Inspection on 18/04/05 for Mayfield

This inspection was carried out on 18th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Mayfield 01/03/10

Mayfield 24/06/09

Mayfield 30/01/09

Mayfield 18/01/07

Mayfield 11/10/05

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 99 Nursteed Road Devizes Wiltshire SN10 3DU Lead Inspector Jacqui Burvill Last Name Unannounced 18th April 2005 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. Mayfield Version 1.10 Page 3 SERVICE INFORMATION Name of service Mayfield Address 99 Nursteed Road Devizes, Wiltshire SN10 3DU 01380 723720 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) Miss Sharon Anne Cooper Mrs Muriel Walton Care Home 20 Category(ies) of DE(E) Dementia - over 65 3 registration, with number OP Old age 17 of places Mayfield Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2004 Brief Description of the Service: Mayfield is a care home providing personal care and accomodation 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. The house has been extended. There is a stairlift to the first floor, as well as an additonal 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 seating in the garden which is on a slight slope to the side of the house. Access to frail service users is limited as they may need staff support to enter the garden and remain seated there. 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 co ordinator, who works three times a week. Mayfield Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over part of one day, taking 5 and half hours. The manager was present in the home during the inspection. The inspector looked at the care plans, risk assessments and pre admission assessments, medication and medication records, complaints record, recruitment records, had a partial tour of the premises, sampled a meal and spoke to four service users and five staff. The manager told the inspector of her intention to retire from the home within the next few months. What the service does well: What has improved since the last inspection? The structure of the care plans has greatly improved. There is a wider range of care needs, which is standard for all residents. Relevant detail is then included. There is a ‘snapshot’ care plan, on one page, which is quick and easy to follow, so that staff can meet the resident’s needs. Twelve of the sixteen requirements and six of the nine recommendations made at the last inspection have been met. Mayfield Version 1.10 Page 6 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. Mayfield 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 Mayfield 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, 6 Standard 6 does not apply in this home, as it does not offer intermediate care. Whilst the service consults with residents regarding their likes and dislikes this is not carried out consistently, leading to some care needs not being identified at admission. EVIDENCE: There have been two new residents since the last inspection. One of the residents is receiving a respite service. The manager receives information about the resident prior to admission. A care needs questionnaire is devised, which asks the resident questions about their likes and dislikes and any specific needs they have. This then forms an interim care plan. In one case, the questionnaire had not been fully completed shortly after admission, and was completed several months later. The interim care plan had been devised from the assessment and amended as the home got to know the resident better. Mayfield Version 1.10 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 standard(s) 7, 8, 9,10 Care plans support the delivery of care as do a range of healthcare professionals. Medication administration practices whilst improving, do not meet the required standard. Staff are currently receiving medication training. Residents rights could be better promoted in the home. EVIDENCE: Care plans cover a wide range of needs. Keyworkers are required to complete how those needs are met. In the majority of entries this is clearly explained. There are a small number of entries, generally around needs such as ‘memory’ and ‘reassurance’ where the need is described, rather than how the need is met. There is other evidence in daily notes to show how staff offer service users this support. The ‘snapshot’ plan in the front of the file gives a quick overview of the entire care plan and is a useful tool. This is reviewed monthly. Dependency levels and scores are also reviewed monthly. Risk assessments had been devised taking into account some of the risks for service users, but the requirement from the last inspection has not been fully met. Use of the chairlift, leaving the building, or falling in the grounds had not been risk assessed for those residents it affected. There are general risk assessments for risks of falling and moving and handling. These are not detailed enough with regard to the specific resident. Mayfield Version 1.10 Page 10 The daily notes show the healthcare needs and how they are followed up by staff. There are other documents showing communication between the surgery and the home. An immediate requirement was given regarding some of the medication held in the home. Staff were receiving medication training as part of a distance learning course during the inspection. The practice of using sticky pharmacy labels on the MAR sheet should stop, as it is not possible to record the number of medication received into the home. During a period of observation, a resident was seen to ask staff to make contact with a relative on their behalf. It was noted that the resident was asked to wait until a time that appeared to be convenient for staff. The resident was observed to wait close by staff until they showed they could carry out the request and this took over an hour and a half. Mayfield Version 1.10 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 standard(s) 12, 13, 15 The residents benefit from an activities co ordinator who focuses on bringing interests into the lives of residents. Meals are well presented and residents seemed to really enjoy their meal. EVIDENCE: Residents spoke about their experience of living in the home. One resident commented that “the problem is they’re too busy” (meaning staff) and another that they “mustn’t grumble”. Further discussion revealed that dependent on where families live, there is good contact. Staff were also observed supporting a resident making contact with a relative by phone during the inspection. The activities in the home are varied – with a programme setting out