Inspection on 13/01/06 for Mendip House

This inspection was carried out on 13th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Mendip House 10/05/07

Mendip House 05/08/05

Mendip House 16/03/05

Mendip House 04/08/04

Similar services:

Turret Villa Retirement Home

Moor House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

The Gardens Care Home

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

CARE HOMES FOR OLDER PEOPLE Mendip House Mendip House West Lane Chester le Street Co Durham DH2 3AS Lead Inspector Mr Stephen Ellis Unannounced Inspection 13th January 2006 1:05 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 Mendip House DS0000031195.V266215.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. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mendip House Address Mendip House West Lane Chester le Street Co Durham DH2 3AS 01913882514 01913882514 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) Durham County Council Mrs Vivien Mary Shingleton Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28), Physical disability (9) of places Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The lifestyle and needs of the PD person to be accommodated in the OP unit must be compatible with the lifestyles and needs of the other service users OP unit, plus the home`s statement of purpose. 5th August 2005 Date of last inspection Brief Description of the Service: Mendip House is a long established care home for older people, provided by Durham County Councils Social and Health Care Services. It provides 28 care beds, all in single rooms. The two- storey building has generous communal space (lounges and dining room) and is generally well equipped for the assessed needs of its service users. Externally, there is a garden and car parking spaces. In 2004, the care home developed an intermediate care unit for 8 people with physical disabilities over the age of 55 years. Its purpose is the rehabilitation of service users who are admitted for short stays so that an intensive rehabilitation programme can be applied. The remaining 20 beds are for either permanent or respite care. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.5 hours. It included a tour of the building, examination of a number of records, plus discussions with 12 residents, 7 relatives, 3 visiting health and social care professionals and 6 staff. What the service does well: What has improved since the last inspection? Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 6 There have been no significant changes. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mendip House DS0000031195.V266215.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 Mendip House DS0000031195.V266215.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): 3 and 6. Thorough assessments of need are carried out prior to admission to ensure that the service will be suitable for the people admitted. Very good arrangements are in place for intermediate care, enabling service users to maximise their independence and return home wherever possible. EVIDENCE: Residents and relatives confirmed that residents’ needs had been fully assessed prior to their admission. Service users on the Intermediate Care Unit (plus several of their relatives and visitors) spoke very highly of the care and assistance received from staff of all disciplines working on the Unit (e.g. care staff, community nursing staff, physiotherapists, occupational therapists and medical staff). Residents’ plans of care showed detailed assessments of need had been carried out and that their admissions were appropriate. Plans of care also showed that service users on the Intermediate Care Unit were helped to Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 9 maximise their independence and return home in the majority of cases (65 since December 2004). Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Residents’ health, personal and social care needs are fully met. Residents are treated with respect and their privacy and dignity are promoted. There are good arrangements for dealing with people’s medication requirements. EVIDENCE: Residents and relatives said that they believed the health and social care needs of residents were well known by staff and were being fully met. They said that the community nurse or doctor would see them whenever required. Residents’ personal and social care needs were known, understood and respected by the staff team. They said that they felt they were treated with respect and sensitivity. As one resident said: “It is really splendid the way I’ve been treated all the time: good food, care and attention. The home is wonderful”. Another resident said: “It couldn’t be better. They’ve given me every care and attention”. Another typical comment from a relative was: “The care and provision here is first class; the staff are tremendous and very helpful”. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 11 Another relative said: “The staff have been absolutely fantastic towards my father; nothing is too much trouble; I can’t commend the staff highly enough”. One visiting social and health care professional said: “I think the home’s superb; the care is first class; it is well managed and well organised; there is a recognition that each client is an individual and everyone here is treated as an individual”. Care plans were detailed and comprehensive about residents’ health and social care needs, providing clear guidance to staff. They were subject to regular review, in keeping with National Minimum Standards. They were to a high standard, focused on person-centred care and emphasising the positive attributes of each service user as well as fully addressing residents’ needs. Staff training (e.g. NVQ level 2 and Customer Care) has included the important issues of privacy and dignity and 76 of care staff have achieved National Vocational Qualifications (NVQ) at either level 2 or 3. There are good arrangements for the safe administration of medicines. Most care staff members, including residential supervisors and manager, have completed the Safe Handling of Medicines course. There is good support from a local Pharmacist who supplies the medication in Monitored Dosage form (in weekly cassettes with the medication clearly identified for the individual resident). There are good storage systems and care staff check all medication when it is received into the home. The home requires medication to be administered only from the container(s) into which the pharmacist dispensed it originally. Medication is kept securely in lockable cabinets and trolleys. Residents may attend to their own medication, but in practice most prefer to delegate this responsibility to staff. Unwanted medicines are returned promptly to the Pharmacist and the home is careful not to stockpile large quantities. Senior care staff members carry out medicine audits routinely. