Inspection on 22/11/05 for Mellish House Residential Home

This inspection was carried out on 22nd November 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

Mellish House Residential Home 18/07/07

Mellish House Residential Home 19/06/06

Mellish House Residential Home 28/01/05

Mellish House Residential Home 11/05/04

Mellish House Residential Home 20/01/04

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

CARE HOMES FOR OLDER PEOPLE Mellish House Residential Home Kings Hill Great Cornard Sudbury Suffolk CO10 0EH Lead Inspector Jill Clarke Unannounced Inspection 22nd November 2005 10:00 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 Mellish House Residential Home DS0000024446.V273503.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. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mellish House Residential Home Address Kings Hill Great Cornard Sudbury Suffolk CO10 0EH 01787 372792 01787 372792 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) Stour Sudbury Limited Suzanne Elizabeth McKeon Care Home 34 Category(ies) of Dementia - over 65 years of age (34) registration, with number of places Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th May 2005 Brief Description of the Service: Mellish House provides care for 34 older people who have dementia. The home is located in a residential area of Great Cornard on the outskirts of the market town of Sudbury. There is a Public House close by, and the town of Sudbury provides a range of shops and eating-places. The home shares grounds with another registered care home, which is also owned by Stour Sudbury Ltd. Mellish House is a purpose built home arranged on two floors. There is a passenger lift and stairs to the first floor, and ramped access to an enclosed garden. All thirty-four single rooms, which are located on both floors, have a wash hand basin and ensuite lavatory. Each floor has a dining room, lounge and two communal bathrooms and lavatories. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to an unannounced inspection, which was carried out by Jill Clarke and Alan Claire, Regulatory Inspectors, on 22 November 2005. Please add in times of inspection. Also you will note I have changed the wording slightly to make reference to your names. Two visiting relatives and four residents were spoken to in private. Due to the nature of some residents difficulties in communication, additional assessment of the residents daily living experience was by witnessing and observing activity in the sitting rooms and dining areas. Six members of staff including the operational and registered manager of the home were spoken to and cooperated well with the Inspectors. Prior to this visit the Commission for Social Care Inspection (CSCI) had received complaints from an anonymous source. The matters of concern raised were investigated as part of the inspection and the findings are referred to within this report. What the service does well: What has improved since the last inspection? Since the last inspection the home has endeavoured to provide residents with ‘Sign Posting’ of their own rooms and bathrooms. This action has not yet been continued throughout the home and some signs need replacing. An odd job person, who was seen to going about tasks, has been employed. The home has installed a new washing machine, which has a sluice cycle. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 6 What they could do better: Whilst residents can be assured that their individual preferences are identified prior to placement, they cannot be confident that this information is always carried out by staff. Parts of documents seen by the Inspectors where not always completed, or information compiled accurately. During their observations in the sitting and dining rooms the inspectors noted that residents were not always given the say in selecting a pastime or item from the lunchtime menu. Residents and relatives can expect that matters relating to residents health details will be monitored. However they cannot expect that details are always recorded accurately or monitored effectively. The Inspectors noted that the home was not monitoring resident’s personal hygiene and weights. In one instance a resident’s weight was recorded differently on the same day but in two different parts of the care plan. Staff checks on a persons food in-take was seen to recorded in accurately. Residents and relatives spoken to described staff as ‘kind’ and ‘generally caring’. On the day of the visit the Inspectors noted a distinct lack of interaction between staff and residents. Involvement was generally task orientated and no one to one activities other than personal care, were observed nor any aspect of Reality Orientation or Reminiscence programmes evidenced. Whilst residents can be assured that staff will sit in their company watching television or as was seen, reading a book. They cannot expect that staff will routinely initiate any specific activity in the absence of the co coordinator Residents can be assured that the home is generally clean however; on the day of the visit the Inspectors noted that the first floor accommodation was cleaned and tidied to a higher standard than the ground floor. Throughout the home there was an unpleasant odour, which became concentrated in two individual’s bedrooms on both floors. The carpet at the far end of the ground was stained and whilst the communal bathrooms appeared clean, although impersonal, dust was present on surfaces throughout with a build up of scum on the base of the ground floor assisted bath chair. Residents can expect that that the home provides a laundry service however they cannot anticipate that their personal items of clothing will be laundered with care. On the day of the visit the Inspectors noted that there was no designated person working with the laundry and that a number of resident’s personal items where being damaged by the lack of proper care in laundering process. Information about past and future activities is available to residents and relatives. However, residents or relatives with sensory or cognitive difficulties Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 7 cannot be sure that the current format that the information is in would enable them to be informed. 