Inspection on 19/11/08 for Melbury Court

This inspection was carried out on 19th November 2008.

CSCI found this care home to be providing an Good service.

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

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Melbury Court Old Dryburn Way Durham DH1 5SE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Allan Helmrich     Date: 2 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Melbury Court Old Dryburn Way Durham DH1 5SE 01913830380 01913830642 melburycourt@helenmcardle.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Helen McArdle Care Ltd Name of registered manager (if applicable) Mrs Catherine Margaret Winning Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The OP category is for nursing and personal care. The DE category is for personal care only. The maximum number of service users who can be accommodated is: 87 The registered person may provide the following categories of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 87 Dementia Code DE, maximum number of places 87 Date of last inspection Brief description of the care home Melbury Court is a purpose built care home that opened in March 2008. It can be found of Southfield Way on the fringe of Durham City next to the University of Durham Hospital. There is ample car parking to the front of the building and level access in and around the home with a large passenger lift to move between floors. The home can Care Homes for Older People Page 4 of 27 care home 87 Over 65 0 87 87 0 Brief description of the care home provided nursing or personal care for 87 older people or personal care for people with a dementia. The home is organised over three floors. There are 87 bedrooms each with ensuite toilet and hand basin. 11 of these rooms are designated premier and include a private shower. The bedrooms below ground level have patio doors leading onto a garden on one side of the building. Information about the home is readily available on request. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good outcomes. This is the highest rating a home can receive for a first inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This key unannounced inspection was started on 19th November and concluded on Care Homes for Older People Page 6 of 27 21st November 2008. It took 9 hours to complete. Information received since the home opened was reviewed. This included information requested from the provider prior to the inspection. Questionnaires were provided for distribution to residents and staff. One resident and two staff responded and information from these sources is used in the report. During the inspection we talked with people who use the service, staff, and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of good information is available to prospective service users and processes are in place to limit the possibility of admitting someone whose needs cannot be met. Evidence: A Service User Guide is placed in each residents bedroom prior to admission. These were seen in plastic wall holders in several bedrooms. This guide is also available on tape and in large print on request. Brochures are available to enquirers and a copy of the Service User Guide is available in lobby for the benefit of casual visitors. Residents and visitors spoken with all stated the information and support they received when moving into the home was good. Contracts are provided by the County Council directly to service users and any self funding residents are provided with the homes terms and conditions. Trial visits are offered as part of the admission process as is the opportunity to stay for lunch and talk Care Homes for Older People Page 11 of 27 Evidence: to other people in the home. The most recent admission has been assessed by the home manager and sufficient detail was obtained to ensure the home would be able to meet the individual needs of this person in the home. A copy of the Councils assessment was also obtained to inform the process. This person had been admitted 5 days before the inspection and had not yet had a full plan of care produced and there was no photograph to identify the resident. Other case records reviewed each contained photographs and a range of information to inform care staff how to provide appropriate supportive care. Two residents spoken to with their families were happy with their choice of home and the care they have received since their move. Intermediate care to rehabilitate people before returning home is not offered but a respite service is available. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health & personal care needs are well supported by good care planning, regular involvement from other professionals and clear recording. Evidence: Shortly after admission a range of assessments to determine the physical and mental needs of the resident are carried out and any identified needs are included in the persons plan of care. These care plans included sufficient detail to enable care staff to support the person and maintain their health. Risks associated with daily living are identified and these are reviewed regularly to promote the persons independence. One plan identified a falls risk and how to minimise the occurrence. Another care plan was re written following changes in needs after a hospital admission. A person identified with poor skin quality has a plan in place for staff to regularly turn them when they are lying down to promote their health. Care Homes for Older People Page 13 of 27 Evidence: The files are regularly reviewed by the manager for quality and any issues are addressed with the staff team. Records demonstrated that residents regularly see health care professionals to promote their good health with details of health checks, visits to their GP and hospital appointments being recorded in the individual files. Three residents spoken to all stated the home provides a good standard of support and staff were observed throughout the inspection talking to residents and involving them in ad-hoc activities. All senior staff that dispense medicines have had training in the safe handling of medication. Appropriate procedures that promote the safety and well-being of residents are in place. Medicines are administered safely and stored securely. A monthly audit is carried out as part of the quality assurance process. Privacy and dignity are promoted in the home. Staff receive induction training in this respect and they were observed knocking on doors before entry and speaking respectfully to people. Residents stated they could have a key to their rooms if they wished and some did have. Each room has a lockable facility. Door locks to bedrooms and toilets were easy to use but could be overridden by staff in an emergency. