Inspection on 31/01/07 for Mayfield Court

This inspection was carried out on 31st January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Court 04/09/07

Mayfield Court 10/01/06

Mayfield Court 22/09/05

Mayfield Court 17/02/05

Mayfield Court 16/09/04

Mayfield Court 24/03/04

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Mayfield Court Youens Way Knotty Ash Liverpool Merseyside L14 2EP Lead Inspector Mrs Julie Garrity Key Unannounced Inspection 31st January 2007 10:45 Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 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 Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. 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 Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mayfield Court Address Youens Way Knotty Ash Liverpool Merseyside L14 2EP 0151 283 9090 0151 283 9091 admin@mayfieldcourt.org 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) Mayfield Fellowship Mrs Carole Ackers Care Home 29 Category(ies) of Physical disability (29), Physical disability over registration, with number 65 years of age (29) of places Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents (PD) between the ages of 18 - 64 years within an overall number of 29 Residents (PD/E) over 65 years of age within an overall number of 29 Date of last inspection 10th January 2006 Brief Description of the Service: Mayfield Court is a large purpose built single storey home that was built providing residential care for 27 service users (residents as they prefer to be addressed) with a physical disability. The home is registered for younger adults There are 16 flats, each has a kitchen, seating and sleeping area along with a bathroom three of those flats are shared, two are shared by married couples. There are eight bedrooms none with ensuite facilities one of which is a shared room. Generally the home is a non-smoking establishment, the staff cannot smoke anywhere in the home. If a resident does smoke staff support this in accordance with appropriate health and safety needs of the other residents in the home. The communal facilities include communal lounges, a dining room, a kitchen and laundry facilities. Both the kitchen and laundry facilities have staff employed to work in this area. There is a courtyard area that residents use in summer months. There are parking facilities to the front of the building. Mayfield Court is located in a residential area of Knotty Ash. There are some shopping facilities within walking distance and a main bus route within 5 minutes walk. Riverside Housing Association owns the property and the care is provided by the staff employed by the Mayfield Fellowship. Mayfield Fellowship is a charity based organisation and has a board of trustees that meet regularly in order that the home can be well managed. The trust does not own or have management responsibility for any other care homes. The manager has been in post for over 5 years and is registered with CSCI. Fees for the service are on an individual basis and dependent on the assessed needs of the resident and the accommodation suitable to meet their needs. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day. The inspector arrived at the home at 10:45 and left at 17:15. The inspector spoke with 6 residents, 7 staff, the care manager and the manager. The inspector completed the inspection by a site visit to Mayfield Court, a review of relevant records (detailed in the body of this report) in home and CSCI offices. Copies of records were submitted to CSCI for review in this inspection. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas identified in need of review were covered. All of the Key standards were covered in this inspection, these are detailed in the report. Feedback was given to the manager during and at the end of the inspection. The arrangements for equality and diversity were discussed throughout the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs and the practices that they put into place into meeting those needs. What the service does well: Mayfield Court is a well managed home that is run in a manner that helps the residents be independent. Residents are encouraged to attend meetings get involved in activities and raise concerns as examples. All the residents spoken with were positive about the care that they received several said that “the staff are excellent”, “they are very caring” and “they know what they are doing”. Staff are recruited to work in the home based on the right person for the job. They are developed to obtain the skills that they need to do their jobs well. Most of the staff work in the home for several years and all have been checked that they are suitable to work with older persons before they come to work in the home. Staff are given training that meet the needs of the residents, good supervision that helps staff gain skills and a good management team that encourages staff and regular staff meetings. All these activities mean that staff have the skills to care for the residents. The arrangements in the home are designed to promote the residents independence and for them to have influence over their lives in the home. The home supports the residents to express their views and involves them in the service that is provided and how that service is put into place. The building is suitable to the residents needs a variety of different combinations of living space for the residents and they access the ones that Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 6 they choose. Outside space is available for residents to enjoy and the location of the home allows them to access the community independently. 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. The summary of this inspection report can be made available in other formats on request. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2 (Adult 18-65) and 3 (Older People) standard 6 is not applicable was reviewed in this area. Quality in this outcome is is good. This judgement has been made using available evidence including a visit to this service. All residents are assessed before they move in to the home. This makes sure that the home can decide if they can meet their individual needs. This assessment is shared with the residents and their relatives and they are supported to give personal information in a sensitive manner. EVIDENCE: New admittances to the home are rare there have not been any new residents move into the home in over 12 months. The manager makes sure that potential residents are given the opportunity to spend time in the home before Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 9 they move in. The service users guide and the admissions policy contains information for residents and staff that supports this good practice. All preadmission assessments are done by the care manager who uses a prepared assessment that is designed to identify all the residents’ needs. A copy of this was reviewed and residents records also showed that these had been completed before the residents were admitted to the home. A resident spoken with said that the care manager had been “kind and caring” whilst doing the assessment and that they had “felt happy to talk about lots of things”. All residents who have their stay paid for by Social Services have a copy of Social Services assessment obtained by the manager before admittance. Copies of these are available in the home and are used to help with the overall assessment of the resident. The assessments are used to help the staff write care plans on how resident’s needs are to be meet. Information to new residents and their families about the home is readily available and a copy of this is placed near the dinning room Different formats are available for residents such as large print and Braille. These can be arranged by the home. At present the home does not have information available on tape, video or in picture format. However they are exploring ways of making sure that all information in the home is available for residents in a variety of different formats that are easy to obtain and can be given to the residents quickly. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 9 (Adults 18-65) and 7, 14, 33 (Older People) were reviewed in this area. Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to make decisions about their lives and to maintain their independence. They are regularly consulted and their choices influence the way that the home is run. EVIDENCE: The layout of the home provides residents with a variety of different facilities. The home has an area that they call the “gallery”. This is an area that the Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 11 residents frequently choose to sit in as it is a main corridor through the home. Although clinical in appearance it was decided on by the residents they choose the colours, the flooring and the layout. It is a multi-purpose area that combines sitting area, party areas and creative activities. The residents spoken with “love it”. They like the fact that “everybody” passes through at some point. The manager holds regular residents meetings and had a “service users “ representative who attends all the meetings. This individual is encouraged to raise any issues that the residents want to discuss and be involved in the planning and management of the care home. Copies of the minutes of the last meeting seen clearly reflect the input given by this residents and how these were to be implemented. There are regular staff meetings and supervision that helps the manager determine concerns from the residents, progress of the staff and any training needs. Throughout the home there are regular audits such as security, medications and environment as examples. Although no formal plan is in place on how to improve areas identified the manager has informally addressed these and any areas that need addressing are discussed and planned for wit the residents. One resident said “all is discussed, very little happens that I didn’t already hear about”. Staff spoke with were able to detail significant amounts about the residents and their needs. Some old fashioned comments were made by a member of staff that were not in context with promoting independence of residents. This was discussed with the manager and the care manager. Staff have received a lot of training to meet individual needs and a lot of support in order to fully understand and support individual needs in the manner that suits the residents. Staff tend to work in the home for a long time and work well with each other, regular staff meetings and verbal discussions have made sure that most staff are aware of the needs of residents. The care/ support plans viewed had been re-written by staff on several occasions as they have received conflicting information. This has lead to plans that are overcomplicated and contain brief but relevant details on how the home is to support individual needs. The home also has an individual activities file in each of the residents bedrooms that detail the activities that they like and it is intended that this be further developed to plan individual activities. They also have “rehab” plans for residents to develop other skills such as cooking. Unfortunately on the day of the site visit these were not available. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 13 Standards 12, 13, 15, 16, 17 (Adults 18-65) and 10, 12, 13, 15 (Older People) were reviewed in this area. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to live a lifestyle that meets their needs. Choices of a personal nature are handled with discretion and maintain confidentiality where needed. Residents say that they like the food, however further opportunities need to be created so that all residents receive a diet at the times they choose that is appetising and meets their medical needs. Information to residents about their choices is available, but this is not readily accessed by residents, as it is not always available in formats that are suitable to their needs. EVIDENCE: The residents spoken with spoke of regular holidays, all of which had enjoyed these experiences. One said, “ I so look forward to it”. There is a full time activity co-ordinator in post but was unfortunately on holiday at the time of the site visit. Whilst she was not available, activities to the same level of activities were not happening. Apart from the individual activities books in residents rooms there was a notice board that detailed general activities. The individual books of the residents contained photographs of what the residents had done, but there was no structured plan in any of these. The activities board contained very brief details and was not available in a format that was suitable to the needs of all the residents. The manager detailed activities plans are being developed further and they were suitable, they include daily activities and independence promotion such as household tasks and further development into managing own funds. One of the residents spoken with had been supported to attend a college and gain a qualification. Intimate relationships are discreetly supported by the home in order that residents who are married or have a partner are supported to keep the personal relationships that they enjoyed before they came to live in the home. These are lead by the residents who decide how they wish to be supported. One residents discussed the support that they received from the home to maintain their relationship and had found the staff ”easy to talk to and happy to help. They tell what I need to know and make sure I’m happy”. Several equality and diversity issues were discussed with the manager and staff. It was evident that staff were aware of how to support residents personal choices. Personal preferences regarding sexuality were discreetly and confidentially managed as requested by the resident. This was very good practice and showed a supportive attitude from the management. