CARE HOME ADULTS 18-65
Mayfield Court Youens Way Knotty Ash Liverpool L14 2EP Lead Inspector
Ingerbritt Moynihan Unannounced 22 September 2005 11.30am
nd 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Mayfield Court Address Youens Way Knotty Ash Liverpool L14 2EP 0151 283 9090 0151 283 9091 www.admin@mayfieldcourt.org Mayfield Fellowship 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 Carole Ackers Care Home 27 Category(ies) of PD Physical disability registration, with number PD(E) Physical disability over 65 of places Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Residents (PD) between the ages of 18 - 64 years within an overall number of 27 Residents (PD/E)over 65 years of age within an overall number of 27 Date of last inspection 17 February 2005 Brief Description of the Service: Mayfield Court is a large purpose built single storey unit providing residential care for 27 service users with a physical disability. The property is owned by Riverside Housing Association and the care is provided by the staff employed by the Mayfield Fellowship.The unit is divided into a number of independent flats and two separate units. Most rooms are single occupancy although there are three double rooms; this arrangement is at the service users’ request. Most rooms have en suite-facilities comprising of a toilet and washbasin and sometimes shower. Each of the flats has a range of different facilities including a kitchen, laundry and a lounge and dining area. All of these arrangements have been set up to reflect the care needs of the service users. The communal facilities include two communal lounges and a dining area. The home is close to the local community amenities and public transport routes. Staff actively encourage service users to maintain contact with local community facilities. The home also provides regular social excursions as well as in-house social events. An activities co-ordinator is also employed on a full time basis. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 3.5 ours and was the statutory unannounced inspection for 2005/2006. A tour of the premises took place and five staff and six service users were spoken to during the inspection. What the service does well:
Service users care needs are assessed to ensure staff can provide the appropriate package of care to each of the service users. Service users are encouraged to take participate in all aspects of the running of the home. Service users are encouraged to take risks within their lifestyle in order to maintain their independence, although at the same time systems are in place to ensure their safety and welfare. The service users spoken to confirmed they are supported and encouraged to live an independent lifestyle and understood this involved taking responsible risks. They confirmed that staff support them in this aspect of care and helped them develop strategies to minimise any potential harm. Staff support service users in their personal development which enables them to maintain a more independent lifestyle. Service users are supported to participate in the local community through the use of healthcare and leisure facilities which ensures they are not segregated because of their disability. A full range of activities are provided within the home and a number of service users have been on holiday this summer. The service users spoken to during the inspection confirmed the activities are appropriate and enjoyable and those who went on holiday spoke of how much they enjoyed their time with the staff. Service users are supported to have personal, family and sexual relationships if they so wish which ensures their rights are recognised and respected. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 6 Varied and balanced meals are provided to ensure service users good health and interest. Service users praised the staff team for their kind and caring nature and said they always respected their privacy and dignity. The service users health care needs are well met with evidence of good multidisciplinary working taking place. Systems for the administration of medication are good and ensure service users safety and good health. The home has a comprehensive complaints procedure to ensure service users views are listened to and acted upon. The service users spoken to during the inspection said they were happy with the standard of care they received and had no complaints to make. They were aware of who to contact should they wish to make a complaint. Systems are in place to ensure service users are safeguarded from abuse and harm. The standard of decoration throughout the unit remains very high and provides a comfortable and pleasant environment for the service users to live. Since the last inspection a new gallery has been built which enables service users and staff to move from one end of the building to the other without having to go outside. This is a lovely bright and open area which service users confirmed they use to sit and chat or have their meals. One part of the gallery is set aside for activities. All of the service users said they love the gallery area and felt it enhanced the unit significantly. The required staffing levels and skill mix are provided to meet service users assessed needs. Staff are provided with a range of appropriate training to ensure they are suitably qualified and competent to care for vulnerable adults. This is a positive aspect of the unit and ensures the service users are being cared for in accordance with their particular needs and current good practice. Staff demonstrated a positive attitude towards their work which contributes to providing a supportive and caring environment to service users who often experience very complex health problems. One member of staff spoken to commented the staff team work well together and I feel well supported in my role. Another member of staff stated the registered manager always encourages the staff to attend any training in relation to the care of the service users. There are clear lines of management and accountability within the home which is run for service users best interest. The care staff confirmed the registered manager and senior staff are always available for support and advice when necessary. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 7 Effective quality assurance systems are in place to ensure the high standards of care provided at Mayfield Court are maintained. The relatives of two service users were spoken to during the inspection. They stated they were very happy with the standard of care their family member received and had no concerns to raise. They confirmed the staff are friendly and polite with a caring nature. The health, safety and welfare of the service users is well promoted throughout the home. 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 Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 3 Service users care needs have been assessed which ensures staff can provide the appropriate package of care to each of the service users. EVIDENCE: All the service users spoken to during the inspection confirmed their individual care requirements are assessed by the staff team with a record of this information being kept. They all confirmed their individual needs and aspirations were fully met and said the staff team were very supportive and caring in their manner. Changes have been made to one service users bedroom which has resulted in them living a more independent lifestyle and having more control over their own life. Service users care needs are met in a variety of ways such as staff being appropriately trained in care issues, the provision of a range of social activities and holidays and the provision of specialist adaptations and equipment to support the service users with their disability. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 9 Service users are encouraged to take participate in all aspects of the running of the home. Service users are encouraged to take risks within their lifestyle in order to maintain their independence, although at the same time systems are in place to ensure their safety and welfare. EVIDENCE: The service users spoken to during inspection confirmed they are consulted on different aspects of the running of the home. They stated regular service user meetings take place for this purpose during which time they are kept up to date on any changes and consulted on their views about the future development of the service. The service users said they were very happy with the way in which this aspect of care was managed. The service users spoken to confirmed they are supported and encouraged to live an independent lifestyle and understood this involved taking responsible risks. They confirmed that staff support them in this aspect of care and helped them develop strategies to minimise any potential harm. Staff confirmed this information had been documented and was available for reference at any time.
Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13, 14,15 and 16 Staff support service users in their personal development which enables them to maintain a more independent lifestyle. Service users are supported to participate in the local community through the use of healthcare and leisure facilities which ensures they are not segregated because of their disability. Service users are supported to have personal, family and sexual relationships if they so wish which ensures their rights are recognised and respected. Varied and balanced meals are provided to ensure service users health and interest. EVIDENCE: The service users spoken to confirm the staff are extremely supportive in enabling them to develop within their own lifestyle. The service users confirmed they make use of all community facilities for their leisure and health care needs. They confirmed they were happy to continue
Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 12 with this arrangement and had established positive relationships with a range of health care professionals. A full range of activities are provided within the unit and a number of service users have been on holiday this summer. An activities organiser is employed at the home and a member of staff carries out rehabilitation tasks with service users. This is a very positive aspect of the unit as this provides a stimulating and interesting environment for the service users to live. The service users spoken to during the inspection confirmed the activities are appropriate and enjoyable and those who went on holiday spoke of how much they enjoyed their time with the staff. Discussion with staff confirmed a number of service users have established personal relationships, which the staff support in a discreet and appropriate manner. A varied and balanced diet is provided with special diets being provided when required. Both catering staff have completed appropriate training in relation to their work and arrangements are in place for one member of staff to complete further training in relation to good nutrition. Service users may have their meals in either the dining room or in their own room if they wish. Some service users have accommodation which includes a kitchen so are free to have their meals when they wish. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users praised the staff team for their kind and caring nature and said they always respected their privacy and dignity. The service users health care needs are well met with evidence of good multidisciplinary working taking place. Systems for the administration of medication are good and ensure service users safety and good health. EVIDENCE: Service users confirmed that staff supported them with their personal care appropriately and always respected their privacy and dignity. They said the staff are helpful and efficient. Service users have access to a range of healthcare professionals to support them with both their physical and mental health needs. Staff monitor service users welfare on a daily basis with a record of this information being kept. All of this is in line with good practice and ensures service users general welfare. Appropriate and safe facilities are in place of storage of medication. Thorough medication procedures are in place and staff who administer medication are been provided with appropriate training from supplying pharmacist.
Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 14 Appropriate risk assessments are in place for service users who administer their own medication; these risk assessments are reviewed on a regular basis to ensure the service users are safe to continue with the responsibility of administering their own medication. An informal check of the medication takes place on a regular basis although no record is kept of this information. The registered person is required to ensure that a formal audit of all medication held at the unit takes place on a regular basis and that a record of this audit is maintained. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The unit a comprehensive complaints procedure to ensure service users views are listened to and acted upon. Systems are in place to ensure service users are safeguarded from abuse and harm. EVIDENCE: The CSCI has not received any complaints about the standard of care provided at Mayfield Court. One complaint about the standard of care provided has been made directly to the unit; this is in the process of being investigated. The service users spoken to during the inspection said they were happy with the standard of care they received and had no complaints to make. Service users confirmed they knew who to contact if she wished to make a complaint. All staff have receive training on the action they should take in the event of them receiving a complaint. Documentation was in place on the protection of vulnerable adults from abuse and the staff spoken to demonstrated they were aware of the action they should take in the event of them knowing or suspecting an incident of abuse had taken place. All staff have been provided the training on the protection of vulnerable adults from abuse. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The standard of decoration throughout the unit remains very high and provides a comfortable and pleasant environment for the service users to live. EVIDENCE: The standard of the décor throughout the unit remains very high and a planned programme of maintenance is in place. The unit is decorated in a way that gives a comfortable and bright environment for the service users to live. All parts of the unit are clean and tidy and free from offensive odours. Adaptations have been made to ensure all parts of the home are accessible to people who use wheelchairs; this includes all doorways. The unit is built in a square so has an inner courtyard which has an attractive garden with a fishpond, patio and garden furniture. All of this area is level with a hard surface. All communal parts of the Unit and a selection of bedrooms and bathrooms were inspected and noted to be clean and tidy. Clearly the domestic staff are working very hard to maintain this high standard. The laundry assistant confirmed she has completed training in relation to health and hygiene. Since the last inspection a new gallery has been built which enables service
Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 17 users and staff to move from one end of the building to the other without having to go outside. This is a lovely bright and open area which service users confirmed they use to sit and chat or have their meals. One part of the gallery is set aside for activities. All of the service users said they love the gallery area and felt it enhanced the unit significantly. The registered person is required to ensure that for service users safety, a lock is fitted to the kitchen door. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 The required staffing levels and skill mix are provided to meet service users assessed needs. Staff are provided with a range of appropriate training to ensure they are suitably qualified and competent to care for vulnerable adults. EVIDENCE: The staff rota indicated staff are evenly deployed across the week and that the required staffing levels are provided. This ensures service users are provided with good levels of support and that their individual care needs are met. Staff spoken to confirmed they have completed a range of training relating to the care of the service users and arrangements are in place a number of staff to complete other relevant training throughout the year. This is a positive aspect of the home and ensures the service users are being cared for in accordance with good practice. Through discussion the staff demonstrated a positive attitude towards their work which contributes to providing a supportive and caring environment to service users who often experience very complex health problems. One member of staff spoken to commented the staff team work well together and I feel well supported in my role. Another member of staff stated the registered manager always encourages the staff to attend any training in relation to the care of the service users.
Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 19 All of these issues reflect well upon the unit and enable positive working relationships to develop and a good standard of care to be provided. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 There are clear lines of management and accountability within the unit which is run for the service users best interest. Effective quality assurance systems are in place to ensure the high standards of care provided at Mayfield Court are maintained. The health, safety and welfare of the service users is well promoted throughout the unit. EVIDENCE: Staff spoken to during the inspection demonstrated an understanding and their role and the importance of ensuring good standard of care are maintained. Staff are clear on the lines of management within the unit and their accountability within their role. The care staff confirmed the registered manager and senior staff are always available for support and advice when necessary. Effective quality assurance systems are in place to ensure high standards of care are maintained. This quality assurance monitoring is carried out by the registered manager, senior staff and non executive directors. The unit is accredited with ‘Investors in People’. The relatives of two service users were
Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 21 spoken to during the inspection. They stated they were very happy with the standard of care they received and had no concerns to raise. They confirmed the staff are friendly and polite with a caring nature. The views of the standard of care provided at Mayfield Court will be obtained from a range of health care professionals that visit the home following the inspection. All comments will be returned to the registered provider who will be asked to deal with any issues that arise. Safe working practices are promoted throughout the unit and staff have completed appropriate training to ensure service user safety. Regular fire safety checks are carried out on all equipment and staff have been provided with regular fire safety training. To further promote service users health and safety, the registered person is advised to keep up to date with the information provided on the Health and Safety Executive and Medical Devices Agency website. Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 4 x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 4 x x x x x 4 Standard No 11 12 13 14 15 16 17 3 x 3 4 3 3 x Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Mayfield Court Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x 4 x F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 23 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. 2. Standard 20 24 Regulation 17 23 Requirement The registered person is required to audit service users medication on a regular basis. The registered person is required to ensure for service users safety a lock is fitted to the kitchen door. Timescale for action 27/10/05 27/10/05 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 Good Practice Recommendations Mayfield Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool L1 5AS 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 Court F52 F02 S25358 Mayfield Court V252106 220905 Stage 4.doc Version 1.30 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. 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!