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. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 8 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 Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 9 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 and 4. The home’s application and placement procedure ensures that people are assessed and given information on the home. This allows the person or their representative to make an informed choice as to whether they believe that the home can meet their needs. Resident’s can expect that their specialist needs are identified during the assessment stage. However, the home does not fully demonstrate that all of the resident’s specialist dementia needs are being met based upon current good practice and reflect relevant specialist guidance. EVIDENCE: One relative felt that the care provided at the home was “generally good” and that they had a “sense of confidence” about the care and attention that their mother was receiving. Another relative informed the Inspector that, “ ….. (their wife) doesn’t know who I am now, but they (the staff) are very good with ….”. Records showed that residents (or advocate) are given a contract, which sets out their terms of residency. A copy of the contract is signed by both parties and held on file. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 10 On the day of the visit staff involvement with residents was generally task orientated and no one to one activities were observed nor were any aspects of Reality Orientation, Reminiscence or Dementia Mapping in place. The home has started to ‘sign Post’ rooms within the home but this is not yet completed throughout the home and in some places signs need replacing. The Registered Manager has undertaken training to increase the home’s knowledge of supporting people with dementia. During this inspection staff were not seen to use suitable methods of engagement and communication with residents to allow them opportunities to enhance aspects of choice in meals and pastimes or orientation to time or place. Residents can be assured that their environment is generally clean and maintained. However, on the day of the visit the Inspectors noted that throughout the home there was an unpleasant odour which became concentrated in two individual’s bedrooms on both floors and the upper floor shared lavatory. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Residents can expect that the home have individual care plans in place. Residents cannot expect that staff regularly and accurately update records accurately to reflect individual changing needs in health care and wishes. Residents can expect to be treated with respect however their support needs may not always be met in a dignified manner. Residents can expect that that the home provides a laundry service however they cannot anticipate that their personal items of clothing will be laundered with care. EVIDENCE: The home uses a Nutrition tool to monitor residents’ weight. In two separate recordings in one resident’s care plan the resident’s weight was recorded as being different on the 3/8/05. For one resident who had lost weight and the GP consulted, staff noted that the resident ate better in the dining room, as their food in-take could be monitored in order to support the resident in putting on weight. However, another resident’s chart showed that they had lost 9 kilograms between Jan – November 2005. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 12 The home keeps diet monitoring sheets, which are completed after meal times. One resident, who was noted to have lost weight, was seen to leave part of their lunch and dessert. Their care plan, which was updated after the meal, was ticked as having eaten well. Care plans record when a resident has a bath. The sheets seen on the day showed that residents were being washed daily – but not being bathed on a regular basis. One resident whose continence is managed was recorded as having had 5 bathes between August 05 and November 05. Another resident was recorded as having not bathed in October, 7 baths in September 3 in August and 2 in July. Medication is stored in a cupboard on the first floor. The room was found to be untidy, cluttered and felt rather warm. Items of sterile dressings were found not to be labelled as prescribed for an individuals use and were out of date. A container of Sudocream was found in the utility room and was not labelled as prescribed for individual use. On the day of the visit the Inspectors noted that there was no designated person working with the laundry and that a number of resident’s personal items where being stored in other persons named ‘pigeon holes’. A complaint had been received that resident’s clothing was not being returned to the rightful owners, which can result in residents not wearing their own clothing. From 2 wardrobes checked, although clearly marked 3 items of clothing were found to have been in the wrong resident’s room. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 13 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 The home is able to offer an activity programme, which is restricted by the part time presence of the co-ordinator. Residents cannot expect that in the absence of the co-ordinator that staff will offer other individual or shared activities, outings or alternative pastimes on their behalf. Relatives are welcomed to the home and assisted in pre paring residents for outings. Whilst residents can be assured that information relating to their personal choices and life style activities are recorded in care plans. They cannot expect that those preferences will be included in their daily living experience within the home. Residents can expect that meals will be wholesome well cooked and served in a pleasing surrounding. However, they cannot expect that meals will be attractively served according to personal choice in a calm and peaceful atmosphere. EVIDENCE: The Registered Manager has undertaken training to increase the home’s knowledge of supporting people with dementia. During this inspection staff were not seen to use suitable methods of engagement and communication with Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 14 residents to allow them opportunities to enhance aspects of choice in meals and pastimes or orientation to time or place. The home does employ an activities co-ordinator on a part time basis with whom residents can expect to be offered a number of activity opportunities. Care plans record resident’s activities undertaken. On the day of the visit staff involvement with residents was generally task orientated and no one to one activities were observed nor were any aspects of Reality Orientation, Reminiscence or Dementia Mapping in place. Residents and relatives spoken to described staff as ‘kind’ and ‘generally caring’. On the day of the visit the Inspectors noted a distinct lack of interaction between staff and residents. Involvement was generally task orientated and no one to one activities other than personal care, were observed nor any aspect of Reality Orientation or Reminiscence programmes evidenced. Whilst residents can be assured that staff will sit in their company watching television or as was seen, reading a book they cannot expect that staff will routinely initiate any specific activity in the absence of the co ordinator Relatives were seen to be taking a resident out for the morning and the Inspectors spoke to two relatives who were visiting the home. The mini bus, which is shared with the adjacent home, is no longer serviceable. At 12.20 pm residents were invited and assisted in to the dining room for lunch. A meal was kept for one late resident who was at the hairdressers. Time spent with residents throughout their lunchtime demonstrated that on the first floor, well pre-pared food was not served in an appealing fashion. Bacon and egg pie was broken in to pieces; the meal was plated up without reference to individuals. Staff stated that they “can remember” residents choices and did not require “the list”. On obtaining the list, the Inspector noted that the ratios of entrée and alternatives did not tally with the orders. No condiments were offered residents and drinks were put in front of them. Whilst some residents did engage in conversation, staff speaking loudly over the serving hatch and across the room was predominant. For part of the time of assisting a resident with their meal, a member of staff stood over them, spooning food in to their mouth and talking across to other staff. Pudding was served unannounced. Those residents who remained in their rooms were provided with a tray service and one resident was assisted to eat in a dignified manner. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 15 On the Ground Floor, staff were seen to stand over residents as they assisted them to eat. Meals and drinks were placed in front of residents. Staff did speak kindly. Residents were left alone in the dining room and one got up and walked off. One resident who was initially being assisted managed to eat alone, only to be assisted again whilst still having food in their mouth. Staff walking in and out of the dinning room where not able to see if a resident was managing or that a resident’s meal had slipped off the plate, so they that used their fingers to place the food back on a fork. One member of staff assisted a resident with food on a fork then walked away. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 16 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): These standards were not assessed at this inspection EVIDENCE: Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24, 26 Residents and their relatives can expect the home to provide a safe, wellmaintained, clean and comfortable environment with aids to daily living to assist staff in meeting their care needs. Residents cannot expect that the home maintain furnishings in a safe and comfortable condition. EVIDENCE: There was a broken toilet holder in one bathroom on the upper floor whilst in the shower room a broken showerhead was also evident. At the last inspection the home was asked to remove any unused furniture. A cloth chair was found in the sluice and an armchair in a bathroom both of which is unhygienic. Knobs were missing from bedroom drawers and cupboards; one came away when opening a wardrobe. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 18 It was noted that the home had only recently employed a handy/odd job person who was seen going about tasks. One resident was using an armchair, which had a badly torn arm, which exposed the foam padding. During their tour of the premises the inspectors noted that the upstairs hall carpet was badly stained. Only one of two assisted bath chairs was in working order. Staff informed Inspectors that it had been broken since July. In the upstairs shower room the showerhead was detached. A layer of dust found covering both shower trays indicated that the showers had not recently been in use. Although the home has purchased some new towels, it was noted when looking around the laundry that a basket of wet laundry included 6 badly frayed towels with no edging. Spare pillows in the linen cupboard and two in bedrooms were found to be lumpy and although clean, were stained. The fillings