Inspection on 19/05/05 for Mayfields

This inspection was carried out on 19th May 2005.

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

Mayfields 14/08/07

Mayfields 05/05/06

Mayfields 26/09/05

Mayfields 18/10/04

Mayfields 22/04/04

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

CARE HOMES FOR OLDER PEOPLE Mayfields Naylor Crescent Netherpool Road Ellesmere Port CH66 1TP Lead Inspector Anthony Groom Unannounced 19 May 2005 09:30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mayfields Address Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Naylor Crescent Netherpool Road Overpool Ellesemere Port Cheshire CH66 1TP 0151 356 4913 0151 356 4915 Methodist Homes for the Aged Care Home 45 Category(ies) of Dementia (DE), 7 registration, with number of places Dementia - over 65 years of age (DE(E)), 45 Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 No more than 45 Service Users may be DE(E). 2 Within the maximum number of 45 no more than 7 Service Users may be DE. Date of last inspection 18/10/04 Brief Description of the Service: Mayfields is a purpose-built single-storey home which provides care for older people who have dementia. Opened in 1997, it is located in the Overpool area near to a range of local shops and within a mile-and-a-half of Ellesmere Port town centre. The home was extended in August 2002 to provide nine additional bedrooms and three additional lounge areas. Accommodation for service users is of a high standard, with all individuals having single, en-suite bedrooms. The home also has three separate lounges, three large lounge/dining areas (with domestic scale kitchen facilities) and a range of communal bathroom/toilet facilities. A separate ‘services wing’ contains a large kitchen, laundry, staff facilities (staff room and changing/shower-rooms), office accommodation and relatives/visitors accommodation. There are also very pleasant, well maintained and fully accessible garden areas. These are secure to protect the safety of service users. All staff within the home receive training in dementia care, and staffing levels reflect the specific needs of this service user group. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 19 May 2005 over seven-anda-half hours by Anthony Groom and John Mills. The manager, an assistant manager, eight care assistants, a cook and a number of ancillary staff were on duty and there were forty-four residents living in the home. During the inspection twelve service users, several relatives and two visiting social workers were spoken with. A range of care, health, safety and maintenance records were examined and a tour of the premises, including all shared rooms and a number of bedrooms, was undertaken. What the service does well: What has improved since the last inspection? What they could do better: Care plans seen during the inspection did not show how the home was meeting particular aspects of residents’ care needs and this could affect the quality of care which some people receive. The home needs to ensure that all care plans show in detail what actions staff need to take in order to fully meet the needs of residents who live at the home. All care plans need to show that they have been written with the involvement of residents and their relatives in order that their views and opinions are included. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 6 Records of residents’ medication need to be reviewed so that the home can accurately account for all medicines which are kept on the premises. 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. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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 standard(s) 3 and 5 Residents’ care needs are assessed by the home’s manager or one of the assistant managers before they move in to ensure that their needs can be met. All residents are encouraged to visit the home to view the facilities and to meet staff and other residents before they move in. EVIDENCE: Care plans contained assessments, completed before the residents moved in, which had been completed by senior staff at the home. These were detailed and identified specific needs. The assessments were made against a wide range of physical needs and specific mental health and dementia criteria. There were also assessments from social workers where they had been involved in the process of referring a resident to this home. A visiting social worker stated that her client (who was from a different area) had been assessed before moving in by senior staff from another Methodist Care Home. She also confirmed that she had been given helpful and accurate written information about Mayfields which informed her decision regarding the placement. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 9 A relative who was spoken with said she had visited the home to discuss her mother’s needs with senior staff before bringing her mother for a look around Mayfields, prior to making a decision to allow her to move in. It was clear from direct observation and speaking with a number of relatives that open and positive relationships existed between staff and residents’ family members. This home does not provide intermediate care. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 Care plans were in operation for all service users but those seen did not identify any specific strategies for meeting residents’ emotional and behavioural needs. This may result in inadequate care being provided to some residents. Medicine procedures require minor improvements in order to demonstrate effective stock control and to ensure that medicines are administered within the timescales specified by prescribing general practitioners. EVIDENCE: Each resident has a care plan. Six were seen and all contained full assessments of physical, social and psychological needs. Not all of those looked at were signed by residents or their families. Whilst assessments were made of mental health/dementia needs, there were no specific care plans to guide staff in these areas. See Requirements 1 and 2 Medicines are correctly stored in either locked trolleys in locked rooms, or within a central medicines room. On the day of the inspection, medicines prescribed for 9.00 a.m. were still being administered at 11.00 a.m. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 11 Staff spoken with said it was not policy to wake people to give them their medication, but that they were aware of those people who had morning and lunchtime medication and made sure that these were given early in the morning. Medicine administration records (MAR) were provided by the dispensing chemist and were computer generated. Some, however, were written by staff if changes had been made by the resident’s general practitioner or in the case of new admissions to the home. On these records no stock balances had been entered. There were also no stock balances shown for those medicines being carried forward from one month to the next. See Requirements 3 and 4 Staff were observed providing care and support in a very positive, friendly and respectful manner. Staff spoken with had a detailed knowledge of those residents they cared for. Visiting relatives said that they were very happy with the care and support being offered and the manner in which staff related to the residents. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 A regular and varied programme of social activities is provided each day and this offers mental stimulation and occupation for residents. Visiting arrangements are flexible and this encourages residents to maintain contact with their family and friends. EVIDENCE: Residents spoken with said they were happy living at the home and that they liked the staff who worked there. At the start of every shift each staff member is allocated five residents to work with and a list of their daily needs is compiled; this includes activities provided by the activities co-ordinator. Each unit has an activities programme which is displayed on the notice board. Activities are provided in small groups or on an individual basis. Care staff are also expected to participate in these activities. Relatives said that they were free to visit at any time and were always made to feel welcome. Residents said that there was always “plenty going on” and that this included trips out in the home’s mini-bus or with staff on an individual basis. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 13 During the afternoon of the inspection the home’s Methodist chaplain was conducting a service of hymn singing and poetry reading in the main forum area. Over 20 residents, together with staff and visitors, joined in and all appeared to enjoy this activity. These services take place twice a week, but the chaplain also visits on other occasions throughout the week and spends time on each of the three units sitting and talking to residents. Residents are also able to receive visits from clergy of other religious denominations whenever they wish. Records of food provided to residents confirmed that all receive a varied and nutritious diet. The lunch was taken to each unit in a separate hot-trolley and staff then served this to individual residents in the dining rooms. Staff were aware of the appetites and preferences of each person and presented the meals in an appetizing manner. There was a choice of main courses and staff said that further choices were available from the kitchen. Residents said that they “really liked the food”. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 There are written procedures for dealing with complaints which ensure that any concerns raised by residents or their relatives are dealt with promptly. Residents are protected from harm and abuse by the home’s adult protection procedures in which all staff receive training. EVIDENCE: The home has a written complaints procedure which includes contact details for the Commission for Social Care Inspection (CSCI). Records of all complaints received are maintained by the home. Information regarding how to make a complaint has been given to all residents or their relatives and was also displayed prominently within the home. Written adult protection procedures had been compiled by the home and a copy of the local authority’s procedures and protocols was also available for inspection. Staff members spoken with confirmed that all staff receive training in this area as part of their induction. There was evidence of appropriate referral to the local authority and police in the case of a recent alleged incident of abuse at the home. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 23, 24, 25 and 26 Mayfields is a purpose-built, spacious and well maintained home which provides residents with a bright and comfortable environment in which to live. There are pleasant, accessible and secure garden areas which residents can use freely. Personal accommodation is provided in single bedrooms which have en-suite toilets/washbasins and this promotes residents’ individual privacy. EVIDENCE: A tour of the premises showed that the home is spacious, well decorated and equipped. There is a programme of routine maintenance to keep it in good order. Service users have a choice of shared spaces in which to sit and there is good access for people who use wheelchairs. All bedrooms are single and have en-suite toilets and wash basins which promote individual privacy. The home is clean and free of unpleasant odours, making it a pleasant environment for residents and their visitors. There are landscaped gardens which are accessible and secure and these provide residents with safe areas in which to walk or sit. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 16 Locks are fitted to all bedroom doors but these are not used by many service users. This does, however, mean that some residents who have the ability to walk freely around the home sometimes wander into other people’s bedrooms and encroach on their privacy. See Recommendation 1 Whilst it was noted that the exterior painted woodwork is starting to ‘flake’ in many areas, and requires attention, the manager reported that this matter is in hand and that work to re-paint the exterior of the home is scheduled to commence later in the year. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The home provides enhanced staffing levels in order to meet the specific needs of older people who have dementia. All staff receive appropriate training which equips them to carry out their work safely and in a sensitive and caring manner. EVIDENCE: Staff rosters confirmed that previously agreed staffing levels were being maintained at the home. Although there had been a number of recent occasions where staffing shortfalls had occurred on some shifts due to sickness, these had been notified to the Commission for Social Care Inspection (CSCI). Five staff files were examined and all contained evidence that appropriate references and Criminal Records Bureau (CRB) disclosures had been obtained for staff, in order to protect the safety of residents. There was also evidence that new staff members were completing a structured induction programme so that they were well prepared to undertake their duties. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 Staff receive regular formal supervision to help them to carry out their jobs effectively. Effective policies, procedures and safe working practices are in place in order protect the health and safety of residents and staff. EVIDENCE: Written records confirmed that all staff were receiving formal supervision every six weeks in order to support them in their work. A range of health and safety records were examined and found to be satisfactory. These included fridge/freezer, food and water temperatures, fire precautions and equipment maintenance records. The health, safety and welfare of service users and staff was being promoted through safe working practices and the training of staff in areas such as moving and handling, first aid, food hygiene, infection control and COSHH (Control Of Substances Hazardous to Health). Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x 3 x 3 Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 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. 2. 3. 4. Standard 7 7 9 9 Regulation 15 15 13 13 Requirement All care plans must accurately address residents mental health/dementia care needs. Care plans must be signed by residents or their families. Stock balances of medicines carried forward must be recorded on all MAR sheets. The times at which prescribed medicines are given must be discussed with residents general practitioners to remove the potential for improper administration. Timescale for action 19/05/05 01/08/05 19/05/05 20/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 24 Good Practice Recommendations The manager should discuss with residents and their relatives whether or not they would like their bedroom doors locking during the day to prevent inadvertant access by other residents who wander. Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 Mayfields F51 F01 S6684 Mayfields V228084 190505 Stage 4.doc Version 1.30 Page 22 - 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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