Inspection on 02/10/05 for Melton House

This inspection was carried out on 2nd October 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

Melton House 29/08/07

Melton House 04/05/06

Melton House 25/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Melton House 47 Melton Road Wymondham Norfolk NR18 0DB Lead Inspector Ruth Hannent Unannounced Inspection 2nd October 2005 11:30 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 Melton House DS0000065210.V255665.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. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Melton House Address 47 Melton Road Wymondham Norfolk NR18 0DB 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) 01953 606645 01953 857390 Four Seasons Health Care (England) Limited (wholly owned subsidiary of Four Seasons Health Care Ltd) Josephine Barrett Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Melton House is a care home providing personal care and accommodation for 34 older people. The home is a large detached building situated in the market town of Wymondham. Bedrooms are on the ground and first floors and consist of five double bedrooms (four with en suite facility) and twenty-four single bedrooms (twenty-two with en-suite facility) The home has a variety of communal rooms, one of which is designated for service users who wish to smoke. A shaft lift is provided to aid service users to the first floor. Car park to the front with a small garden to the rear of the premises. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on a Sunday morning over one and a half hours. The Deputy Manager who was the senior officer on duty, was able to show the Inspector around the Home Four care staff were on duty plus the cook and laundry assistant with twenty three residents at present residing at Melton House. This inspection was to ascertain the lifestyle of residents at the weekend by observation and discussion. Records were not looked at, therefore, only some standards were inspected on this occasion. Requirements identified on the last report will be discussed at the next inspection. What the service does well: What has improved since the last inspection? What they could do better: The Home needs to ensure that staff are given sufficient time off to carry out their duties safely. Activities and stimulation needs to be improved. Staff training, including the NVQ qualification needs to be happening to increase the numbers of qualified staff. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 6 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. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not inspected on this occasion. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 9 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 and 9 The care plans are available but not always easy to read and understand. The Home is well supported with all its health care needs for residents by a community health team. EVIDENCE: Each resident has a care plan folder, which contains all the information required to assist the staff with the care required. The information is not always easy to find within these care plans due to the type of format that is used. Some records are in number format for dependency scoring and some in letter format with a lot of the information spread over many pieces of paper. Although staff get to know the residents requirements, on talking to one staff member this comes from verbal communication and daily records rather than the personal care plan. (Requirement). One resident stated the staff do get to know their needs but “if a strange carer comes to Melton we have to tell them everything”. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 10 The residents at Melton House are supported for their health needs by a health service team from the community nurses and GPs with one surgery directly opposite the Home. One resident is being monitored closely with care in bed and her records are available for continuing care by the staff team. A special pressure-relieving mattress was in situ with clear instructions of the care required. (Records seen and lady observed) The Home also has support from the Community Psychiatric Nurse when required. A recent need to move a resident to a more suitable care environment needed the support of experts in this field to ensure the correct placement was found for this person. (The inspector was involved in this transfer) and all support was given to be sure the placement was suitable for the individual involved. On walking the building it was noted that the locked medication trolley had been left in the dining room with some medication left in small boxes on the top. This was quickly locked away in the staff room by a chain on the wall and the boxes of medication placed inside the locked cabinet. (Requirement) Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 11 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 and 15 The Home does not offer enough variation and stimulation to ensure individuals have access to interests and experiences that will match their preferences. The meals offered are varied and wholesome with special diets accommodated in a setting that is pleasant. EVIDENCE: On arrival at the Home residents were sitting in the lounge with nothing other than the television to occupy them. The staff were around the home carrying out care tasks but not involved with any kind of activities/stimulation. On talking to one resident she was unaware it was Sunday and said all the days were the same and she went from meal to meal until it was bedtime. (Requirement). On talking to the staff occasional events take place such as singers coming to the Home or the recent Autumn Fair but nothing planned on a day to day basis with a designated person to concentrate solely on activities. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 12 The lunchtime Sunday roast was about to be served with the menu available. Residents were arriving at the table with smiles and pleased to be in the dining room which looked clean and attractive. (The room is about to be refurbished with new tables and chairs). A discussion was held over a suitable meal for a lady who had not been so well and food was being prepared for the dietary needs of another lady who is cared for in bed. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 13 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): EVIDENCE: These standards were not inspected on this occasion. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 14 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): 20 and 24 The residents do have comfortable, pleasant areas that they can sit and enjoy safely. The residents do live in safe and comfortable bedrooms with their own processions around them.. EVIDENCE: A tour of most of the building took place with the main office, staff room, kitchen, lounge, dining room and two bedrooms seen. The main lounge is bright and occupied by most of the residents. The furniture is adequate and the room is light and airy with armchairs, small tables, television, radio and wall units. There are smaller areas within the building that can be used by residents with a recent room made to feel like a sitting room in a private house with a fireplace and surround. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 15 The bedrooms were clean and in one room where a lady was in bed on a special pressure-relieving mattress it was noted the linen, bed and furnishings were neat and tidy with a large window that gave adequate natural light to brighten the room. Personal possessions were seen around the rooms which gave it an individual look with photographs, ornaments and small items of furniture. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 16 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 and 28 The safety and welfare of the residents may be at risk due to the long hours and extra shifts that the dedicated staff are giving. The lack of numbers of qualified staff means evidence of residents being cared for by safe hands is not available. EVIDENCE: On the day of the inspection there were four carers on duty including the Deputy Manager, one cook and one laundry assistant. This was seen as just adequate for the morning shift. (Carers were also assisting in the kitchen as there is no kitchen assistant). The rota’s were seen on the wall in the staff room for the three weeks which showed only three staff on in the afternoon and due to odd times of staff arriving and others leaving, on certain days, for an hour, the staff drop to two only on duty. This is not safe practice for the twenty-three residents who at present live at Melton House.(Requirement). It was also noted that many of the staff are working beyond their contracted hours and on occasions not having breaks between shifts. These staff are seen by the Home as the dedicated staff (as discussed with the Deputy and a carer who was working far more hours) and cover the shifts beyond their contracts to ensure residents do not suffer. A recent concern for a senior covering an Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 17 afternoon shift then going straight into a waking night, then the late shift again the following day, was discussed. The Cook who has constantly covered the kitchen without a day off since August and had no kitchen assistant told the Inspector that although she loves her job she was tired and had recently had to give up her holiday as there was no one to cover the kitchen. This practice is not sustainable and could compromise the health and welfare of the residents. (Requirement) The level of staff, who have attained the NVQ is still a long way off reaching the 50 of qualified staff with only four members part the way through the course, which also includes the Deputy Manager. (This is a previous requirement) Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): EVIDENCE: These standards were not inspected on this occasion. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x 3 x x x 3 x x STAFFING Standard No Score 27 1 28 1 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 17 Requirement It is a requirement that care plans are comprehensive and detailed to reflect the full care requirements to include, health, personal and social care that is easy to read and understand. It is a requirement that all medication is locked in the secure medication cabinet and chained to the wall when left unattended by the responsible person. It is a requirement that stimulation and activities are sought and provided to ensure interests are pursued and contacts maintained for all residents. Timescale for action 31/12/05 2 OP9 13 02/10/05 3 OP12 16.2m 31/12/05 4 OP27 18 It is a requirement that at no 31/10/05 time through the day should two care staff be left in the home and therefore the rotas need to be adjusted accordingly. Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 21 5 OP27 18 6 OP28 18 It is a requirement that the Home recruits and retains staff to ensure continuity of care is offered within their contracted hours. It is a requirement that staff obtain the NVQ qualification to equate to the 50 required as stated in standard 28.1. (This is an outstanding requirement) 31/12/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Melton House DS0000065210.V255665.R01.S.doc Version 5.0 Page 23 - 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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