Inspection on 26/09/05 for Mayfields

This inspection was carried out on 26th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 19/05/05

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 Mayfields Naylor Crescent, Netherpool Road Overpool Ellesmere Port Cheshire CH66 1TP Lead Inspector Judith Morton Unannounced Inspection 26th September 2005 06:45 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 Mayfields DS0000006684.V253020.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 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 DS0000006684.V253020.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mayfields Address Mayfields Naylor Crescent, Netherpool Road Overpool Ellesmere Port Cheshire CH66 1TP 0151 356 4913 0151 356 4915 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) Methodist Homes for the Aged Care Home 45 Category(ies) of Dementia (7), Dementia - over 65 years of age registration, with number (45) of places Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No more than 45 Service Users may be DE(E) Within the maximum number of 45 no more than 7 Service Users may be DE 19/05/05 Date of last inspection 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 DS0000006684.V253020.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 8.5 hours and started at 6.45 am to enable the views of the night staff to be taken into account. The inspection was triggered by a number of anonymous complaints, which were largely unfounded. A separate report is available from the Commission for Social Care Inspection on request. The inspection concentrated on the standards that had not been reviewed at the last inspection or those where requirements or recommendations had been made. Four night staff were on duty; three care staff and 1 senior. Nine care staff, the maintenance man and the manager were spoken with. Six residents were also spoken with. Three care files were viewed. What the service does well: What has improved since the last inspection? What they could do better: The staff said that they feel that if they complain or express concern about the running of the service there could be repercussions for them. A more open and honest culture of communication should be encouraged between staff. Alternative communication methods, for those residents who have difficulty using verbal communication, should be explored. Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 6 Details of how to fully meet a person’s specific needs should be included in the care plan. 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 DS0000006684.V253020.R01.S.doc Version 5.0 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 Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 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. Standard 6 is not applicable to the home. Mayfields displays sufficient information for residents and their relatives to know what services are provided. EVIDENCE: Sufficient information within the Statement of purpose and Service User Guide explains the services offered and how the person’s needs can be met. Individual contracts were held on a separate file. Care files contained assessments, completed by the manager and senior staff, before the residents moved in. These were detailed and identified specific needs from which a care plan could be drawn up. The assessments were made against a wide range of physical needs and specific mental health and dementia criteria. Assessments were completed by social workers where they had been involved in referring a resident to Mayfields. Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 9 Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 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 & 11. The risk assessments on individual files ensure that new, or agency staff, can read them together with the care needs, ensuring the residents continue to be safe. EVIDENCE: Three of the residents care files were reviewed. A well-designed front sheet, gives clear identifying information and a recent photograph of the resident was on the front of each file. This helps new or agency staff identify individual residents. A good social history report on each file, gives an insight into the residents’ personality, which may change because of the dementia. The manager said that she had introduced a new document called Getting to Know Me, designed to cover all aspects of the residents past history, including their likes and dislikes. Although the daily routine had been completed, within the three files, some areas were incomplete. Ie. Foot care, oral care, skin care, medication and diagnosis. The oral care read, has own teeth or wears dentures. This needs to be more detailed to show how the teeth are to be cleaned, by whom and with what. Also, whether dentures, should be removed at night. (See recommendation 1) Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 11 Further detail of the communication methods with each resident, need to be included. If non-verbal communication is used a description of what facial expressions, behaviours or gestures may mean, should be recorded. (See recommendation 2) In some instances neither the resident nor their representative had signed the care plan. (See requirement 1) The care plans were reviewed regularly. Although risk assessments were available for each resident they were kept together in a separate risk assessment file. It would be easier for new or agency staff to read these together with the care plans to know how to safely meet the resident’s needs. (See recommendation 3) A record of visits from health professionals, including GP, chiropodist and optician, showed that the resident’s health needs were being met. The manager had found a number of mistakes in the recording and administration of medication. This was clearly evident on the MAR sheets reviewed. Discrepancies had happened on a number of occasions. The senior staff responsible had all received refresher training and were aware of the medication policy. Senior management were investigating and appropriate action would be decided following this. (See requirement 2) The residents spoken with, said that they liked the staff and they were very kind. The staff were seen interacting with the residents in a number of care situations and were respectful and polite. Mayfields produces a seasonal newsletter, which keeps everyone involved with Methodist Homes, informed of events over the past three months. A section called ‘Resident’s News’, contained names of residents who had left Mayfield, the reason and where they had moved. Names of new residents who had moved into the home were also mentioned. This practice must stop. Naming of residents does not maintain confidentiality and does not respect their privacy. (See requirement 3) Staff were not asking residents their wishes in the event of terminal illness or death, although the question was included on the front sheet. (See recommendation 4) Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 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 Residents are able to make choices about some aspects of the their lives at Mayfields. EVIDENCE: Mayfields has an activities co-ordinator who arranges daily activities for the residents. These were displayed on a notice board. They were varied and plentiful and, in the main, would occupy and stimulate the residents. One resident said that some of the activities were childish and described these as Winnie The Pooh jigsaws. An activities room contains games and art materials. However, a number of games were brightly coloured and plastic, which made them appear unsuitable for adults. For example, skittles, magnetic darts and Frizbee. The same are available in a more adult form, ie wooden skittles, carpet bowls, dominoes, hoopla etc. A more suitable range of activities and games should be purchased for the residents. The manager said she had been looking into the provision of more suitable activity equipment and had considered having a multi functional snooker/games table if the foyer/lounge. (See recommendation 5) Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 13 The visitor’s book showed that there were no restrictions on visiting. The manger and staff confirmed that visitors were welcome at any time. Residents could make choices about some aspects of their lives at Mayfield. These included, what time they wanted to get up, go to bed and what they wanted to eat at meal times. Residents were seen to get up at varying times and, in some instances, were able to help themselves to breakfast, as there is a small kitchen in each of the lounges. The manager and staff explained that if a resident didn’t a like choice at mealtime the staff would make them an alternative. The menu appeared wholesome and varied and meals were served in the dining area of each lounge. Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 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, 17 & 18 Written procedures for complaints 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: Mayfields 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. The resident’s legal rights are protected. In a few cases, Power of Attorney has been granted to a resident’s relative if they are unable to attend to their own estate. The manager said that residents would be supported to attend the polling station if they wished and were able to vote. Alternatively, they would be supported to return the postal vote after its completion. Written adult protection procedures had been compiled by the home and a copy of the local authority’s procedures and protocols were also available. Staff members spoken with confirmed that all staff receive adult protection training as part of their induction. Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 15 Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 16 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): 23, 24, 25 & 26 Mayfields is being well maintained to ensure the comfort of the residents. Residents can easily identify their room, key worker and other rooms within the home. EVIDENCE: Mayfields is bright and airy, with the units having a homely feel. One resident showed her bedroom and was particularly pleased with the view from her window and the en suite bathroom. Photographs were displayed of people important to her, together with other items from her home, such as ornaments and pictures. Two of the residents in one unit and one in another said they were cold. It was cold in the lounges and a number of windows were open. The radiators were cold to the touch. Windows were closed over and when the maintenance man checked the main boiler it had been turned to zero. He immediately rectified the problem. Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 17 It is acknowledged that staff can get very hot whilst working, however they should be mindful of the temperature of the home and ask the residents their opinion before opening the windows. (See recommendation 6) The home was clean with no offensive odours. Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 18 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 & 30 The provision of training appropriate to caring for people who have dementia, will ensure that staff understand the mental health needs of the residents and that they manage these needs appropriately and safely. EVIDENCE: The manager’s training matrix clearly identifies what training has been completed by the staff. Staff completed induction training, which included adult abuse awareness training. Many of the staff had attended training specific to caring for people with dementia. Some of the staff had approached the manager following the course, to express their satisfaction with the training, saying that it made them think about how they did things and how they could do them differently. The manager is hoping that it can be provided to all staff as she has also seen some good practices from the staff since. Staff rosters confirmed that previously agreed staffing levels were being maintained. 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). Agency staff had worked some shifts, particularly on night duty. The staff were not always happy with the agency staff as they did not always have the Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 19 experience or training to work independently and the staff felt they spent more time showing them things or directing them to do tasks. After discussion with the manager it was agreed that the agency would be approached to identify a group of staff with appropriate qualifications or training that would be used consistently within the home. The manager should satisfy herself that their training/qualifications are appropriate by having had sight of their certificates before a decision is made. (See recommendation 7) A bell is in operation for access to the building and all visitors are asked to sign the visitors’ book when they enter and leave. The alarm system is also activated at night for the safety of both staff and residents. Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 20 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, 35, 36 & 38 The manager had made a number of improvements and introduced new paperwork to ensure that Mayfields is run better for the residents. The introduction of more choice on the menu shows that the resident’s views are being considered and acted upon. EVIDENCE: The manager is not yet registered with The Commission for Social Care Inspection. She has worked in care services for many years and has achieved NVQ level 4, Registered Manager’s Award. She has also periodically updated her training, specific to the client group. The manager is fully aware of her role and duties to residents and is familiar with the conditions and diseases associated with old age. The manager communicates a clear sense of direction for the staff. However, some staff feel they are unable to approach her if they are uncomfortable about what they are asked to do. The manager should explore ways of enabling the staff to express their views to her either personally, through Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 21 supervision or in writing. This would ensure staff involvement in decisionmaking and encourage creativity and development. (See recommendation 8) Residents have had some say in things that affect their lives, for example, the food they like has been added to the menu as residents wanted more variety and choice. The nature and level of dementia experienced by many of the residents makes residents meetings difficult to manage. However, they are due to be held on a monthly basis. The views of the relatives and other stakeholders in the home are sought via questionnaires and a suggestion box is available in the foyer. The relatives felt that waste bins should be provided in the communal toilets. These are now in place. The health, safety and welfare of residents and staff is 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 DS0000006684.V253020.R01.S.doc Version 5.0 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 2 11 3 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 3 18 3 X X X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? no 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 7 Regulation 15 Requirement The plan must be drawn up with the involvement of the service user, recorded in a style accessible to the service user; agreed and signed by the service user whenever capable and/or representative. Staff must receive additional training and shadowing to ensure they are competent at administering and recording medication. The confidential details of residents or their movement within residential services must not be recorded in the newsletter. Timescale for action 01/03/05 2 9 13 &17 01/03/05 3 10 12 & 16 01/03/05 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 2 3 4 Mayfields Refer to Standard 7 7 7 11 Good Practice Recommendations More detail should be included in the care plans to ensure that the resident’s needs are fully met. The resident’s method of communicating non-verbally needs to be recorded in the care plan. Risk assessments need to be held on individual files. The resident’s wishes in the event of terminal illness or DS0000006684.V253020.R01.S.doc Version 5.0 Page 24 5 6 7 8 12 25 30 36 death should be recorded on their file. More adult/age appropriate activities and equipment should be provided for the residents. The staff need to be mindful of how the residents are feeling and seek their view before adjusting room temperature or opening windows. The training and qualifications of agency staff needs to be sought before a decision to temporarily employ them is reached. The manager should explore ways of enabling the staff to express their views to her either personally, during supervision or in writing. Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 25 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 Mayfields DS0000006684.V253020.R01.S.doc Version 5.0 Page 26 - 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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