having broken up during washing, leaving them uneven for residents to use. A bed sheet was found to frayed on a made up bed. Staff stated that they were having problems keeping a resident’s bedroom odour free. They asked for CSIC’s view on replacing carpet with wipe able flooring. This led to discussions about the home identifying the true cause and that the home would need to make a joint decision with the resident, if able, and family to identify what would be the best possible, safe, choice to ensure that the resident’s dignity is maintained and room kept odour free. These actions would need to be recorded on the resident’s care plan. There was a build up of black residue underneath a bath-assisted chair; this can trap and hold bacteria. The sluice room held an unnamed disposable shaver, combs, etc – as part of infection control all items must be named and kept in resident’s bedroom. The corridor carpets require cleaning. An unpleasant odour was detected throughout the home, which was concentrated in two of the nine rooms visited. The inspectors noted that no action was taken during the inspection to clean and vacuum a bedroom carpet, which was soiled with foodstuff. One bed had been made with a stained sheet and dried food between duvet and sheet. The bedroom floor was covered in foodstuff. One bedroom armchair was dirty and stained. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 19 Prior to the inspection a complaint had been received relating to residents laundered clothing being returned discoloured and stained. In the laundry residents clothing waiting to be returned to their rooms was stored in named ‘pigeon holes’. A sample of 2 residents clothing was checked and looked to be discoloured and stained. Vests looked as though tea and food stains had not been removed during washing. Items of clothing appeared to have been washed/dried in too high temperatures and were creased. Staff had taken some action to repair residents clothing. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 Resident’s can expect that the number and skill mix of the home’s staff, who are correctly recruited and trained, is sufficient to meet the needs of their care. Resident’s cannot always expect that numbers of staff on duty and the knowledge and skill they provide will always be able to meet all their needs. EVIDENCE: On the day of the inspection the cleaning hours of 07.30 – 11.30 were insufficient to ensure that the home was kept clean and resident’s laundry properly processed to an acceptable standard. Please refer to the environmental section of this report for further details. Managers of the home talked about the homes difficulties in recruitment and retention of staff. A new home has recently opened in the locality and managers explained that they suspected staff were leaving for higher rates of pay elsewhere Inspectors met with a high proportion of staff on duty with which English is not yet a conversational language. During conversation with the Inspector staff demonstrated difficulty in understanding some topics and questions. Staff said that sometimes they need to use a translator to assist with their language training. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 21 A sample of two staff files was checked; 1 held all information required. The second did not hold copies of references, the homes own checklist did not identify that the references had been received. This was fed back to management of the home who stated that recruitment of overseas staff was handled by an agency that ensured that all references and paperwork to validate identities was undertaken. It was felt that references had been received but not held at the home. The home was asked to ensure that a copy of all references is held at the home. The hairdresser had not undertaken a Criminal Records Bureau (CRB) check. No regular Dementia training is held. Recording of Induction training in two files differed, one file grouping training together and another with missing dates and signatories. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 22 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): 32, 33, 35, 37, 38 Resident’s arrangements of care should benefit from the proactive and an involved leadership and management approach of the home. They should expect their interests and systems to protect them and their safety are at the forefront of the process. Resident’s cannot be assured that on a daily basis their interests, safety and systems within the home to protect them, benefit from an involved and proactive leadership and management approach. Residents of the home are not experiencing that their specific and group preferences are always at the forefront of action on the part of the home. EVIDENCE: Residents appeared contented, either sat around televisions in the lounges or alone in their rooms with radios switched on throughout the inspection. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 23 There was a very low level of interaction between staff and residents. Staff addressed residents in a kindly way, although there was very little one to one or group interaction initiated by staff other than responding to personal care needs or a task centred routine “ changing those who night staff had got up”. Quality Assurance is undertaken by the home, the most recent report is currently being prepared. However, there is no Quality Assurance of the service specific to dementia such as a Dementia Mapping exercise. In order to be able measure the quality of the service, the home needs to look at ways of obtaining feedback from residents themselves. The home states that it does not hold any money on behalf of residents. All residents are invoiced directly e.g. for Hairdresser with the permission of relatives or relatives are billed. See standard 8. Diet sheets, weight recording, hygiene