CARE HOMES FOR OLDER PEOPLE
Maycroft Residential Home 73 High Street Meldreth, Royston Hertfordshire SG8 6LB
Lead Inspector Alan Buttery Unannounced 12 April 2005 @ 10:00 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. Maycroft Residential Home Version 1.10 Page 3 SERVICE INFORMATION
Name of service Maycroft Residenmtial home Address 73 High Street Meldreth, Royston Hertfordshire SG8 6LB 01763 260217 01763 260217 sanjeev@aermid.com Aermid Health Care Limited 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) Mrs Joan Ogden Care Home 25 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (25) of places Maycroft Residential Home Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27/09/04 Brief Description of the Service: Maycroft is situated in the High Street in Meldreth, and within walking distance of the village amenities. The home is on 2 floors, with a passenger lift to the upper floor. The service users have a variety of sitting and dining areas, and sufficient space to move around the home. All rooms are single occupancy and there are currently no en-suite facilities. There are extensive gardens where service users can sit or walk, weather permitting and access has been improved recently, allowing more service users to enjoy the gardens if they choose. The home offers care to older people and to older people with dementia. Maycroft Residential Home Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first inspection of the current year, and an unannounced visit. The manager of the home was at the company’s head office on the day of the inspection, but her deputy was able to provide most of the information requested by the inspector, and the registered manager forwarded additional information after the inspection. The inspection started at 10.00 and lasted for about three hours, and during this time, the inspector spoke to 4 service users, the head of care and some of the staff working at the time. The homes manager telephoned the following day to discuss the inspection, and forwarded additional information to the inspector, which is include in this report. It is hoped that later in the year, the inspector will join one of the service user/relatives meetings, to give the service users a better opportunity of discussing any issues they may have. A number of service user and relatives comment cards were left at the home, and at the time of writing the report, 9 cards had been returned by service users and 14 by relatives. The comments were received were almost all positive, reflecting well on the home and on the staff team. At the present time, the home charges between £434 and £550 per week, and currently has three vacancies (this includes a room being held whilst a service user is in hospital) What the service does well: What has improved since the last inspection?
The home has made a number of changes since the last inspection, and this has resulted in a much calmer atmosphere within the home, and more positive comments from the service users living there.
Maycroft Residential Home Version 1.10 Page 6 Many of the service users currently living in the home have a formal diagnosis of dementia, but, to ensure that the needs of the more able service users are met, the home has rearranged the communal areas, which gives service users the option to eat in the smaller lounge area, and mealtimes in there have become a very social occasion. Further changes to the environment are being discussed by the owners of the home, and it is hoped the communal spaces within the home can be better utilised. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Maycroft Residential Home Version 1.10 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 Maycroft Residential Home Version 1.10 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) 3 and 5 Maycroft has a detailed admissions procedure, ensuring that they are able to meet the care and social needs of any service user moving to the home. EVIDENCE: During the inspection, and from information that the registered manager sent to the CSCI after the inspection, it is clear that the home has made a lot of progress since the last inspection, and requirements that were left have been met. The manager sent in a detailed statement of purpose, and this clearly details what is available in the home, and the terms and conditions that apply. On the service user files that were examined during the inspection, very detailed information had been gathered on the service users background, social history and likes and dislikes. Much of this information is gathered from prospective service users families during initial visits. The pre assessment information was also very good, but should be signed by the person who carried out the assessment. Maycroft Residential Home Version 1.10 Page 9 Maycroft Residential Home Version 1.10 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) 7,8,9 and 10 The home has detailed care plans ensuring carers have sufficient information to meet the health, personal and social care needs of service users living in the home. EVIDENCE: As detailed above, the service user care plan files contained very detailed information, in particular the social history. The care plans seen during the inspection had been reviewed on a regular basis, and the daily recordings in the file were comprehensive. The relationship between the home and the local GP’s surgeries has now improved, and service users moving into the home are now registered with the local surgery. Some service users in the home remain with the surgery in Royston, which is further away, but suitable arrangements are in place to ensure a service is available outside surgery hours. Staff ensure that the dignity and privacy of service users is respected at all times, and during the inspection were seen to knock on service users doors before entering, and to make sure that they called service users by their preferred name. The home has a medication policy which is followed, and staff receive training in administering medication.
