CARE HOME ADULTS 18-65
Mayfield House King Cross Road King Cross Halifax West Yorkshire HX1 3LN Lead Inspector
Liz Cuddington Unannounced Inspection 25th October 2005 14:10 Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 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 DS0000000990.V254681.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 House DS0000000990.V254681.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Mayfield House Address King Cross Road King Cross Halifax West Yorkshire HX1 3LN 01422 362121 01422 362121 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 Trust Mrs Sharon Linda Porteus Care Home 20 Category(ies) of Learning disability (20), Learning disability over registration, with number 65 years of age (20) of places Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17th February 2005 Brief Description of the Service: Mayfield House consists of a large house and a separate building, set behind the house and known as The Cottages, where the people who wish to live more independently have their homes. The two buildings are separated by a courtyard and car park. Behind The Cottages is a garden, patio and barbeque area. There is one manager with overall responsibility for the two parts of the premises. The manager and staff support the ladies and gentlemen who live at Mayfield to live active, independent lives pursuing their own work and recreational interests and maintaining connections with family and friends. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The manager and staff at Mayfield House and Cottages have worked hard to make improvements since the last inspection. The two long-standing requirements have now been dealt with satisfactorily. Three of the four good practice recommendations from the last inspection have been put in place and the fourth has been partly completed. This inspection has produced two good practice recommendations and no requirements. The inspection lasted just over four hours and during that time I spoke with twelve service users and four members of staff. The atmosphere is comfortable and relaxed and the ladies and gentlemen gave every indication that they enjoy living there and are well supported by the staff. On the day of the inspection Hallowe’en was approaching and a party was planned at the house, which everyone said they were looking forward to. I would like to thank all the people who live and work at Mayfield House and Cottages for their warm welcome and hospitality. What the service does well: What has improved since the last inspection?
The manager has employed a full-time caretaker/handyman. He has clearly been working hard and has made noticeable improvements to the home. A fulltime cook has also been employed. This appointment has freed staff, giving them more time to spend supporting service users. Additional funding has also been acquired to provide more time for staff to work with service users who need extra support. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 6 More re-decorating has been done and the carpet in the hall, stairs and landing of the main house has been replaced. A stair lift has been fitted in the main house. The fire escapes are now in good condition and provide safe emergency exits from the house and cottages. The kitchen has been refurbished with just a small amount of work outstanding. After discussions with the home’s pharmacist a new, more user-friendly way of providing solid medication for service users who look after their own medicines has been put in place. The plans of care and support now include information about the individual’s last wishes. The home’s Statement of Purpose has been amended to include the necessary information. The quality assurance process has been started and questionnaires have been sent to one group of people with an interest in Mayfield House and Cottages. 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 DS0000000990.V254681.R01.S.doc Version 5.0 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 1, 2 & 4 The Statement of Purpose includes all the necessary information. The preadmission assessment of needs and decision making process meet the standard. EVIDENCE: The Statement of Purpose now includes all the information outlined in Schedule 1 of the Care Homes Regulations 2001. A bit more clarity to show that nursing care is not provided would be helpful and the reference to the former Commission needs to be replaced with the name, or initials, of the Commission for Social Care Inspection. Each service user’s personal file contains a copy of their Social Services needs assessment. For a new service user this forms the basis of their plan of care and support. It is some years now since a new service user went to live at Mayfield House and Cottages. When there is a vacancy the prospective service user is invited to visit, and stay if they wish, as often as they like until the person has reached a decision. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 6, 7, 8 & 9 The personal plans of care and support reflect the needs of the individual and how changes and assessed risks are to be managed. Service users take part in the running of the establishment and people’s choices are respected. EVIDENCE: I looked at two service users’ personal plans of care and support. Both reflected the current needs and preferences of the individual and showed how their wishes and ambitions are achieved. Where someone’s circumstances have altered these changes are reflected in the plan. The service user is involved in developing and reviewing the plan with his or her keyworker. The ladies and gentlemen who live at Mayfield House and Mayfield Cottages are supported to make their own decisions about every aspect of their life. There is an advocacy service available if people wish to use it. Staff support those service users who need assistance to manage their own finances. The people who live at Mayfield are very much involved in saying how they want their home to be run. There are informal discussions and more formal service users meetings.
Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 10 Risk assessments are carried out to help keep any risk for service users at an acceptable level while making sure that individual freedom and choice is not compromised. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 15, 16 & 17 Service users are involved in work and have an active and varied social life. Staff treat service users in a respectful and friendly manner. Visitors are welcome. The meals are good and special diets catered for. EVIDENCE: Some service users continue to work locally and attend the Skill Shop, formerly called Boosters, which people said they enjoyed very much. Staff at Mayfield support service users to find employment opportunities. Service users are involved in the local community life. On the evening of the inspection some people were attending a Hallowe’en party at their local pub. Staff support people to participate in social activities outside the home, as far as staffing levels allow. A cook has recently been appointed which has released staff to spend more time with service users. Most of the ladies and gentlemen who live at Mayfield vote in elections. Service users families and friends are welcomed into their home. Visitors can be received in the communal areas or in the service user’s own bedroom.
Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 12 The relationship and interaction between service users and staff was seen, as always, to be friendly and relaxed. Staff show respect towards service users and their privacy and dignity is maintained at all times. The people who commented said how nice the meals are and preparations were underway for the food for Mayfield’s own Hallowe’en party. The evening meal prepared on the day of the inspection looked appetising and people told me it tasted very good. Special diets are catered for. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 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 the following standard(s): 18, 19, 20 & 21 There are suitable adaptations to assist people to maintain their independence. Continuity of support and promoting privacy and dignity are considered very important. Service users health care needs are met. A policy and procedures needs to be developed to guide staff when secondary dispensing of medicines is needed. Alterations have been made to meet individual’s changing circumstances. Information about service users last wishes is now being included in people’s personal files. EVIDENCE: A stair lift has recently been fitted to the staircase in the main house, which is proving invaluable. There is a track hoist fitted in one of the bathrooms and there are grab rails. All personal support is offered discreetly and privately. A key worker system is used and this helps to provide continuity of support for service users. The OK Healthcheck system is used to assess and monitor each individual’s health care needs. The staff provide any support needed for service users to see healthcare professionals such as GP’s, dentists and opticians. Service users who manage their own medication have the tablets dispensed into weekly blister packs by the pharmacist. A procedure needs to be developed to guide staff should they need to transfer any medication from the
Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 14 blister packs, or other packaging, to enable service users to take their medicine out with them more easily. Advice on this should be taken from the pharmacist. The home’s pharmacist trains staff in medication administration. Since the last inspection the registration of Mayfield House and Cottages has been changed to remove the upper age limit of 65 years. This means that the people who live there are able to stay in their home for as long as their needs can be met. The personal files now include information from service users about their funeral wishes. There is also a form to complete about how the individual wishes the last part of their life to be conducted. The changing circumstances of some service users have resulted in some alterations to the rooms. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 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 the following standard(s): 22 The home’s complaints procedure is suitable for the service users. EVIDENCE: The complaints procedure for service users is available in a format with illustrations and using straightforward language. Service users are aware of how to make a complaint and evidence showed that any concern or complaint is treated appropriately and in confidence. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 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 the following standard(s): 24, 27, 28, 29 & 30 The house and cottages are well maintained and where necessary the environmental standards have improved since the last inspection. EVIDENCE: Since the last inspection the furniture in the lounge has been re-covered and a new carpet has been fitted on the stairs and landing. Re-decorating of rooms is continuing and the fire escape has been repaired and re-painted to meet fire safety standards. A full-time caretaker/handyman has recently been employed and he completes a lot of the decorating and general repair and maintenance work around the house. These measures have made a great improvement to the environment of the house and cottages. There are enough bathrooms, toilets and communal areas to meet the needs of the people who live at Mayfield. The house is kept clean and measures are in place to make sure a good standard of hygiene is maintained. The laundry meets the necessary standards. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 17 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 All staff are offered suitable training to help them in their work. EVIDENCE: There is a training and development plan for the home and there was evidence to confirm that new staff undertake an induction training programme followed by the Learning Disabilities Award Framework (LDAF) training. All staff are encouraged to take an NVQ qualification after their initial training. Learning and development needs and opportunities are discussed during supervision. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 18 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 The quality assurance system has been started and plans suggest that further development will make it more effective. EVIDENCE: The home’s manager has the necessary experience and qualifications to run the home effectively. The home’s annual development plan is presented to the Trust’s Annual General Meeting for comments and approval. A quality assurance questionnaire was sent to stakeholders, such as the family and friends of service users, in June 2005. An action plan has been produced based upon the comments in the survey questionnaire. There is also a questionnaire for service users, produced in a reader friendly format. This has not been used yet. Discussions during the inspection suggest that this will be put to service users at a residents’ meeting. Advocacy service may be involved in supporting people to complete the questionnaires. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 3 X 3 X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Mayfield House Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X X X DS0000000990.V254681.R01.S.doc Version 5.0 Page 20 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. 1 2 Refer to Standard YA20 YA39 Good Practice Recommendations Policies and procedures for secondary dispensing of medication should be developed. The service users quality assurance questionnaire should be used to gain feedback from the people who live at Mayfield House. Mayfield House DS0000000990.V254681.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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