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Very good arrangements are in place for service users’ daily life and social activities, including catering standards. EVIDENCE: Residents were extremely complimentary about the high standards of service experienced concerning daily life and social activities. As one resident said: “It’s like a 5 star hotel. Many thanks to all the staff for their kindness and help”. Other residents said: “The food and care are very good”. Another resident said he would give the home “99 out of a hundred!” His friend agreed and added: “You get the best of grub here!” Service users are regularly consulted about matters affecting the life of the home, both formally and informally, individually and in small groups. For example, residents meetings are held every two months and annual satisfaction surveys are carried out. A Newsletter is produced every 3 months. Residents’ comments are invited and kept in a book. The manager has an ‘open door’ policy and invites residents and their representatives to speak about any matters of interest or concern. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 13 Residents confirmed that they are encouraged to exercise choice in their daily lives. For example, residents have been invited to choose new curtains for their bedrooms from many different pattern designs and colours. They also choose how they spend their time, including the times of getting up and going to bed. There is a good choice of social and recreational activities from a varied programme of events, including individual and group activities, in and out of the home. For example, on Saturday nights there is often a special supper put on with music and singing. There are visiting entertainers from time to time and recently many residents were involved in making Christmas crackers, decorations and cards. Residents were particularly complimentary in their comments about the home’s catering service, describing it either as very good or excellent. A varied and appetising menu is provided, reflecting service user choice. An attractive, easy to read menu is displayed in a clear plastic holder on each table and on a large board near the entrance to the dining room. An attractive dining room is provided. Tables are supplied with linen tablecloths and napkins. Meals and beverages are served using utensils, crockery and cutlery of good quality. New meals are offered from time to time so that residents can try different menus and exercise choice. The home tries hard to provide meals that residents will enjoy. A drinks trolley and separate sweet trolley are provided each day with a good choice of beverages and sweets. These were very popular with residents. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. Residents are protected from abuse. EVIDENCE: Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau and Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to try to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training to ensure they have the right knowledge and skills to do their jobs competently. All care staff members have completed Protection of Vulnerable Adults training. Residents, relatives and visitors reported a caring, supportive atmosphere in the home, which is well established. There is good leadership and teamwork evident and these features reinforce the caring culture and provider policies concerning adult protection. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 15 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 and 26. Service users live in a safe, well-maintained environment that is clean, pleasant and hygienic. EVIDENCE: A tour of the building revealed the premises to be well maintained, clean and pleasant. There is a full time handyman who monitors safety standards and ensures that repairs, redecoration and servicing are carried out at appropriate intervals. Records are kept of tests and servicing. Residents were positive and complimentary in their comments about the premises, describing them as pleasant, comfortable and suitable for their needs. They felt the home was well equipped. Residents personalise their rooms and are invited to bring in personal items of furniture, ornaments and photographs/pictures as they wish. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 16 Paper towels and liquid soap are supplied in wall-mounted dispensers in communal toilets and bathrooms. Care staff members have completed training in Infection Control, Food Hygiene and Health and Safety. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Staffing numbers and mix of skills are appropriate for the needs of residents. Care staff members are trained and competent to do their jobs, with 76 having NVQ level 2 or above. The home’s recruitment policy and practices support and protect residents. EVIDENCE: At the time of inspection, there were 25 residents being accommodated: 5 on the Intermediate Care Unit and 20 in the main body of the home (including 2 people for respite care). Typically during the day (7 am - 10 pm) there are 2 members of care staff on duty on the Intermediate Care Unit (8 beds) and 2 care staff plus a residential supervisor on the Older Persons’ Unit (20 beds). At night there are 2 care staff on duty across the home. The registered manager is full-time and her hours are not included in the number of care hours supplied. There is a part-time administrator, plus catering and domestic staff in sufficient numbers for the needs of the home. There is a full-time Handyman. Residents said that staff members were available in sufficient numbers to provide timely assistance when required. They were all well