Maycroft Residential Home Version 1.10 Page 11 Maycroft Residential Home Version 1.10 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) 12,13,14,and 15 Service users are offered choice in many aspects of their lives, and suitable activities are available. A good variety of food is offered, with choices always available. EVIDENCE: One of the requirements left at the last inspection was to ensure an activities co-ordinator was appointed to the home, and although this has not yet happened, care staff have tried to ensure that a variety of activities are provided for the service users. Service users spoken with during the inspection felt there was a good selection of activities arranged, and these are advertised throughout the home, and detailed on a newsletter sent to all service users and relatives. During the inspection, staff were observed in a number of different activities with service users. Arrangements for serving food have changed, with a smaller group of more able service users now using the second lounge at mealtimes, allowing them to spend more time socially over the meal, without the disturbances that sometime come from other less able service users. Domestic staff assist at meal times, helping some of the service users who may have difficulties managing their food.
Maycroft Residential Home Version 1.10 Page 13 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 and 18 The homes complaints policy is available to all service users and their families, and service users are confident that any concerns they may have will be dealt with properly. Adult protection policies are in place to ensure the protection of service users from abuse. EVIDENCE: The home complaints procedure meets the requirements under this standard, and during the inspection a record of complaints received since the last visit was looked at. The home has received three complaints, and all have been dealt with in a satisfactory manner. All staff have received training in adult protection issues, and the home has a detailed policy to ensure staff are aware of procedures, and access to the local authority policy Maycroft Residential Home Version 1.10 Page 14 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 and 26 The home has sufficient domestic staff to ensure the home is clean and hygienic, and service users safety is considered at all times. EVIDENCE: At the last inspection, requirements were left that carpets be replaced on the upstairs’ corridor, which has been done, and further refurbishment is planned. The home offers a safe and comfortable setting but further consideration is being given to providing more communal space for service users. The home was clean on the day of the inspection, and free form any unpleasant smells. Maycroft Residential Home Version 1.10 Page 15 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, 29, and 30 Although recruitment remains difficult, the home do ensure sufficient trained and experienced staff are available, and ensure recruitment checks are always undertaken. EVIDENCE: The home continues to find recruitment quite difficult but do have new staff about to start, which will leave vacancies for night staff and a kitchen assistant. The homes recruitment policy was discussed, and evidence seen on files that full recruitment checks are made prior to new staff starting with the home. The home are currently discussing their training requirements for the coming year, and a copy of the training plan will be sent to the CSCI when it is completed. The homes manager must ensure that all suitable checks are in place to prevent the outbreak of infection Maycroft Residential Home Version 1.10 Page 16 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, 35, 36 and 38 The homes manager appears to manage the home in a competent manner, and service users are involved in decisions. Suitable policies and procedures are in place to make sure that health and safety risks are minimised at all times. EVIDENCE: The home is well managed, and staff spoke highly of the management team. A number of recent changes have improved the quality of life, particularly for those more able, and the comments received as part of the inspection from service users and relatives were all in the main favourable, the only concern expressed being about the difficulties accessing a telephone, and the home will be looking at how this can be overcome. They do not directly manage any service users finances, but will assist where required to ensure that service users have access to money when required.
Maycroft Residential Home Version 1.10 Page 17 Health and safety procedures and training is in place to make sure service users and staff are safe, although some further checks do need to be made, for example to protect service users and staff from the risks of legionella. The records examined for service users and staff were generally satisfactory, but the home should make sure that all files have the required information, for example a service users file did not include a photograph of the person. The manager advised that regulation 26 visits are made, however these have not been sent to the CSCI, and this must now be done. Maycroft Residential Home Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 x 3 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 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 2 x 3 Maycroft Residential Home Version 1.10 Page 19 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. 3. Standard 36 36 38 Regulation 26 19(1)(b) 13(4) Requirement The registered person must provide a monthly report in accordance with regulation 26 All staff files must contain the information specified in schedule 2 of the Regulations All necessary measures musrt be taken to identify and prevent the outbreak and spread of infection Timescale for action 30/6/05 30/6/05 30/6/05 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. Refer to Standard 3 Good Practice Recommendations All pre admission assessments should be signed by the person com pleting them Maycroft Residential Home Version 1.10 Page 20 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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