Inspection on 11/10/05 for Mayfield

This inspection was carried out on 11th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Mayfield 01/03/10

Mayfield 24/06/09

Mayfield 30/01/09

Mayfield 18/01/07

Mayfield 18/04/05

Mayfield 01/11/04

Mayfield 07/06/04

Mayfield 20/05/04

Mayfield 14/04/04

Mayfield 05/06/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Mayfield Mayfield 99 Nursteed Road Devizes Wiltshire SN10 3DU Lead Inspector Mrs Jacqui Burvill Unannounced Inspection 11th October 2005 09:50 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 Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 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. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mayfield Address Mayfield 99 Nursteed Road Devizes Wiltshire SN10 3DU 01380 723720 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) Miss Sharon Anne Cooper Care Home 20 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (17) of places Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th April 2005 Brief Description of the Service: Mayfield is a care home providing personal care and accommodation for twenty older people. It is privately owned and the proprietor employs a manager to run the home. The home is a short drive from Devizes town centre. The home was first opened in 1983 and has changed ownership since that time. The current owner has been in place since 2000. The house is a detached Victorian residence with many period features, which has been extended. There is a stair lift to the first floor, as well as an additional staircase. There are bedrooms on the ground floor and the first floor. There are bathrooms on both floors of the home. One of these is an assisted bath. All of the bedrooms are single and none of the bedrooms provide ensuite facilities. The home has large gardens surrounding three sides of the home. There is a side garden, which has a pathway and rails leading to seating. There are three staff on duty during the morning and two staff on duty during the afternoon and evening. There are domestic staff employed and an activities coordinator, who works three times a week. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7 hours on 11th October 2005. There had been an additional visit to the home on the 18th July 2005, to follow up on the requirements and recommendations set at the inspection of the 18th April 2005. The inspector met with the manager, who has been in post since July 2005 and was in an acting manager post prior to this. The manager’s application to be registered has been received and is being processed. The inspector met with the proprietor and spoke to three staff who were on duty and six service users over two and half hours. There was a partial tour of the premises and the following records were looked; menu records, care plans, risk assessments, daily notes, medication and medication records and staff training and recruitment records. There has been a period of change since the last inspection. The atmosphere in Mayfield was relaxed and calm. Staff commented on the changeover in a favourable way and service users did not appear to have been adversely affected during the changeover of the manager. Service user’s comments were wide ranging in their views of the home. Some like to be involved in activities and other prefer to keep to themselves. There is the opportunity to follow both these choices. One service user commented that she is ‘very happy’ at Mayfield and demonstrated some of the activities that she takes part in. Another service user on respite said that ‘the care here is excellent.’ Two service users commented that staff were busy and had a job to do when asked if staff had time to sit and talk to them. One service user commented that ‘staff do the best they can’ and that they try to enable her to maintain a level of independence, which she appreciates. One service user had recently had a birthday and appreciated the way she was helped to celebrate this special day. What the service does well: The home and staff team consider the individual service user’s needs and try very hard to accommodate all the different choices and requests that the service users make. The management team are looking at ways to improve and develop the service and have involved health care professionalS in doing this. Service users commented that they are able to be as independent as possible and can choose to take part in activities if they wish to. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 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. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 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 the following standard(s): 3, 6 Standard 6 is not applicable. Service users may choose the home after staying for periods of respite. Details of service user’s needs are assessed so that their needs can be met. EVIDENCE: Records for a service user receiving respite care were seen. There is an assessment and a care plan arising from the assessment questionnaire. This service user has had other periods of respite care in the home and each time, the records have been updated. This is good practice. There is a description of the service user’s likes and dislikes, daily care needs and dependency levels. The inspector observed an interaction between the service user and a senior staff member, who described a changing situation clearly and with empathy, which reassured the service user. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 7, 8, 9 Care plans describe a wide range of care needs and how they are to be met. Service users would benefit from clearer details in some sections. Service users have up to date risk assessments covering a wide range of potential risks, with details of how to prevent harm. Service user’s medication needs are safely managed. EVIDENCE: The above standards were looked during the last inspection and were looked at again because of requirements that were set. Three service user’s care plans and risk assessments were looked at. The care plan has a ‘snapshot’ sheet that lists all points of the care plan and whether there have been any changes on a monthly basis. The care plan has a description of the how needs are to be met and shows the service user’s preferences and lifestyle choices. This shows that service users are enabled to remain as independent as possible. Risk assessments or manual handling assessments are recorded alongside for reference. There are a few occasions when the wording in the care plan could be clearer – i.e. the use of the word ‘regular’ could be interpreted in different ways by staff and sometimes staff have recorded the presenting behaviour in the care plan Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 10 rather than how the need is to be met. This is particularly evident in sections to do with cognition and communication. One care plan showed a clear deterioration over a period of months with separate entries in the care plan to respond to changing needs and yet the ‘snapshot’ sheet showed that there were no changes to the care plan. Details of how skin care needs are to met and followed through showed some inconsistencies. Aspects of this plan were discussed with the manager, as elements of how care was provided were in question, due to the service user’s needs. Risk assessments are detailed and up to date and cover a range of potential risks that may affect the service user. Daily notes may not be completed every day with gaps of up to five days between entries for one service user. There are subjective comments recorded such as ‘good today’ or ‘fine today’, referring to the service user by name. This does not describe the care that was provided or positive contact that may have taken place and may imply that the service user did not have any contact with staff during that time. Medication and medication records were seen. There is a clear procedure for recording medication in and out of the home. Only staff who have received the distance learning medication training may administer medication. Records were well kept. The storage of medication in a fridge was discussed, as it needs to be in a more appropriate storage box. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 12, 14 Service users are able to choose from a variety of activities that reflect their interests. Service users have control over their lives, by exercising choice in activities, meals, finances and personal possessions. EVIDENCE: The manager explained that the occupational therapist and the community psychiatric nurse are going to work alongside the new activities coordinator to establish what activity will be suitable for service users and to improve the quality of the activities that are provided. This will include ‘pampering’ sessions, one to one reminiscence and help in devising a further improved activities plan. A meeting has been arranged to do this. The activities plan is on display, showing something happening every day and points of interest at several times during the day. The manager reported that the new activities coordinator is in post three times a week and that this gives service users something to look forward to. Service users made a variety of comments about the activities. One service user said the activities made things more interesting. One showed the inspector the exercises she liked to do and was clearly very interested in anything the home had to offer. Another service user was reluctant to join in and felt that the activities were of no real interest to her. One service user said that she enjoyed talking to the inspector and Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 12 would like to do this with staff, but commented; ‘they are too busy to do that.’ Another service user made a similar comment. When asked if staff were kind and polite, replied that they come when she calls them and that she feels bad about this as ‘they have other jobs to do.’ Service users did not feel pressured into taking part in activities and enjoyed trips out over the summer and especially enjoyed the garden which is far more accessible to service users now. Service users are supported in managing their own finances and the home will support service users who feel they cannot do this. Service users are able to bring some personal possessions with them to the home. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 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 the following standard(s): 18 Service users are protected from abuse by a staff team that are aware of adult protection procedures. EVIDENCE: There have been no complaints since the last inspection. When asked, staff were familiar with aspects of the Wiltshire and Swindon ‘No Secrets’ guidance and had taken part in abuse awareness training in the home. There have been some new staff employed in the home since the last inspection and not all of these staff have received this training yet. None of these staff were on duty to discuss whether they were familiar with the reporting procedure. As new staff are employed it may be worthwhile keeping evidence of when staff are given their ‘No Secrets’ booklet. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 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 the following standard(s): 19 Service users benefit from a home which is comfortable and a garden that is now safely accessible to them. EVIDENCE: There was a partial tour of the premises so as to meet with service users in their bedrooms and in communal areas. All parts of the home are very comfortably furnished and seemed clean and tidy. There was a cleaner on duty at the time of the inspection. The home felt quite cold in the older part of the building. Service users commented on this when asked, as there was a marked difference between the old and newer parts of the home. This was reported to the senior on duty, so that it could be rectified at once. Service users’ rooms are very individual and some rooms are large enough to be bed sitting rooms. The sitting room and the dining room are linked and part of the dining room is used as an office base for staff. This has been in place for many years and there are some discussions about a more suitable record storage and recording area. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 15 Risk assessments for radiators and hot pipes in communal areas and bathrooms and toilets had not been fully completed as some were undated and others need to be reviewed. There is a large garden and part of this has been made more accessible to service users. There is a pathway on a slight slope leading to a seating area with a garden swing chair and other seating. The area has been sectioned of with handrails and a gate has been installed with some fencing. There are bedding plants around this area. This has made this part of the garden much safer and service users commented on how they had enjoyed sitting in the garden in good weather. The home was clean and tidy with no odours on the day of inspection. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Service users benefit from weekly team training sessions, which helps to ensure that staff are up to date with current practice. This would be further enhanced by more staff gaining NVQ certificates. EVIDENCE: Staff were asked to describe the training they had received in recent months. They described training that included medication, health and safety, adult protection and NVQ training. Part of the team meting every week is devoted to in house training of different topics. The manager and the senior staff member are doing a ‘training for trainers’ course. There are two senior staff in post, following some staff leaving earlier this year. There has been a six week course on dementia and newer staff are completing an induction with ‘Learn Direct.’ One staff member has completed NVQ level 2, two staff members are doing level 2, one has almost completed level 2 and is keen to do level 3. This means that 33 of the staff team have NVQ certificates, where 50 should have it. This may be due to staff who have left the home in the last few months. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 Service users benefit from a manager who has managed a period of change in the home and continues to look to develop the home to meet service user’s needs. Service users finance records are not always kept accurately, which is not in their best interests. EVIDENCE: Since the last inspection, the acting manager has been in charge of the home. Her application to be the Registered Manager is being processed at this time. There was a calm and relaxed atmosphere in the home and it is to the manager and staff’s credit that the changeover and subsequent loss of some of the staff team, does not appear to have had a negative effect on the service users and the staff team. Staff and service users spoke positively about the changes that have taken place and that the manager is approachable. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 18 The manager is doing NVQ level 4 at the moment and completing several units at a time. Service user’s finance records were seen and there were some errors that had occurred during the checking process completed by staff. The manager had picked up these errors and corrected the accounts and discussed the mistakes with the staff concerned in supervision sessions. Only senior staff have access to these records and money. Service users are supported to keep small amounts of money so as to pay for sundries and visits from the hairdresser and chiropodist. Neither of them provides receipts, but they and the staff member sign the service user’s account sheet. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 2 X X X Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard OP18 Regulation 13(6) Requirement All new staff must receive training in Adult protection and the Swindon and Wiltshire ‘No Secrets’ guidance and in future, as part of their induction. Radiators and hot pipes in communal areas, toilets and bathrooms must be risk assessed, with an action plan identifying radiators that must be covered. Timescale for action 30/12/05 2. OP19 13(4) (a) (c ) 30/11/05 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. Refer to Standard OP7 OP7 OP9 Good Practice Recommendations Service user’s daily note entries should be recorded at least every 48 hours. Care plans should describe how staff support service users memory, reassurance and orientation. (Carried forward from additional visit 18th July2005) Medication held in the fridge should be in a lockable clear plastic lockable container. DS0000028227.V258482.R01.S.doc Version 5.0 Page 21 Mayfield 4 OP35 The manager should ensure that staff are familiar and competent with the procedure to manage service users’ finances. Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Mayfield DS0000028227.V258482.R01.S.doc Version 5.0 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!