Inspection on 02/08/06 for McGillicuddy House

This inspection was carried out on 2nd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

McGillicuddy House 14/09/07

McGillicuddy House 20/02/06

McGillicuddy House 13/09/05

McGillicuddy House 08/02/05

McGillicuddy House 02/11/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 McGillicuddy House 18 Vicarage Road Strood Rochester Kent ME2 4DG Lead Inspector Anne Butts Unannounced Inspection 2nd August 2006 11.30 McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 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 McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 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. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service McGillicuddy House Address 18 Vicarage Road Strood Rochester Kent ME2 4DG 01843 580812 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) Mr Dennis Gover Payne Mrs Assumpta Ann Payne Care Home 8 Category(ies) of Learning disability (8) registration, with number of places McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home to continue to monitor the 4 service users whose dates of birth are: 3.5.38, 27.6.38, 6.2.40 and 18.1.30 to ensure their good health and mobility is maintained. 20th February 2006 Date of last inspection Brief Description of the Service: McGillicuddy House is an eight bedded home providing twenty-four hour care to adults who have a mild to moderate learning disability. The home is a large semi-detached Victorian property situated in a quiet residential road close to Strood Town centre and a short journey from Rochester and Chatham. It has easy access to a variety of amenities and shops and is close to local bus routes and the train station. The accommodation is situated over four floors and consists of six single rooms and one double room. There is a large open plan communal room that provides living, dining and kitchen facilities and there is a further quiet lounge on the first floor. There is a small garden to the rear of the home with limited parking. The range of fees were not available at the time of this inspection. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place over the course of a day and a half. The key inspections for care home services are part of the new methodology for The Commission For Social Care Inspection, whereby the home provides information through a questionnaire process and further feedback is gained through surveys sent to service users and relatives and information provided from professionals associated with the home, wherever possible. The actual date of the site visit is unannounced. At the site visit, service users and staff were spoken to, records were viewed and a tour of the environment was undertaken. Some judgements have been made through observation only. Overall this was a positive inspection with generally good outcomes for service users. What the service does well: What has improved since the last inspection? The format of the care plans has improved and identifies individual areas of care and support for service users. The home has introduced a mobile phone and service users are aware of the number so if they are out and about they are able to contact staff easily. A new freezer has been purchased. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 6 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. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 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 McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 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 and 5 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Service users are provided with adequate information with regards to the service provided by the home, however service users would benefit if the Service Users Guide were made available in a format that suits their needs. Individual contracts protect service users’ right. EVIDENCE: The Statement of Purpose was briefly viewed and appeared to contain all appropriate information and showed evidence of being reviewed regularly. The Service User Guide was also available, but when speaking to staff it was stated that not all service users would be able to fully understand it. It must be in a format that all service users can easily understand and a requirement is being made that the service users guide is reviewed and a recommendation is being made that it is produced in a user friendlier format or made available in a format that suits the needs of the service users and records should be kept of this. There have been no new service users admitted since the last occasion when these records were inspected but The Home is fully aware of the importance of these assessments. Records viewed showed that there are full needs assessments in place for all service users and that they take into account McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 9 personal support, assessed health needs and medical history, emotional support, cultural and religious needs, communication needs and family support and involvement. The Home has assessments from Care Managers for all service users and recognises the individual needs. Staff, who were on duty, at the time of inspection, were fully able to demonstrate that they were aware of the needs of the service users. Contracts are in place for all service users, and state a trial period. contracts cover terms and conditions. These McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. An improved care plan format that incorporates the outcomes of risk assessments has benefited some service users. However this would further be improved if all service user plans were in this format and any identified individual risks were incorporated. Service users can be confident that they are consulted with and are able to participate in making decisions with regards to all aspects of life within the home. EVIDENCE: A new care plan format has been introduced. It continues to identify individual areas of care and support but now includes a supportive risk assessment and the action required to reduce these risks. However of the three care plans viewed within The Home – none had been updated appropriately. It was stated that care plans were being updated as a full review was taking place with Care managers. It is being recommended that all care plans be updated McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 11 on a six monthly basis in order to further monitor any ongoing changing needs. Observations showed that Service users are fully able to make their own choices with regards to their lives and that they are happy living within the home. Service users take an active part with the decisions made about the home and how they spend their days. There are regular meetings for service users, and the home has recently carried out a survey / questionnaire with the