Inspection on 30/05/08 for Maurice House

This inspection was carried out on 30th May 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Maurice House 25/05/07

Maurice House 12/09/06

Maurice House 06/03/06

Maurice House 17/10/05

Maurice House 07/03/05

Maurice House 14/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Maurice House Callis Court Road Broadstairs Kent CT10 3AH Lead Inspector Julie Sumner Unannounced Inspection 30th May 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Maurice House DS0000037465.V363325.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. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maurice House Address Callis Court Road Broadstairs Kent CT10 3AH 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) 01843 603323 tfullagar@britishlegion.org.uk www.britishlegion.org.uk The Royal British Legion Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 47. Date of last inspection 25th May 2007 Brief Description of the Service: Maurice House is a large detached purpose built care home, which is set in accessible attractive grounds in a semi-rural location. Nearby towns and amenities are only a few minutes drive away. The home is registered to provide nursing care and therefore employs a number of registered nurses. The home has a hotel type atmosphere. The home has a number of shaft lifts to access all levels of the home. The grounds have had pathways built so that service users can access them and appreciate the views over the sea. The fees are: £525.00 residential; £575.00 higher residential; £745.00 medium nursing; £805.00 high nursing per week. The charity provides extra funds to support the residents needs within the home and the social activities held in and outside the home. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report is based on information received about Maurice House including an annual quality assurance assessment (AQAA) completed by the registered manager and an unannounced site visit to the home with a follow up visit lasting around 9 hours altogether. Information was gathered for this inspection in a variety of ways both prior to and during the visit to the home. Surveys have been sent out to residents, relatives, staff and visiting professionals. Those returned have been taken into account in this report. The visit included talking with residents, the manager, staff and some visiting relatives. General observations were made during the day of how people are supported. There was a tour of the building and various records were inspected. The people living in Maurice House were able to participate in the inspection by having conversations about their lifestyle and completing the surveys prior to the visit. Two recommendations were made after this visit. There need to be enough staff so that records can be updated and staff are not rushing from one task to another. The manager is to make sure all staff have supervision at least 6 times a year. What the service does well: Clear assessments are carried out to make sure that people moving into the home can have their needs met. Care plans are well completed and showed good nursing care. The home makes sure that nurses have the opportunity to maintain and develop their nursing skills and competencies. Good, varied outside and indoor entertainment and group activities are provided for the people living in the home. The home provides a clean, spacious environment for residents with very good facilities. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 6 The home demonstrates well, that despite its size, each person’s individual requirements are taken into account. Residents are given the opportunity to say how they would like to be supported and cared for and the home make arrangements to do what they have been asked. What has improved since the last inspection? What they could do better: Residents spoken with during the visit were not aware who their key worker is. They also spoke about the lack of time staff have to chat with them. They said Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 7 that everyone has to rush to do their jobs and there is no time to stop. The managers are looking at the staffing levels in the home to see what is needed. Not all staff files had all the information needed to be kept in the home. The manager said she would check the file contents and make sure any missing documentation required by the regulations was included. Staff supervision has been introduced. This needs to happen more often so that if staff need some training or guidance this can be given and so that they can be told what they are doing well. 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. Maurice House DS0000037465.V363325.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 Maurice House DS0000037465.V363325.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): 1, 3 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents have their needs fully assessed before they are admitted to the home. EVIDENCE: The statement of purpose and service user guide have been reviewed and contain all information necessary to assist a person making a choice to move in. Before new residents are admitted to the home a full needs assessment is carried out to decide whether or not the home is a suitable place for the person to live. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 10 One of the people who lives in the home described his experience of moving in and the assessment process. He explained that he was asked about his preferences and these have been recorded. Maurice House DS0000037465.V363325.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 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staff team meets the health and personal care needs of the service users and their privacy and dignity are respected. The people living in the home are given the support they need to manage their medication. EVIDENCE: Each resident has their own care plan that is completed by their key worker or named nurse. New care plans have been designed with the Bradford University to create a layout that is person centred. A sample of 6 care plans was viewed. They contain clearly laid out information. Additional assessments were seen for dietary needs, social interests and environmental needs and the care plan was based on the wishes identified. Risk assessments are included as part of the care planning. Risk assessments were seen for skin care, nutrition, moving and handling needs and prevention of falls. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 12 Staff spoke positively about the new care planning system. Residents said they were aware of the contents of their plan and participated in parts of it. There were areas in the plan that had their signature in it. They said that staff support them well with their personal and health care. Residents were not aware who their key worker is. This was brought to the attention of the manager and head of care. Staff assist the residents to have access to health professionals in the community and to the services they provide in the home. A podiatrist attended to individuals during the day. Records of support given by different health professionals are kept in the care plan folder. Each person has their own GP. Equipment and aids are provided to support each person with their individual care needs. The medication administration procedure has been updated and includes all relevant guidelines for staff. The clinical room and medication storage was viewed. There is a separate storage and administration procedure for controlled medication and this was also viewed and discussed with the nurse and head of care. The head of care explained that medication administration is now being reviewed as part of person centred planning. The aim is that residents will be given their medication individually as part of their personal care as opposed to a separate medication round. Individual medication cabinets are fixed to bedroom walls. Residents are supported to manage their own medication as much as possible. Risk assessments for this were seen in the care plans for people who want to self medicate. Maurice House DS0000037465.V363325.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 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has sought the views of the residents and considered their varied interests when planning the routines of daily living and arranging activities. Care staff are sensitive the needs of those residents who find it difficult to eat and take their wishes into consideration when giving support. EVIDENCE: A social activities action plan is completed by one of the activities team for each person. This gives them the opportunity to discuss any interests and social preferences. New activities can also be introduced to meet the needs of each person. There is an activities programme based on the individual plans. This has been reviewed to introduce more group activities. Residents said that they enjoy the exercise class that has been re-introduced. A singer was in the main lounge entertaining a group of residents, which afterwards they said they enjoyed. The one to one activities have been increased so that all residents that choose to remain in their rooms are visited on a more regular basis. Residents spoke Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 14 about their leisure pursuits and about trips that are arranged. They said there is plenty to do and they spoke about crafts they are making ready for the homes open day. There were discussions about visits to Buckingham Palace and ceremonies attended. One person said she goes on all the trips while she has the ability to enjoy them. Visitors are welcome at any reasonable time. Residents spoke about their families coming over and going out with them for walks around the grounds. A visiting relative said the staff are really welcoming. “The home is the same whatever time you come, its always warm and there is a good atmosphere.” The inspector had lunch with some of the residents who were happy to chat about their lifestyle. Menu sheets give choices for people to indicate what they want. The catering staff carry out an assessment when residents move in. A cook visits the resident and chats through their dietary requirements, likes and dislikes, completing the record for the care plan. Residents can choose where they would like to eat their meals. There are three dining areas and residents can also eat in their rooms if they prefer. Individual needs are taken into consideration and arrangements are made to accommodate their wishes. Maurice House DS0000037465.V363325.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 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. Residents are protected by the homes policies and procedures. EVIDENCE: The home have a complaints procedure. Residents and relatives said they knew who to speak to if they have a concern. Complaint forms are kept in the reception if people want to complain anonymously. The complaints log was viewed it was evident that the issues had been responded to. Staff have received training in the mental capacity act to support residents to make their wishes known. Meetings have been held and literature has been provided so that residents and their relatives are aware of the new legislation and how it can support their wishes. The home has a clear adult protection procedure and whistle blowing policy. All staff have attended adult protection training. This training also forms part of the induction. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 16 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, 26 People who use the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The provider has ensured that the physical environment of the home provides for the individual requirements of the people who live there. It is fully accessible throughout to people with physical disabilities and specialist equipment is provided. EVIDENCE: The managers showed us around the home and when opportunities came up, left us to speak with residents in private. This allowed us to meet people in an informal way. The home is very spacious with all the appropriate facilities. The corridors are wide which provides enough space for electric wheelchairs to be used to promote independence. A heated door screen has been fitted to provide extra Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 17 heat to the reception and lounge areas during cold periods. There are several lounges and a bar so that people can relax in a variety of settings and different activities can be provided. There are sufficient communal areas to allow residents to have use of a quiet room and to be able to have private family gatherings. One of the lounge bays has been changed into an alternative dining room as residents requested. There are very spacious bathrooms with specialist baths, flush floor showers and appropriate rails and support equipment. Residents have their own possessions, including furniture if they wish, to personalise their rooms. Specialist equipment is provided as required. The home has provided 4 motor scooters for residents use to access the gardens. Individuals have also brought their own scooters into the home. The manager said they are planning to build a sheltered walkway outside the home to provide cover for the scooters. The home implemented the the No Smoking law in July 2007. To enable the residents that smoke to smoke in a safe comfortable place a room has been provided within the required terms of the legislation. A shelter has been provided in the garden. The home was clean and well maintained throughout. Staff have received training in infection control and measures to prevent infection were in place. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using services are very satisfied with the care they receive to meet their needs but there are times when they may need to wait a short time for staff support and attention. EVIDENCE: Residents spoken to said that staff were very good but had to rush a bit to get to the next person. The home uses agency staff to provide the appropriate staffing levels. Surveys received from residents and staff commented that all staff are very busy and sometimes residents have to wait some time when they use their call bells. A staffing review has taken place and the action to be taken from this is still being considered. In the AQAA the manager states that it is their intention to recruit more permanent staff and reduce the agency staff hours more. There is also a need to increase the head of care and senior staff hours to include administration time to do in-house training and staff supervison. Residents were unclear who their key worker is and this was mentioned to the manager so that it could be addressed. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 19 The recruitment procedure is thorough. All safety checks are made prior to a member of staff being employed. The manager who is new in post said that she was interviewed by some of the residents. The staff said there has been an improvement in communication. Senior staff have handover times but they also have a daily meeting with the carers to make sure everyone knows any changes with residents needs and care. Staff said that the information is in the care plan but they do not always have time to read all of these each shift so the meetings are really useful. There is a good NVQ training programme. Over half the staff have achieved an NVQ qualification. The home provides a training placement for student nurses. Staff training is organised in advance. The British Legion provide a wide range of training both internally and externally for all staff employed. The training programme and training matrix were viewed. Individual staff training plans were viewed with what they had attended and a sample of certificates were also seen to confirm attendance. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 20 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, 33, 35, 36, 38 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager has good people skills and a clear understanding of the key principles and focus of the service. There is an atmosphere of openness and respect in which residents and relatives feel their opinions matter and where the safety and welfare of residents is most important. EVIDENCE: The registered manager, Marcella Warbuton, retired at the end of May. A new manager has been employed and worked a week with the registered manager to get to know the home before taking over. The new manager said she would be applying to be registered manager as soon as possible. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 21 Quality assurance monitoring has been developed. New staff have been employed by the British Legion to measure quality across all the homes in their organisation. There was a timetable for auditing all the different areas of running the home. Residents are given surveys and attend meetings to air their views. Visiting professionals, relatives and staff are also given surveys and the feedback is used to see what people like and what needs to be improved. A summary of feedback was viewed. This forms the basis of the homes development plan for the year. Residents are supported to manage their own money or have an appointee. The home maintains a safe method of handling residents money when needed. The home keeps receipts of transactions made on individual’s behalf. The head of care and nurses plan to carry out staff supervision. Two staff folders were viewed to check supervision. Both care staff had had one supervision session only. It was stated in the AQAA that staff hours were being reviewed. This has identified that there is insufficient time to enable the head of care and nurses to carry out additional tasks including supervision. The requirement made at the previous inspection has been carried over as supervision has not been carried out at the frequency needed for good practice. The home has a maintenance department. The maintenance department keep a wide range of records for all areas of the maintenance of the home. A sample of these risk assessments and records were viewed including the maintenance plan for refurbishment, water temperature checks and the health and safety assessment. A fire safety risk assessment was being carried out on the first day of the visit to the home. There is a rolling staff training programme for all health and safety training and records were seen of the recent fire training. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X 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 4 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes 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. 2. Refer to Standard OP27 OP36 Good Practice Recommendations There need to be enough staff on duty so that they are not rushing from one task to another and so that there is enough time for the necessary day to day administration. The manager needs to make sure that staff are suitably supervised at a frequency that will be supportive of good practice. Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Maurice House DS0000037465.V363325.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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