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Inspection on 09/02/06 for Mayfield Residential Home

Also see our care home review for Mayfield Residential Home for more information

This inspection was carried out on 9th February 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People living in his home are cared for by a well managed and educated team of staff. People live in attractive, well decorated and safe accommodation. All the residents said they liked their bedrooms. Staff have received training in order to meet the needs of people living in the home. Most of the people have qualifications in care. People living in this home are happy and contented. People living in the home enjoy well cooked and well presented food.

What has improved since the last inspection?

A new wash basin has been installed in one bedroom. There is to be a future installation of a new floor covering in one bathroom. Units in the kitchen have been improved to make them more hygienic.

What the care home could do better:

The owner must ensure that as a result of the increasing frailty of the residents that there is a suitable hoist provided to ensure that the residents are handled correctly and staff protected from injury. Wedges to fire doors must be removed, as they may not allow the fire doors to close correctly in case of fire.

CARE HOMES FOR OLDER PEOPLE Mayfield Residential Home Fleet Street Holbeach Spalding Lincolnshire PE12 7AG Lead Inspector Mr Toby Payne Unannounced Inspection 9th February 2006 08:25 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 Residential Home DS0000043941.V282542.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 Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Mayfield Residential Home Address Fleet Street Holbeach Spalding Lincolnshire PE12 7AG 01406 426063 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 Residential Care Ltd Mrs Susan Stuffins Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2005 Brief Description of the Service: Mayfield Care Home is a converted house with a purpose built extension set in its own grounds within walking distance of the centre of the town of Holbeach. All accommodation is on the ground floor. The home is registered to provide personal care for up to 10 people who are over the age of 65 years. On the day of the inspection there were 8 residents. The registered provider visits the home weekly and works closely with the registered manager. The majority of rooms are single with one double bedroom. There are 4 bedrooms with en-suite facilities. There is car parking to the front of the home and there are gardens to the front and rear of the home. The home is also on a bus route. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and started at 8.25 a.m. It took place over 3 hours. The inspector spoke to 6 residents, one visitor, 2 staff and the manager. The main method of the inspection was called “case tracking”. This involved selecting one newly admitted resident and tracking the care they received through the checking of records, discussion with them and the care staff. The inspector also observed how care was delivered and how staff responded to other residents living in the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 6 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 Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 7 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): 3, 5 and 6 All residents are involved in their admission to the home. They decide about where they wish to live. Each person receives a detailed assessment, which results in their needs being met EVIDENCE: Records of a newly admitted resident showed the person had been admitted correctly with an assessment by the manager, several visits to the home to meet other residents and written confirmation sent to them that based on the assessment the home could meet their needs. The resident commented. “I received a very warm welcome and have settled very well in the home”. The home does not provide intermediate care. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 8 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 and 10 Resident’s care, health and welfare needs are met by staff who know the resident’s needs. Where required residents can receive attention from their GP and Community Nurse. Medication is safely and correctly administered. EVIDENCE: All residents had detailed and up to date care plans. These described their health and welfare needs. Records outlined risk assessments, moving and handling assessment and tissue viability as well as social needs. There was evidence to show that wherever possible residents had been involved in their care. Their signatures showed this. There was evidence to show that the care plans had also been reviewed. Where required, the Community Nurse provides any nursing care. Where required, residents are referred to GPs, Community Nurse, Tissue Viability Nurse, Dentist, Chiropodist and Optician. The home receives regular visits by Boots who provide the medicine administration system. The last visit was on the 17/3/2005. There were no Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 9 concerns. Boots also ensure that staff receive training in order to ensure that safe administration of medication takes place. The home has a written policy concerning privacy and dignity and this is also addressed during the induction programme. Residents spoke of how staff respected their privacy and dignity. Locks are provided to bedrooms and bathrooms/toilets. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 10 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 and 15 A selection of activities were available in the home. People were offered a choice of well-balanced and wholesome meals and commented positively about the catering in the home. EVIDENCE: The home has no written activities programme. On admission to the home details are obtained of resident’s likes and dislikes. Activities include knitting, crocheting, library and newspapers. In addition, there is also a video and games library. Details are also available of local clubs and there are occasional social outings. Local clergy also visit. There is also the garden and terrace available. Residents were seen to be reading in their bedrooms, watching television in the lounge or sitting outside. On admission to the home details are obtained of the resident’s likes and dislikes and dietary needs. Care staff prepare the meals and all have received food hygiene training. Breakfast can be taken in the resident’s bedrooms or dining room. Lunch can be taken in the dining room. There is a set menu but an alternative can be made available at request. Snacks and beverages are available throughout the day. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 11 The menu was displayed on the wall and residents were eating their lunch, which consisted of steak and kidney pie with potatoes and vegetables. They were eating at tables attractively laid with table cloths in the dining area off from the lounge on the ground floor. They were all complimentary about the catering service. The last inspection by the environmental health officer was on the 22/6/2005. There were no concerns. Residents commented, “the food is most enjoyable” and “it is always nicely served”. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 12 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 and 17 Residents know that any concerns they have are taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: Each resident is given a complaints procedure when they are admitted to the home. No complaints have been received by the home and the CSCI since the last inspection. Residents are encouraged and supported when voting and legal advice can be obtained at the request of the resident. All the residents and a visitor expressed satisfaction with the care and approach of staff. All remarked on the happy and relaxed atmosphere. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 13 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, 21, 22, 23, 24 and 25 People live in well decorated, comfortable, safe and clean accommodation. EVIDENCE: The home was clean and odour free throughout. Residents were satisfied with the cleanliness of the home and how well their clothes were laundered. The home has 2 toilets, 2 bathrooms and 4 en-suites with washbasin and toilet facilities. All these facilities, excluding the en-suites have locks. One of the bathrooms has a Bathmaster 2000 bath aid. At previous inspections the home was asked to address the observation that the mobile hoist could not access the entrance to the home. Previous responses were received in which explanation was given that the hoist had not been used and the dependency of service users had indicated that there was no need. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 14 At this inspection there was evidence from the risk assessments of 7 residents to show that a hoist was required. Records also showed that a number of people had suffered minor falls, which required the assistance of staff. The home is now required to ensure that there is a suitable and accessible hoist available. Staff should be trained to use this equipment safely. The manager told the inspector that she monitors the dependency and needs of the people living in the home. There was evidence to support this. The home provides handrails in the corridor, raised toilet seats; fixed toilet frames and grab rails in the toilets. There is also a Bathmaster 2000 bath aid in one of the bathrooms. Where required, advice can be obtained from an Occupational Therapist. Residents were encouraged to personalise their bedrooms with small items of furniture, television, pictures and personal mementoes. Resident comments were, “I enjoy sitting in my bedroom with all my possessions”, “my room is very comfortable” and “my clothes are well looked after”. Low surface temperature radiators have been installed throughout the home. Hot water temperatures were controlled at the water boiler. The home tests hot water temperatures. Where required they are adjusted/monitored in order to give a safe hot water temperature of 43º Centigrade. Records showed they were within safe limits. During the inspection the inspector observed 2 doors in the corridor, which were fire doors and required to be kept shut were wedged open to ease access. This observation was discussed with the manager and fire safety officer who did the last inspection on the 22/6/2006. The home was advised to remove any wedges and provide suitable equipment to allow access but to close the doors in case of fire. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 15 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, 29 and 30 There is a trained, knowledgeable and competent staff team. The numbers of staff are sufficient to meet the needs of the residents. Staff are correctly recruited. The home has a very high level of trained staff. EVIDENCE: Staff in the home are required to undertake catering, domestic and laundry duties as well as caring for service users. The home provides a gardener and the provider works in the home. On the day of the inspection there was a part time vacancy. All posts are advertised locally. The home provides night sleep in cover. The manager monitors this and ensures where required, that they are on wakeful duty. None of the residents or staff expressed any concerns about the level of care or delay in staff responding to their needs. Residents comments were, “you always ask me how I am and I reply I love it here” and “I am very happy here”. Staff commented, “I enjoy working here”, “I have time to spend and talk with the residents” and “everyone is very supportive and we work as one team”. The home has a written recruitment and equal opportunities policy. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 16 All staff have been recruited in line with these regulations. Staff records include an application form, 2 references, photograph, birth certificate and Criminal Records Bureau check. All staff have obtained CRB clearance and since the 26/7/2005 staff have also received a POVA check. All training provided was recorded. The home has exceeded the 50 of care staff who have been required to achieve a qualification in care (NVQ) since the 31/12/2005. Out of 6 care staff, 5 have achieved NVQ level 2 and one member of staff is studying for this. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 34, 35, 36, 37 and 38 The home is well lead by a competent manager and staff are supported in their work. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 18 EVIDENCE: The manager is registered with the Commission. She has had extensive experience in caring and supporting elderly people. She has been the registered manager of the home since July 2002. She has also obtained a management qualification and is studying for a care qualification. All care staff receive formal supervision to support them in their roles. The home has employment procedures. The home has a written induction programme which includes the home’s routine, communication, needs of service users, fire prevention, assisting the service user, laundry, policies and procedures, health and safety and use of mechanical aids. Each person receives an appropriate, structured and documented induction programme. Records were examined and were found to be well maintained with review dates. Records were also kept securely. The home has a health and safety policy. At the previous inspections the inspector was told that the mobile hoist could not access the home due to its design. There was no evidence to show at this inspection that the residents were becoming frailer and now required suitable moving and handling equipment. This to ensure the safety of residents and staff. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 19 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 2 x 3 2 3 3 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 3 3 2 Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 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. 1 Standard OP22 Regulation 13(5) and 23(n) Requirement Timescale for action 09/05/06 2 OP19 23(4) The owner is required to provide suitable accessible equipment to enable staff to safely lift/transfer residents who require assistance. In addition, staff must receive training in moving and handling and use of this equipment. 09/04/06 The owner and manager must ensure that all fire doors are kept shut and any wedges are removed. It was noted that this had been agreed in a letter from the Fire Safety Officer at his last inspection on the 22/6/2005. Measures must be provided to ensure the doors can remain open to ease access for residents from their rooms but to safely close in case of an emergency. Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP27 Good Practice Recommendations It is recommended that the manager obtain a copy of the Residential Forum Care Staffing in Care Homes for Older People. This provides staffing guidance recommended by the Department of Health. This can be obtained from the Social Care Association. It is recommended that the manager gives a copy of the General Social Care Council’s Codes of Practice to each member of the care staff and explains what the code is for. 2 OP29 Mayfield Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Residential Home DS0000043941.V282542.R01.S.doc Version 5.1 Page 23 - 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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