service users so that they can further gain their opinions on how they live in the home. Service users also participate in the daily running of the home including carrying out their preferences of daily chores such as general housework; keeping own rooms tidy, planning the menu and going shopping. Several service users were spoken to during the inspection and comments about the overall care and support that they felt they received were very positive. Comments included: “I like it here – the people are very nice and I can choose what I want to do” “I like going shopping and choosing what we are going to have to eat”. Records showed that service users have control over their own spending money and that they are able to access their monies as required and are supported in managing their money. There are some risk assessments in place that ensure that overall the service users are supported in their daily lives and as previously stated these are now being incorporated into the care plans and guiding staff into how to support service users. Additional risk assessments that are specific to the individual needs of service users would further promote their safety and a recommendation is being made to this effect. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 12 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 and 17 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Service users can be confident that they are able to make positive choices with regards to maintaining independent lifestyles. Service users benefit from having an active role within the home so that their rights and choices are respected. Service users benefit from well balanced meals that are properly discussed with them EVIDENCE: Service users are actively encouraged to participate in daily chores around the home so promoting and developing independent living skills. Some Service users attend college or day centres where they take part in a number of activities and they also attend a regular evening club that all service users stated that they enjoyed. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 13 A member of staff also stated that during the warm spell they had also arranged for an evening out, whereby, they had all visited a local pub garden over-looking the river and enjoyed a pleasant evening. A service user spoken to also confirmed that they had enjoyed this activity. The home is looking at promoting further excursions in agreement with the service users. Service users also stated that they had recently enjoyed a holiday to Cornwall and were looking forward to a day trip to Hastings. Service users had unrestricted access around the home, and although all service users are offered a key – they had declined and this was recorded onto their care plans. Service users are actively encouraged to vote and all had their own voting cards. The home also encourages, where possible, the involvement of families and or advocates and visitors are always welcome. Service users plan meals with staff and are able to choose what they would prefer to eat. Meals are recorded and service users stated that they enjoyed their meals and that they participate in shopping and menu planning. Observation also showed that service users are free to use the kitchen and are supported by staff in this. It was also evident that service users are encouraged to maintain a healthy diet. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 14 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 and 20 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The personal and health care needs of service users are well met, with full access to all professional health care services as required. The medication procedures and staff who are trained in this area protect Service users. EVIDENCE: Care plans support service users in maintaining their own self care needs and full reviews are carried out with the Care Manager and changing needs are identified and acted upon. Personal choice with regards to getting up and going to bed is accommodated for individual service users – but this is based around their daily activities i.e. going to college or work. Records contained full health care information – including medical history, evidence of contact with chiropodist, dentist, opticians, GP’s and community nurse. Where appropriate the speech and language therapist had input into service users needs. Regular health checks and reviews are carried out with the G.P. and service users are assisted with their individual health care needs as they identified. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 15 A spot check was carried out on medication and overall this is well managed. All staff who assist with medication are trained. There are good recording systems in place – although the actual Medication Administration Records (MAR sheets) would benefit from being organised by service user – with a divider between to ensure that the system is more robust. Bottles and boxes should be dated as to when they are opened – so that there is a through audit trail. Good practice recommendations are being made with regards to these issues. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Complaints and adult protection procedures within the home serve to safeguard service users. EVIDENCE: There have been no concerns or complaints recorded and service users spoken to confirmed that they did not have any complaints. They also stated that they were quite happy to speak to any members of staff and the owners on an individual basis if they felt that they had any problems. Service users are supported with their financial needs and there are good recording procedures to ensure that there is a full audit trail. The majority of service users have their own bank account and are supported by staff in accessing their money. Bankbooks and valuables are safeguarded. There are policies and procedures in place with regards to Adult Protection protocols and all staff are trained in this area. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 17 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, 25, 26, 27, 28 and 30. Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to this service. The home provides a comfortable, homely and clean environment but service users would benefit from the maintenance and refurbishment of bathrooms and toilets in order to promote their comfort and safety. EVIDENCE: This is a large property situated close to the town centre and has easy access to local amenities and local transport. The property, itself, is set out over four floors – one of which is at basement level. There is a large kitchen, dining and living area that all service users have full access to and overall the home is kept clean and tidy and retains a ‘homely’ feel. Although this is an older property it is reasonably well maintained and decorated and the service users enjoy living here. All bedrooms were viewed and all showed evidence of individual choices and preferences and were personalised by the service users. All bedrooms are of a good size and there is only one double room, in which both service users have made a positive choice to share. One room also has a shower unit in place. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 18 Service users spoken to stated how much they liked their bedrooms and living in the home. There are sufficient bathroom and toilet facilities within the home, and are easily accessible to all service users as required. Service users generally use the shower room, and there is another bathroom for general use. All bathrooms and toilets, however, are showing signs of aging with cracked tiles, old, stained grouting and sealant around baths and sink and in some areas there was only an unsealed wooden rim, there were also exposed pipes that were seen to be green and in one bathroom the radiator was seen to be rusty. Cabinets were also old and the flooring was in need of attention. Overall the bathrooms and toilets were not conducive for service users and also do not promote issues regarding health and safety and infection control matters. A requirement is being made that the home puts into a place a programme, with timescales, with regards to addressing the bathrooms and toilets in the home. There are separate laundry facilities situated away from the kitchen and there are systems in place to control the spread of infection. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 19 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): 32, 33, 34, 35 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Service users can be confident that their care and support needs are met by competent staff, who respect their preferences and choices. Service users would further procedures being adhered to. EVIDENCE: The acting manager is currently being supported by the current registered manager through her NVQ level 4 registered managers award, so that she will eventually take over the role of manager. The majority of staff have worked in the home for a number of years and are familiar with the needs of the service users; they are supported in this role with accessing NVQ’s and training programmes. There is some training that is in need of addressing – however the senior in charge on the day of the site visit stated that there are training programmes organised and staff were also able to confirm relevant training that they had attended. Staff spoken to all stated that they enjoyed working at the home and were able to describe how to meet the different needs of the service users. The McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 20 be protected by the home’s recruitment home has also taken into account the ‘evening shift’ and has put systems in place to ensure that service users are aware of staff availability during the evenings. All staff have a Criminal Records Bureau check – although the owners must ensure that they are relevant to this home. The home must also ensure that when taking on any new staff that there are full recruitment procedures in place and that any gaps in employment are explored and they are receipt of two written references. Supervision and appraisals are taking place, although the supervision records were fairly brief. Overall, though, the staff who were on duty at time of inspection all demonstrated that they were aware of the aims of the home and were experienced in meeting the needs of the service users. They also showed a good rapport with service users and there was obvious trust and respect between both parties. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 21 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 and 42 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Service users can be confidant that the philosophies of the home promote their best interests and that their views and opinions are listened to. EVIDENCE: Records evidenced, and service users confirmed, that the home includes service users in achieving the aims and objectives of the home. A quality assurance monitoring process is in place and outcomes are recorded and acted upon. Regular meetings are held with service users and they also confirmed that they take an active role within the home and are able to participate with regards to decision-making and this included menu planning and organising outings. Environmental risk assessments are in place to protect the health and safety of service users and are reviewed on a monthly basis and these are fairly comprehensive. There are fire safety drills and all staff were aware of the fire McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 22 routine. Records also showed that all relevant maintenance checks had been carried out. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 2 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 24 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 YA1 Regulation 5 (2) Requirement Timescale for action 30/11/06 2. YA30 13 (3) “The registered person shall supply a copy of the service user’s guide to the Commission and each service user” In that as the service users guide is reviewed and updated in accordance with recommendation One of this report. 05/10/06 “The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home” In that: A maintenance programme is devised with regards to addressing the issues relating to the bathrooms and toilets as identified within this report. This should be forwarded to the Commission within the timescale stated. McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 25 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 YA1 Good Practice Recommendations It is strongly recommended that the registered person reviews the service users guide and make arrangements for it to be available in a format suitable for the people for whom the home is intended. It is strongly recommended that all care plans are updated into the new format and reviewed on a six monthly basis ensuring that they take into account any individual risks. It is a good practice recommendation that the home ensures that individual service user records with regards to medication are easily identifiable – in that that they divide records into sections and use photographs to identify records. It is a good practice recommendation that boxes and bottles of medication have the date of opening written on them. It is recommended that the home ensures that they have a current CRB check for all staff relating to this home, and have a written explanation with regards to any gaps in employment. 2. 3. YA6 YA20 4. 5. YA20 YA34 McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 McGillicuddy House DS0000028900.V306798.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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