regarded by service users. A typical comment made by residents was: “The staff are excellent. Nothing’s a trouble to them”. On the Intermediate Care Unit, there is a multi-disciplinary staff team involved, including care staff, community nursing staff, physiotherapists, occupational therapists, social workers and Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 18 medical staff. They are reported to work and communicate well together to achieve the aims and objectives set out for the Unit. There are very good staff training arrangements at this home. Thirteen members of care staff out of the 17 employed have achieved NVQ level 2 or above (76 ), which is commendable. An impressive staff training and development programme is operating at the home, including customer care, equality and diversity, dementia awareness, moving and handling, first aid, safe handling of medicines, protection of vulnerable adults, health and safety, infection control and food hygiene. Staff confirmed that they had undergone extensive induction and foundation training. A visiting social and health care professional said: “The staff have been doing a lot of training and their work is excellent”. Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau and Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to try to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training to provide them with the right knowledge and skills to do their jobs competently. All care staff members have completed Protection of Vulnerable Adults training. Residents reported a caring, supportive atmosphere in the home, which is well established. There is good leadership and teamwork evident and these features reinforce the caring culture and provider policies concerning adult protection. As one relative said: “It’s lovely and clean; no smells and staff are very caring; Dad’s been well looked after”. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. The manager of the home is fit to be in charge, of good character and able to discharge her responsibilities fully. The home is run in the best interests of residents. Residents’ financial interests are safeguarded in those situations where the home is involved. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered manager is experienced and competent in her role. Residents, relatives, visiting social and health care professionals, plus staff at the home, all spoke well of her leadership skills and commitment to good outcomes for residents. She was described as being approachable and caring. For example, one visiting social and health care professional said: “Viv is an excellent Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 20 manager and very responsive; she looks for the positives and not the negatives; her assessment skills are excellent; her observations at Reviews are first class; she is very aware of what’s going on; she keeps relatives very well informed; she is very good at liaising with other agencies”. Another visiting social and health care professional said: “Viv is a very good manager, one of the best I’ve come across; I couldn’t praise her highly enough”. She expects to complete her Registered Manager’s Award (RMA) at NVQ level 4 by the end of March 2006. The home’s management team, comprising the registered manager and senior staff such as the residential supervisors, communicates well, both with each other and the whole staff group. Management and staff are working towards the aims and objectives of the home and doing this consistently. For example, 76 people had been admitted to the Intermediate Care Unit from December 2004 (when it opened) to January 2006. Of these admissions, 65 went home. The average length of stay on the Unit was well within the 6 weeks maximum target. Good accounting procedures are followed, with receipts and signatures being obtained for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of many residents. In those situations where the home helps look after residents’ monies, such as pocket monies, clear individual accounts and records are maintained. Comments received from staff and management confirmed that there are very good health and safety policies and practices that promote the health, safety and welfare of residents and staff. All staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This helps reinforce the registered provider’s written policies on Health and Safety. Health and Safety issues are also discussed at monthly staff meetings. The home recently passed a health and safety audit carried out by Durham County Council. Residents, relatives and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. They said they believed the home was safe and run in the best interests of residents. For example, there is an annual survey of residents’ satisfaction carried out and the findings are reported within the home. There is a quarterly magazine/ newsletter for residents, plus bimonthly residents’ meetings, in which issues of interest and concern are discussed. However, the registered provider’s representative needs to report on the findings of her monthly, unannounced visits to the home, in keeping with regulation 26 of the Care Homes Regulations 2001. Copies of the report are should be sent to the Commission for Social Care Inspection and the home’s manager, as well as key members of the registered provider organisation. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 21 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 3 x x 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x x x 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 4 x 3 x x 4 Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP33 Regulation 26 Requirement Reports of monthly quality assurance visits carried out by the Responsible Individuals agent are required to be sent to the Commission for Social Care Inspection. The previous timescale of 30/09/05 was not met. Timescale for action 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP31 Good Practice Recommendations It is expected that the registered manager will complete her NVQ level 4 in management by the end of March 2006. Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Mendip House DS0000031195.V266215.R01.S.doc Version 5.0 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!