CARE HOMES FOR OLDER PEOPLE
Mauricare Residential Home 22-24 Fosse Road Central Leicester Leicestershire LE3 5PR Lead Inspector
Thea Richards Key Unannounced Inspection 24th May 2007 09:15 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 Mauricare Residential Home DS0000064312.V337627.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. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Mauricare Residential Home Address 22-24 Fosse Road Central Leicester Leicestershire LE3 5PR 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) 0116 251 3785 0116 251 3785 manager@mauricare.com Mauricare Ltd Zarine Golamy Care Home 17 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (4), Dementia (1), Dementia - over of places 65 years of age (17), Mental Disorder, excluding learning disability or dementia - over 65 years of age (17), Old age, not falling within any other category (17), Sensory Impairment over 65 years of age (3) Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. No one falling within category A may be admitted into the home where there are 4 persons of category A already accommodated within the home. No one falling within category SI may be admitted into the Mauricare where there are 3 persons of category SI already accommodated within the home. No one falling within the DE category can be admitted to Mauricare where there is already one person of category DE accommodated within the home. No one falling within the MD(E) category can be admitted into Mauricare where there is already one person of category MD(E) accommodated within the home. The maximum number of persons to be accommodated at Mauricare is 17. Mauricare residential care home provides personal care for male and female service users who fall within the following categories: Past or present alcohol dependencer over 65 years of age (A(E)) 4, Demential (DE) 1, Dementia over 65 years of age (DE(E)) 17, Mental Disorder, excluding learning disability or dementia, over 65 yers of age (MD(E)) 17, Old age not falling within any other category (OP) 17, Sensory Impairment over 65 years of age (SI(E)) 3. 11th May 2006 Date of last inspection Brief Description of the Service: Mauricare Residential Home is a care home providing personal care and accommodation for 17 older people with a physical frailty and/or mental health needs. Mauricare Limited, own the home, with Zarine Golamy working as the manager. The home is situated on the outskirts of Leicester city off a busy main road and is easily reached by private and public transport. There are local amenities of shops, cafes, churches and parks close to the home. There is limited parking available on the front of the home. The accommodation is a converted three storey detached house with two lounges and a dining room on the ground floor. There are bedrooms on all floors; the first and second floors can be reached by stairs or by a passenger lift. There are single and shared bedrooms, some of
Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 5 which have en-suite facilities. Outside, there is a well - maintained paved garden with seating, which is easily reached for the residents to use in the better weather. The current registration certificate and the latest report from the Commission for Social Care Inspection are available in the reception area. The home can be contacted by telephone, email or fax. The current level of fees range from £280.00 to £387.00pw. There are extra charges for hairdressing, chiropody, newspapers and personal items. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit the inspector spent four hours reviewing information received by the Commission for Social Care Inspection (CSCI) since the last inspection on the 10th May 2006. This included a pre inspection questionnaire from the home and twenty-nine survey forms from residents and families received by the CSCI. The visit took place on the 24th May 2007 and lasted six and a half hours. During the visit the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called ‘case tracking’. Case tracking means that the inspector looked at the care provided to three of the residents. To achieve this, the residents were spoken with. The inspector spoke with the staff supporting their care and looked at the records relating to their health and welfare. With their permission the residents’ bedrooms were looked at. The inspector also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. The inspector looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them were looked at. The inspector looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit the inspector spoke with the manager, the provider, staff and the residents. What the service does well:
Mauricare residential home provides a pleasant environment for the residents to live in. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 7 The care staff and the manager are well trained to meet all the needs of the residents and show care and support to the residents when looking after them. The manager, the provider and the staff are committed to giving the residents the best quality of life possible. 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. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 8 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 Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 9 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): 2, 3. 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. To make sure that they will receive the right care, residents’ needs are well assessed prior to moving into the home by the completion of a pre-admission assessment and a visit to the home. EVIDENCE: All of the case tracked residents had received a Statement of Purpose and a Service Users guide. The Statement of Purpose and Service Users’ Guide give all of the required information about the services offered and the Terms and Conditions that apply. Providing a thorough Statement of Purpose & Service Users’ Guide gives the residents good information, making sure that they they can get the most suitable care.
Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 10 The manager visits all the residents before they are admitted to the home and completes an assessment . This makes sure that she knows what their needs are and that Mauricare can provide for them. Where possible, prospective residents and their families are invited to the home to look at it to help them to make a decision about coming in. This makes sure that that the staff in the home have the the right information before the resident is admitted so that the resident gets the best care. It makes sure that the home can meet the residents needs and that the resident meets someone from the home who they can recognise. This makes the move into care easier to manage for them. Comments from the relatives surveys received by the Commission for Social Care Inspection confirmed that they had received the Statement of purpose and service user guide and that they had seen someone from the home before admission. Members of the staff spoken with said that they knew what the residents needs were before they moved in. The current registration certificate from the Commission for Social Care Inspection (CSCI) was displayed in the entrance of the home. This lets prospective residents know that the home is registered to provide the care that they need. An up to date insurance certificate was displayed in the entrance hall. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 11 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, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff meet the care needs of the residents as identified in the care plans, which the residents and their families are happy with. EVIDENCE: The care plans which were ‘case tracked were found to contain good individual evidence of the care being given. There are records of the involvement of G.P.s, chiropodist, optician and dentist in them, showing that thorough health care is being provided for the residents. The residents spoken with said that they could see the doctor and other health professionals when they needed to. There are records of the meals that the residents have eaten in the care plan and a record of their weight. This makes sure that they are having an adequate diet and maintaining their weight.
Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 12 The care plans seen had been agreed with by the resident or their families. This makes sure that the resident and/or their families ere aware of the care to be given and that they were happy with it. There is a very thorough daily record of care which was up to date, this makes sure that the residents receive the right care and the staff know what has happened to them during the day or night. The inspector observed residents being treated with dignity and respect when staff spoke with them. The staff were seen sitting with the residents helping them with their lunch and sitting talking with them in the lounge area. Staff seen giving care did so in the right way, giving the residents privacy where needed. Staff spoken with were aware of the care needs of the residents and the residents and the residents spoken with were happy that their care needs were being met. There are risk assessments in place to cover all the identified risks for the residents. This makes sure that the residents and the staff are protected from any risks that have been identified, without restricting their activities. Medication records for the case tracked residents were in order. Medicines are given by members of staff who have had training to administer medicines. This was seen by the inspector and medicines were administered individually and the residents seen to be taking them. The controlled (dangerous) drugs were correct and the drugs book in order, with two signatures to witness the administration of them. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. There is a policy in place for the residents who are able to look after their own medicines. However there are no residents looking after their own medicines at the moment. Comments from relative’s surveys received by the commission for Social Care Inspection were all very positive about the care being given. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 13 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, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their social, spiritual and nutritional needs met. Their views are taken into consideration and acted on. EVIDENCE: There was evidence of activites being provided for the residents and these were recorded in the residents files. Although there didn’t appear to be a very full programme of activity planned, the residents spoken with were happy with those that had been arranged. On the day of the visit they were playing skittlesin one of the lounges, however, they told the inspector that they wanted to keep the television on at the same time. The residents have a choice of meals every day and the cook was seen to be talking to all the residents to ask which meal they would like that day. The inspector saw lunchtime in the dining room and all the residents spoken with said that they On the day of the visit a resident was having her hair washed and dried by a member of staff.
Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 14 were enjoying their meal and that they always had a choice. The cook is not qualified but has a good understanding of the dietary needs of the residents including diabetic diets. He has just started a National Vocational Qualification in catering. The manager and the staff said that visitors are made vey welcome in the home and are invited to activities and may have a meal with their relative. Once a month there is musical entertainment which is followed by a tea party, which a lot of the families come in to. The manager makes sure that she speaks to all of the visitors to talk with them about their relative and about the home. There were no visitors in the home on the day of the visit. Comments on the relatives surveys received by the Commission for Social Care Inspection were positive about the communication with the manager. They felt that the level of activity arranged was suitable for the residents. The staff use various methods to communicate with residents who have difficulties. These include picture boards, writing pads and sign language. The manager sees each of the residents on a one to one basis every day. There are annual quality audits to get the views of the residents and their families. The manager holds regular residents meetings, which have minutes taken. These practices make sure that the residents keep their contact with the community and their families and that views for improvements can be considered. There was independent advocacy information displayed and available for the residents. This means that if a resident needs to have somebody to support and help them they would be able to contact someone. Religious needs would be catered for, but at the moment there are no residents who wish to take part in any religious activity. This was confirmed by the residents spoken with. The manager arranged for a hairdresser to come to the home fortnightly, but the residents refused to go regularly, so she comes when they want her to. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 15 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, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place to support and protect residents and staff are aware of the processes. EVIDENCE: There is a complaints policy in place which gives the details of how to complain and who to complain to if they needed to. The complaints book was looked at and one complaint had been received since the last inspection on the 11th May 2006. This had also been sent to the Commission for Social Care Inspection (CSCI). The complaint had been about staffing levels and had been dealt with correctly by the home. The manager said that she would be reprinting the complaints policy in large print to make it easier for the residents to read. The residents spoken with were happy that they would speak to the manager or a member of staff if they had a problem, and that it would be dealt with. The staff spoken with knew how to deal with a complaint which was given to them, but told the inspector that none of them had ever received a complaint to deal with. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 16 There were no visitors in the home on the day of the visit, but comments on the relatives survey forms received by the CSCI confirmed that they knew about it and would complain if they needed to. The care staff spoken with were aware of ‘safeguarding adults’, the procedure to follow and would be prepared to ‘whistle blow’ if they thought that there was a need to. The staff confirmed that they had had training in safeguarding adults and this was confirmed by the training records held in the home. This makes sure that the residents are safe from any abuse and that any concerns are handled correctly. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 17 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, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a pleasant home, which is run in their best interests. EVIDENCE: Mauricare is a converted house on the outskirts of Leicester city centre. There are two lounges, one that has a television and one that is quiet room that is used for music and has stereo equipment and a piano. There is a separate dining room. The home is very well maintained, clean and free from any unpleasant odours and it gives the residents a pleasant place to live in. The gardens and patio areas are very well kept and easy for the residents to get to in the better weather.
Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 18 The bathrooms are clean, tidy and free of any hazards. With their permission, the case tracked residents bedrooms were looked at by the inspector. They provided good accommodation, which had been personalised with the resident’s belongings and a resident spoken with was said that ‘she liked her room’. The bedrooms were clean and well maintained. There was evidence of equipment such as hoists having been provided to help in the care and comfort of the residents. Maintenance, hot water temperatures and fire records were checked and found to up to date and in order. There were no outstanding safety or maintenance issues seen on the tour of the premises. The registration certificate from the Commission for Social Care Inspection was displayed with a current certificate of insurance. The inspection reports are available in the reception area. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 19 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, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs are met and their safety protected by the recruitment policy and by the training that is in place. EVIDENCE: There is evidence of a good skill mix of staff to make sure that the residents have the right care. The duty rota reflected the number of staff on duty. The residents, staff and relatives surveys felt that there were always enough staff on duty to look after them properly. Two staff files were looked at by the inspector and the required information was complete in both the files. This included evidence of identification, adequately completed application forms, two written references and Criminal Records Bureau checks. There were records of staff training including induction and the staff spoken with confirmed that they received regular training in moving and handling. They said that they had training in first aid, food hygiene and medicine training. There is a record of training held by the manager with the certificates in the staff files.
Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 20 The home has three members of staff with a National Vocational Award (NVQ) at level 2 or above, this is 25 of the stafff, which is below the minimum required standard. The manager has enrolled every member of staff on an NVQ. This includes care staff who hold an NVQ now working towards level 3 and 4. Domestic and catering staff have been enrolled to complete a relevant award. This was confirmed by the staff spoken with. The Manager has completed a level 4 in care and is now working towards the registered managers award and the assessors award through the National Vocational Award programme. The National Vocational Qualification is a qualification for care staff to make that they receive the right training in the needs of the resident group whom they are caring for. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 21 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, 36, 37, 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manger is committed to the best care for the residents through training, good communication and excellent record keeping. EVIDENCE: The manager was available throughout the visit to the home. The manager has been registered with the Commission for Social Care Inspection since March 2007 and managed the home since then. She has completed an NVQ at level four and is working towards her registered managers award and assessors award. The provider was available for part of the visit.
Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 22 Both the manager and the provider are committed to the improvement of the home and have made a lot of progress in raising the standards. There were records to confirm that regular staff supervision was in place. The members of staff spoken with confirmed that they received regular supervision. The process of formal supervision time gives the staff and their ‘line manager’ the opportunity to have individual discussions about work and training needs. There are regular meetings held with the staff to pass on and exchange information. The manager meets regularly with the residents and their families as well as one to one discussions both to pass information on and to listen to their views and opinions. There are annual quality questionaires sent out to residents and their families to gain their views about the home. These practices allow the manager and the responsible person to respond to the residents and the staff’s needs. Ther are accounts held to manage the residents personal allowances and are being managed correctly with two signatures and the receipts in place. The policies and procedures are in place for the home and are regularly reviewed. They are available for the staff to read to make sure that they know how the residents are to be cared for. Records for the maintenance of fire equipment, fire drills and training were found to be in place and up to date. The registered provider completes a provider report (Reg 26) every month but a copy is not kept at the home. These have now been placed in the home. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 23 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 3 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 X X 3 3 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 4 4 3 X 3 3 4 3 Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? None 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. 1. Refer to Standard OP7 Good Practice Recommendations The registered provider should ensure that a written plan (care plan) is completed in respect of all residents needs including those of social care and diversity. Mauricare Residential Home DS0000064312.V337627.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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
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