invited to attend carer meetings. The intermediate care facilities provide help to residents, to maximise their independence and return home. EVIDENCE: Residents spoken with confirmed that they had all the information they needed about the home and confirmed they had been issued with a service user guide and copy of the complaints procedures. Service user guides were evident in resident’s rooms. There was evidence of terms and conditions of residence, however this, was not signed by the resident and this is recommended. Three service users files were examined and Extended Community Care assessments and the homes own assessment documents were seen. There was evidence of annual care reviews and a key-worker system is responsible for completion of three monthly summaries. Residents confirmed that they have visitors who are welcomed at any time and there appeared to be good liaison with relatives regarding contact, carers meetings and entertainment events in the home. Residents confirmed they could have visitors in private. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 9 Six residents were able to confirm that their needs were being met and praised the staff team highly. Residents’ wishes and preferences are, clearly identified within the care plans and service users informed the inspector that they can go to bed and get up when they want to and have a say in all of their daily routines and lifestyle wherever possible. Staff training is clearly provided to a good level and there are monitoring systems in place to ensure residents need are met and that the input of care is of a good quality. In appearance and demeanour residents presented as well cared for. The home has ten allocated beds under the RICS scheme [residential intermediate care scheme], with a dedicated social worker, occupational therapist, physiotherapists, technical instructor, nurse and GP for the service. Service users are referred under specific criteria and are allocated a placement for six weeks, should they need this time, however it was reported that most service users are rehabilitated to return home around four weeks after admission. Therapy is intense with lots of home visits prior to discharge. The RICS has a dedicated kitchenette, use of the main building for mobility and a small office is provided, however the RICS staff, tend to spend more time on the unit and therefore share the office on the unit with the care staff so this can be cramped at times. Feedback from the professionals spoken with regarding the care at the home was that the care provided in the home is good, that the carers are good and that they work alongside the RICS staff and are receptive and promote what is advised. The relationship between the RICS staff and the unit staff was observed to be good. The RICS scheme and the unit staff reported that they would like to have more staff allocated to the unit to improve the service further. Regular meetings take place and both the manager of the home and the RICS manager have some issues to discuss currently. A meeting had been arranged on the day of the inspection but was unfortunately cancelled because of it. Residents comments included the following: “Staff are very kind”. “If ever there was a band of angels in heaven, sent to walk this earth, then they are here working at Maun View” “ Staff are good at listening” “We are well cared for” All facilities including laundry services are fine” Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-10 Residents are well aware of their care plans and state that their needs are fully met, including personal and health care. Medication management is generally of a good standard, however staff need to ensure that the policies and procedures are followed on every occasion. Residents unanimously reported that staff, treat them with respect at all times. The registered provider needs to address NHS entitlements on behalf of some service users. EVIDENCE: The care plans for the three residents were seen on this inspection. They all contained, comprehensive information and instructions for staff, as to the level of need and actions required. The care plans are signed in agreement by either the resident or their representative and three of the residents spoken with said they had a copy in their bedrooms. Monthly reviews take place but these were not up to date. The inspector saw records to confirm that the resident’s health needs are monitored and GP interventions sought for any health concerns. There was also evidence of other healthcare input including physiotherapy, optical and District Nurse visits. All residents confirmed that staff, contact GP’s promptly if they are ill. There was evidence of risk assessments for mobility and risk of pressure sores. There was evidence that not all service users who should be Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 11 receiving NHS entitlements, are doing so. Staff reported that this had been difficult to obtain. The registered provider should now address this. It would be beneficial for diabetes to be noted on the nail care section of the care plan Medication management was assessed and found to be generally satisfactory, however a medicines round was observed and the staff member actually signed for the medication prior to visually observing the medication being taken and this is not appropriate practice. It was reported that there are no residents self- medicating currently but appropriate policies and procedures were seen in relation to all medicines management. [Service users on the RICS scheme do however self medicate as part of their rehabilitation programme and NHS policies and procedures are used for this purpose]. Photographs were seen and the records were satisfactory. Staff, were aware of the need to keep medication for seven days after the death of a service user. It is recommended that a copy of the drug error procedure should be kept with the medication administration records. There was no evidence of storage temperatures of medication being taken apart from medication that requires cool storage therefore this, needs to be implemented. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 15 Residents expectations and preferences are met and they exercise control and choice over their lives and confirm they are happy with the food provision. It is however recommended that a review of the activities provision is undertaken with residents and staff and that consideration is given to the employment of an activities co-ordinator. EVIDENCE: Activities were reported to be carried out on each unit by the care staff, which included bingo, dominoes, board games, skittles, quiz sessions and the occasional singer. Some residents spoken with reported that there was something arranged every night but two, from their experience, another resident reported that activities seemed to always take place when visitors arrived so didn’t get the opportunity to participate. Others reported that more activities could be provided. On speaking with staff in the home, their opinion was that more trips out should be facilitated, however these were restricted due to budget limitations and they reported that two day trips had unfortunately been cancelled due to conflicts regarding salary re-numerations. The manager reported that all residents were registered with dial a ride and that activities provision is discussed in resident meetings and in resident surveys, and that extra staff are rotered as needed. Any allocated funds for activities have to be raised by the home, and the way funds are spent and are discussed in resident meetings. There is a day centre adjacent to the home, Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 13 but this can only be resourced by residents on short–term placements. A resident reported that she had moved from short-term care to long-term care and had missed the daycentre facilities very much. It is recommended that a review of the activities provision is undertaken with residents and staff, and that consideration is given to the employment of an activities co-ordinator. Residents confirmed that they can make decisions about their daily routines and this was evidenced in care plans and through observations made at the inspection. The quality and quantity of food was reported to be very good and the lunchtime meal options served looked appetising and well presented. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16-18 Residents are very clear about how to make a complaint should they wish to do so and use their right to vote. Residents are protected from abuse. EVIDENCE: The inspector spoke with six of the residents about complaints, and all were very clear about how they would raise any issues or concerns. None had made any recent complaints. One complaint had been received by the home, since the last inspection. The complaints procedure was available on the notice board in the entrance to the home. Residents confirmed that they were able to use their vote at the recent election. Adult protection policies are in place and records and staff spoken with confirmed that all staff, attend induction and training on abuse awareness. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 24, 26 Residents live in a generally safe, clean and well-maintained environment with facilities which are adapted for use by residents with a disability. Furniture and equipment meets required standards. Residents’ rooms are safe and personalised. EVIDENCE: Maun View presents as comfortable and satisfactorily maintained throughout, with homely communal areas and bedrooms that are individually personalised. There is a system for logging day-to-day maintenance issues, with details of remedial action taken. Residents said they are encouraged to bring personal possessions to Maun View, and bedrooms viewed during this unannounced inspection were personalised to suit the individual in residence in that room. The dining areas within the home are set out in a manner that is conducive to the enjoyment of meals. Maun View was free from odour and, overall, in those communal and private areas inspected, the rooms and walkways were seen to be clean. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 16 There are numerous hoists available and assisted bathing facilities throughout the home. Handrails are site around the walkways and in bathrooms and toilets. The manager reported that occupational therapy input is obtained where necessary to ensure aids and adaptations meet all individual needs. A lift provides access to both floors and there is a loop system in place. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 30 Residents needs are met by, minimum staffing numbers of staff who are well trained and competent. A staffing review would further benefit residents and provided clearer information for all. EVIDENCE: The staffing rotas were examined and these indicated that minimum staffing levels were provided. Residents and staff did however make comments that there was sometimes a problem with staffing numbers due to short notice sickness and holidays and comments were made that staff wished to provide more one to one time with residents, but this was not always possible and that higher dependency levels were now being taken. Residents reported that staff worked very hard. The manager reported that relief staff were always utilised and the home had never fallen below minimum staffing levels and that regular needs assessments were carried out in relation to staffing numbers required. There was also conflicting information gathered about the role of the team leader and the inspector recommends that a review of both staffing levels and the roles and responsibilities of care staff and team leaders is undertaken to ensure that all staff are clear about this. Induction and training records were seen and found to be satisfactory. The ratio of staff, who have achieved NVQ level 2 or above is now 48/50 , many are undertaking level 3 or 4 also. The team are commended for this. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 The home is run in the best interests of residents and they are safeguarded from by the accounting and financial procedures in the home. EVIDENCE: Quality monitoring systems are in place with service resident’s surveys and feedback in resident meetings being evident. The local authority and home business plans were examined alongside appropriate insurance policies and Regulation 26 reports. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 3 x x x x Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 20 NO Are there any outstanding requirements from the last inspection? 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. 2. Standard OP9 OP9 Regulation Medicines Act, 12 Medicines Act, 12 Requirement Medication must be signed for only, after being visualy observed as taken. Ensure the storage temperature of medication is monitored and recorded. Timescale for action 1/11/05 1/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP2 OP7 OP8 OP12 OP27 Good Practice Recommendations The terms and conditions document should be signed by residents. Care plans should be reviewed monthly and kept up to date. Ensure residents receive their NHS entitlements in relation to Chiropody and Inco aids. undertake a review of the activities and consider employment of an activities ogansiser. Undertake a review of the staffing levels, roles and responsibilities as detailed in the report. Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 21 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham, NG2 1RT 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 Maun View C02 C53 Maun View S36331 V235637 030805 Stage 0.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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