Inspection on 23/05/06 for Mayfield House

This inspection was carried out on 23rd May 2006.

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 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 House 07/10/08

Mayfield House 30/10/07

Mayfield House 22/02/06

Mayfield House 04/08/05

Mayfield House 06/01/05

Mayfield House 15/06/04

Mayfield House 19/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Mayfield House Mayfield Mews Minshull New Road Crewe Cheshire CW1 3FZ Lead Inspector John Mills Key Unannounced Inspection 23rd May 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Mayfield House Address Mayfield Mews Minshull New Road Crewe Cheshire CW1 3FZ 01270 500414 01270 214946 mayfieldhouse@bt.connect.com 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) Littleton Homes Limited Lynne Woodroffe Care Home 51 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (23), Old age, not falling within any other of places category (51) Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service is registered for a maximum of 51 service users in the category of OP (Old age, not falling within any other category) Within the overall number of service users to be accommodated a maximum of 23 service users may be accommodated in the category of DE(E) (Dementia over the age of 65 years) Within the overall numbers of service users to be accommodated 1 named service user may be accommodated in the category DE (Dementia under the age of 65 years) until 18/12/2007 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 22nd February 2006 3. 4. Date of last inspection Brief Description of the Service: Mayfield House is a two-storey purpose-built property that provides 51 places for older people. The home is located on a modern housing estate, and is within approximately a mile-and-a-half of Crewe town centre with access to bus links and the railway. The property has been extended and now has two separate units - one for residents with general care needs, and the other for residents who have dementia. Access to the homes second floor is provided by a passenger shaft lift, and three stairways. There are accessible and wellmaintained gardens surrounding the home. The manager confirmed that the contracted cost of residency was based on the standard social services fee with an additional £50 per week that is either part of the private fee or a top up for those residents funded by the local authority. This information is provided to service users and families prior to admission and is also included in the formal contracted of residency. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A regulatory inspector conducted this unannounced site visit on 25th May 2006 over a period of six and a half hours. Feedback was given directly to the manager and verbally by phone to one of the directors of the company on 2nd June 2006. Records were inspected and staff practice was observed. Discussion took place with residents, visitors and staff. The manager confirmed that the contracted cost of residency was based on the standard social services fee with an additional £50 per week that is either part of the private fee or a top up for those residents funded by the local authority. This information is provided to service users and families prior to admission and is also included in the formal contracted of residency One requirement remains unmet and is outstanding from the previous two inspections. Additional requirements in relation to general staff training, Adult protection and the registration of a manager are made within this report. What the service does well: What has improved since the last inspection? A new computerised record management system is in place. This crossreferences information between service user files, key worker files and the general diary for the service. Medicines management has improved and service users are supported by senior staff that are trained and competent in this area of activity. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 6 Following to recent meetings, under Cheshire’s Protection of Vulnerable Adults procedures, to address the service’s responsibilities when two service users with dementia left the home without the awareness of staff, security within the home has been improved. 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 House DS0000006654.V289952.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 & 5 The quality rating for this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users and their relatives are given appropriate advice upon which to make regarding accessing this service. The assessment of need completed before residents move into the home, to ascertain if their needs can be met, are not currently being carried out by suitably qualified or experienced staff. See Requirement No 1. The staff within this service are experienced and able to meet the identified needs of service users. The physical structure of the service and the grouping of service users allows staff to provide specific support to the individual needs of each group in an appropriate setting. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 9 EVIDENCE: Mayfield House does not provide intermediate care facilities and this standard (6) is not applicable. Conversations with three visiting relatives confirmed that they had been provided with information about the home prior to making a decision regarding accessing this service. They also confirmed that they had been given an opportunity to visit the home on their relatives’ behalf. Conversations with these relatives and with service users indicated that they were satisfied that the service was able to meet their needs and those of their relatives. The care records of four residents were examined, two from each of the units within the service. One had recently been admitted to the home and had been assessed prior to admission by the new manager and one of the Senior Care Assistants. A pre-admission form had been completed as part of the pre-admission assessment for all service users case tracked as part of this inspection. The information includes the residents’ previous history, physical illnesses and current medication. The structure and organisation of the service is such that each unit has a desiganted group of service users, one unit provides care and support to 28 older people with the general care needs of the elderly, the second unit provides care and support to 23 older people with dementia. Within this seperation staff are given training and support specific to the needs of those service users they work with. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 The quality rating for this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The use of computerised and non specific care plans does not provide staff with appropriate information to identify and meet the complex needs of service users living within this service. The needs of service users are only partially identified and therefore are not being fully met. Service users are treated with dignity and respect by staff. Medication procedures and practices are such that service users can be satisfied that this aspect of care is safe. EVIDENCE: The service continues to use a form of care plan that is computer generated. This plan gives general comments regarding the meeting of needs. The care plans do not contain service user specific information or guidance. See Requirement No 2. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 11 Daily records included such phrases as OK No problems no change There is no evidence in care files to confirm that service users or their families are involved in the development of care plans. Service users have access to health care services, such as GPs, Dentis, Opticians and Chiropodists that meet their individual needs. Ongoing health needs are monitored and recorded and when necessary appropriate actions taken. There is within this service a medication policy that is accessable to those staff with responsibilities in this area. Medication records were up to date. The processes for recipt of, storage, administration and disposal of medication were correctly recorded. Conversations with two SCAs confirmed that they understood these procedures and responsibilities. Staff were aware of and were observed to be treating service users with respect and where actively seen to be promoting practices that enhanced the dignity of service users. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged and supported to express and exercise choice in daily activities. There are opportunities for individuals to maintain links with their families and continue to access the local and wider community. Service users have a good choice of meals that are taken in pleasant surroundings. EVIDENCE: Staff were observed talking with and listening to service users when attending to their needs, this was most eviden during the lunch time period. There is a designated activities co-ordinator and this role with care staff involvement is used to arrange and provide recreational and diversional activities within the service. There are also opportunities for musicians and entertainers to visit the home. The information relating to forthcoming events is displayed for the informing of service users and visitors alike. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 13 Families and friends are able to visit throughout the day. Comments received confirmed that they are made to feel welcome and have confidence in the staff providing care and support. Service users were observed to have choice in daily routines, choosing where to spend time. One resident had planned to go out for the day with her daughter and stated that this was a regular activity for her. The home provides service users with three cooked meals each day and there is a minimum choice of two alternatives. Service users with identified nutritional needs have supplements provided. Staff were observed to support those residents who required specific assistance during meal times with quiet dignity and respect. Service users commented that the food was good with plenty of choice Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The quality rating for this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users and their families have access to a satisfacory complaints procedure. The absence of specific training on Adult Protection makes both staff and service user vulnerable within potentially abusive situations. EVIDENCE: There is within this service an appropriate complaints procedure that is made available to residents and their families in the Service User guide prior to admission. Visiting families and service users knew of this procedure and were aware of how, if necessary to make complaints. The manager had recently been involved in two Adult Protection meetings and was aware of her responsibilities towards protecting vulnerable service users. There was no evidence to confirm that staff had received training on Adult Protection. The manager confirmed that this training had not been provided to staff prior to her appointment. See Requirement No 3. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,25 & 26 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well maintained and safe environment, with a demonstrated commitment to maintenance and improvement. Staff are aware of their various responsibilities in maintaining these standards. EVIDENCE: A tour of the premises included all communal areas and identified a well maintained, decorated and furnished home. There is a handiman who has a clearly identified schedule of work to complete. There is a small enclosed garden to the rear of the home and this is easily accessible to service users. Residents were observed moving freely from one of the conservetories into this area. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 16 Time was also spent in conversation with two housekeeping staff who also had a clearly precribed routine to work to. Both were able to desribe their responsibilities in maintainin a safe and clean environment. Both were also able to describe how emergency situations regarding personal hygiene were responded to and how they and care staff worked closely together. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28.29 & 30 The quality rating for this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and the skill mix of staff employed are appropriate to the needs of service users. There are robust recruitment processes in place, to ensure the continued safety of residents. The absence of specific training on Adult Protection and a plan of future training increases the vulnerability of service users. EVIDENCE: On the day of the site visit to this service there was the manager, three senior care assistants and four care assistants during the morning, this is reduced to two senior care assistants and three care assistants. In addition to this there were catering and domestic staff on duty. The three senior care assistants on duty were experienced and trained to NVQ level 2. All three together with senior night staff had started to work towards NVQ level 3. Training records confirmed that a comprehensive range of training opportunities had been provide to staff. This included mandatory training in such areas as Health & Safety, Fire Safety, Food Hygiene and Moving and handling. Training had also been provided in service user related areas such as Understanding Dementia and basic Principles of Care. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 18 Staff spoken with were able to describe the needs of individuals within the home, but lacked specific and individual details in such areas as toileting routines, mobalising and managing confusion. There was as stated an absence of specific training on Adult Protection. See Standard 3 & Requirement No 1. See Requirement No 4. Examination of personnel files identified a varying standard of information being useed to recruit staff. One member of staff recruited had not completed and application form, two written references had been optained as had an enhanced Criminal Records Disclosure. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,3,36 & 38 The quality rating for this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A person registered with CSCI with the necessary experience and qualifications does not presently manage the home. The general ethos of the service and management practices are designed to promote the development of staff and the quality of services provided to service users. EVIDENCE: Following the resignation of the previous registered manger the day to day management of the service has been given to the homes administrator. This Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 20 person has worked at the home for six months and had previously worked at another care home as an adminiostrator for 12 month. The present manager has limited experience of wotrking in or managing a care home and has no care or management qualification to NVQ level 4. SEE Requirement No 5. Conversations with the manager, senior staff, visting families and individual residents confirmed their perception of home the home is positively organised towards the best interests of service users. The monies of service users who wish to are retained by the homes accountant, residents and family members spoken with confirmed that they can accress these monies at any time. There is a clearly identified programme of supervision that is cascaded through the senior staff team. All care staff receive formal supervison at least six times a year. Staff training in mandatory health & safety matters, domestic staff and care staff were able to desribe their responsibilities regarding COSHH regulations, moving and handling and safe working practices. All care staff have training in the use of mechanical hoists and the stand aid used within the home. Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 X X X X 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 3 X 3 Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement The registered person must ensure that the pre-admission assessment of prospective service users are undertaken by suitable qualified and appropriate staff. The registered person must ensure records that identify residents needs, and staff responsibilities in meeting their health and welfare, are detailed and identify how residents needs are proposed to be met, and include appropriate risk assessments and risk management strategies. (Previous timescales of 1.12.05 and 1.5.06 not met) The registered person must ensure that all staff receive training on Adult Protection. The registered person must ensure that a planned training programme is prepared for the next 6-9 months. The registered person must ensure that an application for a suitably experienced and DS0000006654.V289952.R01.S.doc Timescale for action 01/07/06 2. OP7 14 and 15 01/08/06 3. 4. OP18 OP30 18 19 01/09/06 01/07/06 5 OP31 9 01/08/06 Mayfield House Version 5.1 Page 23 qualified person to be the registered manager is made. 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 Good Practice Recommendations Mayfield House DS0000006654.V289952.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 House DS0000006654.V289952.R01.S.doc Version 5.1 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. 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