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents may take part in regular activities of their choice. Visitors are made welcome. A good standard of healthy food is provided. Evidence: A social activities co-coordinator has been employed to promote activity for people in the home. She has only been employed a short time and has not yet looked at the individual life histories collected as part of the admission process. She is employed five days a week and is currently speaking to each resident on a daily basis, reviewing the equipment needed and organising activities inside and outside of the home. These are recorded in a log that can be reviewed to monitor who is involved in activities and when. Around the home there were copies of magazines and personal newspapers. There was a set of dominoes on a table and a part completed jigsaw. The notice board identified future events and had an activities programme displayed. There were details of a future residents meeting and an advert for a mini bus trip. A photo album in the lobby showed pictures of residents on a trip to a local flower show, people singing, baking and involved in activities and crafts. Each fortnight there is keep fit for a small charge. Care Homes for Older People Page 15 of 27 Evidence: This goes into the residents fund to help purchase activity items. The televisions in communal areas can receive all free to air channels and the home has a wireless free internet service for anyone with their own computer. Each fortnight there is a church service in the home. The manager stated that currently there is no one in the home whose needs cannot be met in the local community. The survey returned from a resident stated there are usually activities arranged in the home to take part in. One resident stated she had been on a shopping trip in the homes mini bus. Everyone spoken to said they enjoy living at Melbury Court and can choose what to do and where to go. Juice was available in the home and a fresh coffee machine was in the reception area for residents and visitors to the home. Fresh fruit was in bowls available to all. The inspector had lunch with three residents on the first floor. The tables were attractively set with a cloth, napkins and table decoration. There were condiments and vinegar on the table. Each residents choice was respected. One person who refused a meal was persuaded to eat a sandwich and another resident requested a banana instead of the menued sweet choices. Residents who chose to eat in their rooms were well supported with staff keeping regular contact with them to ensure their needs were met. Meals taken to individual rooms should have a plate cover. Before lunch a carer was overheard discussing the lunchtime meal with a resident. The carer asked how the resident preferred the fish cooked and then went on to describe the teatime choices. This demonstrated that residents preferences are important. The menus are well balanced and include a preference for healthy eating. The care plans contain good information about individual eating habits with statements such as, good but not large diet and sugar free. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home takes complaints seriously and staff are well trained to ensure everyone is protected from abuse. Evidence: The home has received one complaint since it opened. This was fully investigated by the manager and a response was provided in writing to the complainant. The manager stated she takes complaints seriously and uses them to improve the service provided. The one survey returned from a resident stated they are aware of how to complain and who to complain to. Details of the complaints process is detailed in the homes guide, a copy of which is in each bedroom and also in the entrance of the home for the benefit of visitors. Everyone spoken to felt safe in the home and also felt they could complain should an issue arise. Staff have received training related to safeguarding vulnerable people and in conversation appeared well aware of their responsibilities in ensuring people live in a safe environment. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is accessible, comfortable, safe and well constructed. Evidence: This home was newly constructed in 2008 to a high standard. Outside there is ample car parking for visitors and well tended gardens maintained by a contractor. There is level access into the home suitable for wheelchairs. Internally there are three floors connected by stairs and a passenger lift. There are 87 bedrooms, 11 of which are designated premier that have en suite shower, toilet and hand basin. The other 76 bedrooms have en suite toilet and hand basin. Bedrooms contained appropriate storage with a lockable facility and most were personalised with small items of furniture and memorabilia. The temperature in each room is individually controllable, windows are opening and are restricted with sturdy safety catches for the safety of the residents. The home is built on a slope, 16 bedrooms are in the basement and benefit from patio doors opening onto the gardens on one side of the building. None of these bedrooms were currently in use. However one resident was viewing a bedroom and felt she would like to move into it as soon as this floor is open for use. The home is decorated to a high standard. There are four lounges that contain chairs Care Homes for Older People Page 19 of 27 Evidence: and couches with lighting being provided by centre, wall and table lights to alter the mood, depending on whether residents are reading, watching television or entertaining visitors. There are two dining rooms and a lounge diner all well equipped and set with table cloths matching crockery, napkins and table decorations. Each floor has a veranda that can be accessed from the lounges to provide a place to sit and enjoy fresh air. Currently they are not used but an assessment of risks associated with their use has not been produced. The home has been designed to be able to provide social and cultural activities. There is a hairdressing room that may be used by the attending hairdresser and those of individual choice. There are sufficient bathrooms and toilets and these are large and fitted with appropriate equipment to assist residents to bathe in safety and comfort. Should they be needed the home has two hoists and other appropriate equipment used in moving residents safely. There is a non smoking policy in the home. The homes kitchen and laundry are appropriate for the size of the home and contain a good standard of equipment. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff to meet the needs of each resident and recruitment procedures ensure people who live in the home are safe and are provided with a good standard of care. Evidence: Information provided by the home manager showed that 60 percent of care staff have an appropriate vocational qualification. The records showed that a regular training programme is in place to ensure staff receive the training they need to care for older people and people with a dementia. The range of training provided since the home opened includes moving and handling, first aid, fire, infection control, caring for people with a dementia and safeguarding of vulnerable people. Staffing rotas showed that there are enough staff on duty to meet the necessary staffing levels. There were thirty one residents on the day of inspection, five of them with a dementia were being supported on the first floor. The following care staff were on duty in addition to the manager, during the inspection Four care staff proving support on the ground floor Care Homes for Older People Page 21 of 27 Evidence: One care staff on the first floor. This is increased to two care staff at the weekend The manager is also supported by an administrator, activities person, catering and domestic staff. A handy man visits on three days each week and is on call for any emergencies. The manager stated that currently she is fully staffed but will recruit as occupancy increases. The files of recent recruits were reviewed and found to contain appropriate information in the form of application forms, references and Criminal Record Bureau checks to ensure residents can live in a safe environment. Each file also contained a signed awareness of the company handbook, first day induction details and one to one development interviews with the manager who ensures staff employed are able and understand the standards she expects of them. Following this each new staff member is provided with a full full induction into care supported by a senior member of staff as a mentor. Staff spoke knowledgeably about the individual needs of people who use the service and confirmed in the returned surveys that up to date information is given to help support people living in the home. And that the induction mostly covered everything they needed to do the job properly. Residents and visitors spoken to stated that the staff team are very good. A resident and daughter said they were very happy with the care provided. Two other residents said the staff are good and react to the buzzer very quickly. Throughout the inspection staff were observed talking with residents, asking how they were or if they needed anything. This ethos in the home provides a good basis for care. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run for the benefit of the people who live there. Evidence: The manager who has been in post since the home opened in March 2008 is experienced and qualified in the care of older people. She has been a first level nurse for 28 years, has the Registered Managers Award to demonstrate her abilities and has been in management for the last 12 years. Recently she has completed training in equality and diversity to better promote the chosen lifestyle of residents in the home. She is supported by an operations manager who visits the home frequently and produces a monthly audit report detailing her assessment of the home. She also is improving her knowledge of the resident group by completing a university course related to dementia care. Also a system is in place to monitor the quality of care provided using a total quality Care Homes for Older People Page 23 of 27 Evidence: management tool that can identify areas for improvement. Audits of medication, care plans and the environment are regularly done. The manager is part of a continuing development team, organised by the company, that meet each month to improve the standards of care generally throughout the organisation. Staff and resident meetings are held regularly and a company news sheet is available for all to see on the homes notice boards. Residents surveys are done with the results going to head office. The manager said that she has not yet received formal feedback but that generally all replays are positive about the care provided. The company are also trialling an admission survey before putting this in place in all homes. Residents and their families are encouraged to manage their own finances, however if requested the home can provide a service. Individual records are kept and two signatures evidence each transaction. Receipts are kept for all purchases made and a balance check of monies held is regularly done by the manager and administrator. Residents can be confident their monies are held safely. Health and safety is monitored by the manager and meetings are arranged regarding these issues. A system for fire checks is in place and a risk assessment for the building has been completed. Any accidents involving residents or staff are recorded and these are audited monthly for any trends. Staff spoken to stated they are provided with the right equipment to do the job. Two staff surveys returned stated they receive regular support from management. Residents and visitors commented the home appears well run and it is a lovely place to live. The one resident survey returned stated the home is always fresh and clean. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The manager should ensure she is aware of how and where to obtain information in different formats and languages to support the range of people the home intends to accept. A recent photograph of new residents should be obtained at the earliest available opportunity. This may be useful to ensure shift changes are aware of new residents they will encounter. Staff should use plate covers when transporting individual plates of food to bedrooms. The manager should produce a risk assessment for the use of external verandas that are above ground level. 2 3 3 4 15 19 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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