a range through out the day. The four week plan identifies the day and the time for the next activity, by using colourful arrows. This may be better in a larger print, as it appears to be more for staff to follow. The plan includes watching films a couple of nights a week, or listening to a radio soap opera, as well as more structured activities during the day. Residents were observed taking part in an exercise class, which they seemed to enjoy. Lunch is a social event, with residents talking to each other at their table of three or four. The meal was sampled. This was tasty and appetising. There is a choice of two dishes each lunchtime and a dessert. The meal looked well Mayfield Version 1.10 Page 12 presented and residents said they enjoyed it. Drinks and meals were served to the tables by staff. Mayfield 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 It is not clear how effective the complaints procedure is, or how able residents feel about making complaints. This could lead to residents feeling vulnerable about the care they receive. EVIDENCE: There is a complaint record, detailing whether complaints have been received each month. There are monthly records showing that no complaints have been made. The complaints procedure is displayed in each resident’s bedroom. A complaints procedure is in place, however, it is not clear how this is promoted and how residents are made aware of how to make a complaint. Mayfield 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, 20, 24, 26 The home is comfortable, clean and tidy and residents appear to feel at ease there. Current risk assessments do not ensure that the environment is safe. Residents are able to bring their own possessions with them to the home. EVIDENCE: The home was clean and tidy on the day of inspection. There were no unpleasant odours. Residents were sitting in the lounge and dining room and were free to move about the home independently. Residents said they sometimes needed help with using the stair lift and this was detailed in their care plan. Residents had been able to bring small possessions with them when they moved to the home and said that they were happy and comfortable in their bedrooms. There are problems in getting into parts of the garden without staff support as some of the seating is on a slight slope. There are plans to improve this area. There is a large garden and watching the wildlife gives residents a lot of pleasure. Improvements to the garden would make this area much safer and more accessible for residents. Mayfield Version 1.10 Page 15 Mayfield Version 1.10 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 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 There are sufficient staff on duty to meet the needs of the residents. There are recruitment practices in the home to ensure that service users are protected. EVIDENCE: The four week rota was examined. There is a waking night staff and a sleep in. During the day, there are two staff on duty in the morning, as well as the activities co ordinator. On the day of inspection, three staff were rostered to work 2 – 4. This is because Monday afternoon is set aside as a training session every week. During the evening, there are two staff on duty. At key changeover times, there is an extra hour for the handover of information. Additional staff, such as cooks and cleaners are also employed. There are two new staff members since the last inspection. The recruitment records for both of these staff were in order. The skills of the staff team are currently being developed. Staff have a mixture of skills, some have previous care experience and are completing further training, for others this is their first experience of care work. Mayfield Version 1.10 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 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) 38 Fire records show that staff are aware of how to safe guard residents in the event of a fire. EVIDENCE: Fire safety records show that staff have completed training between January and March of this year. There has been a fire drill, and three staff were named as attending. Records were up to date. There is one of the range of records missing called Means of Escape. This is a monthly check. This will be sent to the home so they can make copies. The manager should obtain a copy of the Wiltshire Fire Brigade’s distance learning pack. This can be used to train staff in fire safety in the care home. The manager has re- written the fire procedure. Mayfield 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 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x x x 3 Mayfield Version 1.10 Page 19 YES 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. Standard OP8 Regulation 13(4) ( c) Requirement Residents risk assesments must be written to reflect risks that may affect them due to their care needs, such as medical health, self medication and falls etc. (Carried forward for the third time. This was a requirement at the inspection 28.4.04. This has been met in part) Failure to meet this requirement by the date specified may result in enforcement action The registered person must ensure that all staff who handle medicines are appropriately trained. (Carried forward from last inspection) Met in part as staff are completing a distance learning course in medication and administration. All written additions to the medication administration record should be signed and checked and by two members of staff. The garden needs to be more accessible to residents with a handrail and level seating. (Carried forward from last inspection) Timescale for action 30th June 2005 2. OP9 18 ( c) (i) 30th August 2005 3. OP9 13(2) 18th April 2005 30th June 2005 4. OP19 23 (2) (a) Mayfield Version 1.10 Page 20 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 OP12 OP16 Good Practice Recommendations The activity programme should be on display in type large enough for residents to read.(Carried forward from the last inspection) The way in which the complaints procedure is described and explained to residents should be reviewed. This should include providing information on the procedure to members of residents families. There should be an assessment of the premises and facilities by suitably qualified persons, including a qualified occupational therapist.(Carried forward from the last inspection) 3. OP22 Mayfield Version 1.10 Page 21 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Version 1.10 Page 22 - 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. 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