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 14 Residents spoken with said that they “like”, “enjoy” the food and that “the cook is good”. The menus are created by the catering department from information that the chef keeps in the kitchen about resident’s likes and dislikes. Those records seen were out of date and staff were aware of other choices not in this record. Menus are also discussed at residents meetings and the minutes of the last meeting had detailed a discussion around the food. The minutes are available near the kitchen but are not printed in formats to meet the resident’s needs. Residents said that the staff talk to them about what food is available. The menus and ordering system showed that plenty of choice was available. Menus are not readily available in formats that are suitable to the residents for them to look at. Two residents said that they “don’t always remember what the meal is”. One resident has the meal in their flat and will re-heat it in their microwave supporting them to have their meal at a time that they choose. This opportunity is not as easily accessed by residents without access or the skills to use a microwave and as such does not enable all residents to have the same opportunity. The menus available do not detail special diets such as a soft of liquidized and diabetic diet. The chef said that the catering staff had not received training in diabetic diet but was keen to receive training. Training records showed that diabetes and diets training is available later in the year. Liquidized food is combined together and this is unappetising and does not support residents who need this food to have a diet that meet their choices. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19, 20 (Adults 18-65) and 8, 9, 10 (Older People) were reviewed in this area. Quality in this outcome is is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to attend healthcare appointments and have access to health care services when they are needed. Regular contact is made with a range of health care professionals who give advice and support as and when required. All of this is in line with good practice and makes sure that physical and mental health is monitored and maintained in a manner that is lead by the resident’s choice. EVIDENCE: Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 16 Residents are supported to manage their own medications were possible and risk assessments were in place. However this had not included where residents managed one of their medications as apposed to them all and risk assessments were not in place for items such as inhalers. One resident said “staff leave me to it they don’t interfere and glad that they don’t”. Risk assessments had not been revisited to make sure that the residents were still receiving the appropriate support. The medications in the home were reviewed. Records regarding medications were mainly well kept and in general gave clear instructions to staff. A number of areas of practice need to be developed in order to maintain good management of medications, these included handwritten entries, entries into controlled drugs book, records for medications not given. An audit of the medications showed that medications were being given in accordance with the prescription and the home supports residents to take over the counter medications as they choose. This is good practice as residents can then be involved in the medications they take. Records and discussion with the manager showed that medical services are accessed as needed. Although this was a little difficult as records of visits are not easy to find in the daily records and rely on staff remembering when the visit occurred. Some of the residents manage their own medical needs with minimal support and others need staff to assist. The home makes sure that they give the appropriate support to each resident. One resident said, “its my business I let them know when I need to see a doctor and I decide if someone is with me or not”. The home has some very high medical needs including PEG feed, which is where an individual receives their food directly by a tube into their stomach. All the staff have received training in this and this is regularly updated. District nurses also give regular support and ate contacted as needed. The home has been undertaking blood monitoring for residents with diabetes, there is no protocol for this written by the district nurses, although training has been done this has not been updated, there is no records of whose responsibility or how the equipment needed for this is maintained. This is a medical task that the home needs to make sure is undertaken with proper support and instructions. Residents are given additional support as needed when they are ill, and they are monitored to make sure that the treatment in place from the healthcare services is appropriate. One resident said, “ they are good if I have a sniffle or an ache and pain it gets sorted”. Residents are also supported to access mental health services as needed, this has included counselling services as needed and community mental health nurse support when necessary. Some of the residents have dementia care needs this has been recognised by the home and although not fully explored in care plans it is briefly outlined. The training programme for staff the following year includes an overview of dementia care needs. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22, 23 (Adults 18-65) and 16,18 (Older People) were reviewed in this area. Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that any concerns they have will be recognised and dealt with in order to make them feel safe. Good training for staff supports resident’s confidence and makes sure that staff are aware of how to protect residents. Staff are not fully aware of the responsibilities for dealing with serious concerns and run the risk of compromising any investigations that may need to be done. EVIDENCE: Mayfield Court has a complaints procedure, a copy of this is available in the home. It is in a printed format and is not suitable to meet the needs of all the residents in the home. Residents meetings are also an opportunity for residents to raise concerns and influence services. Any complaints are recorded and addressed with full information given to the individual raising the complaint. There has been 1 complaint made to CSCI regarding Mayfield Court. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 18 This was dealt with by Social services. The home has learnt from this complaint and others and used it to influence the quality in the home. All staff have received training in protecting vulnerable adults. This is covered in induction, in policies in the home, in regularly updated training and in staff meetings. The policies and procedures regarding protection of residents are in place. These have also bee reviewed by a professional outside the home who has suggested a number of updates and include changes in legislation that are to be occurred. Discussions with staff showed that they were aware of how to raise concerns but were unsure as to whose responsibility to investigate it was. All of the residents spoken with were confident that the home supported the residents to be safe. One resident said, “ I have absolute belief that I am safe here. The staff make me feel happy that they know what they are doing”. One of the residents said, “anytime I’ve had anything I didn’t like I just tell someone, its sorted, these are great staff”. The home does hold some funds for the residents. This money is either given directly to the residents for them to deal with themselves or is put into an individual account for the resident. All spending has full receipts in order to make sure that the resident’s funds can be accounted for. There is limited access to resident’s funds by staff and all spending must have a receipt to explain it. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 30 (Adults 18-65) and 19, 26 (Older People) were reviewed in this area. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mayfield Court is well maintained and clean and tidy. There is suitable equipment available that helps to maintain residents independence and promote safety. Staff are aware of the ways to maintain good hygiene levels and are able to do so to a good standard. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 20 EVIDENCE: There is regular audits on the home that helps say what actions such as redecoration needs to be done. A tour of the home showed that in general it is well maintained with different areas for the residents to use. The only area that is presently in need of replacing is the carpet near the kitchen, which is stained. The cleaning staff regularly clean this area but are struggling to keep it maintained at a suitable level. Some areas of the home look clinical but this was decided on by the residents who live in the home and supported by the manager. Bedrooms and flats viewed had been personalised by the residents, there own personal items had been brought into the home. Equipment in the home is extensive, there has been a lot of money spent quality moving and handling equipment to keep both staff and residents safe. Both staff and residents were pleased with the level of equipment staff found it helped them transfer residents safely and residents felt safer with the equipment in place. The kitchen and laundry were viewed. Both were clean and tidy and had regular cleaning schedules in place. Both had equipment that enabled them to supply good services to the residents. Some residents do their own washing in their flats and staff support this as needed. The main kitchen is not accessed by the residents as those in flats have minimal cooking facilities such as a microwave available for their use. The home has policies and procedures to deal with hygiene such as crossinfection and cleaning and these are meet by the staff. The kitchen staff have received the guidance from environmental health that supports them to monitor all food produced. Some items of food in the freezers had not been labelled for expiry date appropriately but all fridge items were. The proper labelling of food items can assist in the staff making sure that food stocks in the home are properly managed. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 (Adults 18-65) and 27, 28, 29, 30 (Older People) were reviewed in this area. Quality in this outcome is is good. This judgement has been made using available evidence including a visit to this service. There is sufficient staff available in the home to meet the residents needs. All the staff have been recruited and monitored to make sure that they are aware of their job role and how to support residents. There is training available that will provide staff with the skills that they need to meet the resident’s needs. Further work is needed on staff’s understanding of the differing approaches needed for individual residents and how to make sure that they practice equality and diversity in relation to the care of residents. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 22 EVIDENCE: Staff have done a range appropriate training to support the residents with their care needs and to ensure the smooth running of the home. Many staff have completed training in a qualification specific to staff working in care and other staff are in the process of completing this qualification. Staff have completed specialist training to reflect residents individual care needs. Further training in aspects such as epilepsy, mental health, learning disabilities, dementia and diabetes is planned for the coming year. The home has a full induction process. When first recruited all staff work supervised to make sure that they can meet the role that they were recruited for. They are monitored regularly and given additional training if needed. The majority of staff have worked in the home for over three years and this provides a stable staff team. All staff are recruited in line with equality and diversity. The service users have a variety of differing needs and dependencies, staff are recruited for their skills and developed. Examples of this include the recruitment of male members of staff to support the male residents. Staffing files examined contained records that each member of staff is checked properly before they start working in the home. This includes police checks, checks on fitness to work with adults, references and a working history. All staff that start working before the police check is completed are supervised. However the home does not have formal arrangements for this or records that it is in place for staff until fully checked. The home has policies and procedures that cover a wide range of equality and diversity issues such as bullying, harassment, code of conduct as examples. Some comments made by staff and some of the practices observed on the site visit and detailed by the manager show that not all staff are fully aware of the need to meet equality and diversity. Staff and residents spoken with confirmed that there is always enough staff available at all times. Staff said that they could arrange to take residents out to things such as local shops as there is usually enough staff to cover this. Residents said that they “never have to wait”, “staff are available when I need them” and “they are there when I want and not when I don’t need them. Very good at what they do”. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 42 (Adults 18-65) and 31, 33, 35, 38 (Older People) were reviewed in this area. Quality in this outcome are is good, This judgement has been made using available evidence including a visit to this service. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 24 A well skilled management team that are aware of how to support residents and to safeguard their safety runs the home. Quality is seen as an important aspect and resident’s points of view and wishes are asked for in order to increase the quality of the service. There is room for further development such as including residents in training, accessing information in the home and in developing a formal plan to increase the quality provided. EVIDENCE: The manager is registered with the Commission, she is qualified nurse, has a qualification in management and has been in post for over four years. This maintains a consistent management approach and supports staff and residents to express their views. There is a structured staff team that also includes a care manager and a facilities manager who help support the manager. Residents spoken with said that the manger and the management team were “very easy to get on with”, “very happy to help. They understand me “ and “ so good, I’d be lost without them”. Staff spoken with found that the manager was “tough, but fair”, “knows her stuff” and “always available to talk”. A concerns and compliments book is available in the reception area as is a suggestions book. This enables residents, relatives and visitors to put forward their point of vie regarding the service provided by the home. The home did undergo a formal quality assurance scheme but felt that it was more designed to check the systems in the home rather than the opinions and feelings of the residents living there. They do not have a formal quality system in place but do undertake a variety of systems audits such as medications and environment. Additionally there are regular residents meetings and opportunities for residents to express their opinions. Staff are also able to give an input in regular staff meetings. As yet the information given by all these areas is informally acted on and addressed. This means that the home is reacting to situations as they occur. The manager said that she intends to have regular opportunities to gather opinions from residents, relatives and staff and to progress these into a formal plan that all people involved in the home can be aware of and input into. Policies and procedures are available in the home and staff are able to access and read this. These are not available in different formats that would support the residents to be involved in their development or be ware of the contents. Staff receive regular training in health and safety, certificates were seen on staff files that supported this and staff detailed the training in this area that they had done. Fire safety training is regularly done, however no evidence was seen that residents also receive fire training or any other health and safety training that they might find useful. Certificates of maintenance such as gas and electricity are available and up to date. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 25 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. 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 Standard No Score 1 X 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mayfield Court Score 3 3 3 X DS0000025358.V329460.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard YA1 Good Practice Recommendations 1. Consideration should be made to making the information in the home such as service users guide, minutes of meetings, care plans, risk assessment policies and procedures in formats that enable the residents to access these easily. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 27 2. YA7 Care plans should be reviewed and a system put into place that has clear in put from the residents and clearly records their diverse needs, This will also promote staffs understanding of equality and diversity. The activities and rehabilitation plans should be reviewed and expanded to make sure that they fully cover the needs and promotion of independence of residents and where applicable provide a structured plan that staff can follow in the absence of activities organiser. This will also make sure that key workers are able to better plan days out and social activities of the residents who need their support. Food should be presented in an appetising manner at all times. Consideration should be in place to include specialist diets on the menus and to provide menus as a reminder to residents in a format that meets their needs. Medications management should be reviewed, although audits are in place these may need to be expanded to make sure all aspects are covered. A clear understanding of good practice is in place and these needs to be followed at all times by all staff. All residents should have risk assessments in place for any medications they deal with and are regularly reviewed to make sure that the support is appropriate. Staff should have full awareness of the protection of vulnerable adults processes and how this will be investigated. They should also make sure that they inform the manager of all concerns expressed. Consideration should be made in including the residents who wish to in training events including aspects such as fire training and protection of vulnerable adults training. 3. YA16 4. YA17 4. YA20 5. YA23 6. YA35 Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Mayfield Court DS0000025358.V329460.R01.S.doc Version 5.2 Page 29 - 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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