records are not recorded accurately. Complete recruitment records for all staff were not available in the home for inspection on the day of the visit. Part of the home’s own risk assessment states that the lint tray on the tumble dryer be checked each day. A check on this found that the tray was had a build up of lint which could be a potential fire hazard. The home was required to action this immediately. In two bathrooms there are large walk in cupboards where beds and other items are stored. The home is asked to place a lock on these doors to ensure that a resident may not walk in and be in danger of furniture falling on them. The assisted bath chair was broken and needs a sign to inform staff. In the sluice room a commercial spray bottle had a hand written label over the original indicating the bottle contained a different solution. Sample of servicing certificates were seen. These were as follows: Landlord Gas certificate – 11/4/05 Chubb Fire servicing – 27/1/05 Weekly Fire checks. Two weeks were missing 25/1/05 and 14/11/05. The home should ensure that these checks are carried out weekly. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 x 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 2 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 2 x 2 x 2 x 2 STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 2 2 x 3 x 2 2 Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 25 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 4 Regulation 18,1,a Requirement Staff must be provided with training to improve their understanding on ways to meet the specialist needs of the residents who have specialist needs. Staff must regularly and accurately update records to reflect changing needs of residents. Staff must ensure changes in resident’s health or well-being are reported to appropriate Health or Social Care professionals. Staff must ensure that creams, ointments and dressings are stored correctly and labelled for individual’s use. Staff must ensure that during the laundering processes, they are aware of and apply due care and attention to the washing and storage of resident’s clothes. The registered person must provide training and time to staff to enable them to extend the availability of arranged activities to beyond the presence of the DS0000024446.V273503.R01.S.doc Timescale for action 31/01/06 2 7 14,a,b 22/11/05 3 8 13,1,b,3 22/11/05 4 9 13,2 31/01/06 22/11/06 5 10 12,4,a 18,1,c,i 6 12 16,2n,18c I,121b 25b 31/01/06 Mellish House Residential Home Version 5.0 Page 26 7 14 16,2,i 8 19 &20 & 22, 24,26 16,343 23,1a2cd, 16k 9 10 24 27 16,2,c 18,1aci, 16,2,c 11 29 19,4,c 12 30 18,1,b part time activity coordinator and develop more specialist ways of communicating and engaging resident’s personal choice. Staff need to behave in a calm way that enhances the interactive and social opportunities that mealtimes offer residents. The home needs to demonstrate what alternative methods of transport for outings they are able to offer residents. The home must attend to items of repair and remove items of furniture, which are broken or unused. All parts of the home must be kept clean, free from odours and reasonably decorated. The home must inform CSCI in writing of how they intend to meet this standard. Stained and damaged items of linen and towels must be replaced. Staff must be trained to understand correct and careful processes of washing items of laundry and how to operate equipment correctly. The home must inform CSCI in writing on how they are going to address problems relating to the laundry system to ensure that it is brought up to an acceptable standard. The home must ensure that all staff records are up to date and complete and available for inspection. This includes; copies of CRB checks, and authenticated references for all staff. Training records need to be updated accurately. Staff need to be provided with a programme of training in DS0000024446.V273503.R01.S.doc 31/01/06 31/01/06 31/01/06 31/01/06 22/11/06 31/01/06 Page 27 Mellish House Residential Home Version 5.0 13 32 & 33 14 35 15 37 & 38 dementia care, which will enable them to more appropriately meet the specific needs of the residents. The home must inform CSCI in writing of how they intend to meet this requirement. 12,1,b,24, The home needs to take a more 31/01/06 1,a,b,3 proactive lead in directing the home’s systems of care towards the specific needs of people who have dementia. The home must inform CSCI in writing on how they intend to meet this requirement. 17,1,a The home must ensure that all 22/11/05 residents’ records hold accurate information. This includes records of payments for hairdressing and any other extra items. 17,1a,13, The home must meet the 22/11/05 4c6 requirements of Risk assessments, which include the daily checking of the lint tray in the tumble dryer. Staff must be trained to understand this. 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 Refer to Standard 9 19 33 35 Good Practice Recommendations The registered provider should provide a thermometer in the medicine storage room to record the temperature of the room. An audit of required repairs within the home should be undertaken. In order to develop services in line with ‘Good Practice’, the home would benefit from developing links and contacts with other dementia specialist services. The registered person should set up a record of charges that residents are paying for hairdressing, which would DS0000024446.V273503.R01.S.doc Version 5.0 Page 28 Mellish House Residential Home ensure that relatives are billed correctly. Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 29 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Mellish House Residential Home DS0000024446.V273503.R01.S.doc Version 5.0 Page 30 - 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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