Inspection on 01/06/05 for Mildred Stone House

This inspection was carried out on 1st June 2005.

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

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

Other inspections for this house

Mildred Stone House 30/08/07

Mildred Stone House 26/10/06

Mildred Stone House 15/02/06

Mildred Stone House 12/01/05

Mildred Stone House 08/07/04

Mildred Stone House 04/06/04

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

CARE HOMES FOR OLDER PEOPLE Mildred Stone House Lawn Avenue Great Yarmouth Norfolk NR30 1QS Lead Inspector Hilda Stephenson Unannounced 1 June 2005 - 07.00hrs 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 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. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mildred Stone House Address Lawn Avenue Great Yarmouth Norfolk NR30 1QS 01493 855797 01493 332128 mildredstone.socs@norfolk.gov.uk Norfolk County Council - Community Care Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Position vacant at present Care Home 32 Category(ies) of Dementia (25) registration, with number Mental Disorder - over 65 (1) of places Old Age (7) Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. From time to time the home may accommodate up to twenty-five(25) service users with dementia in the category DE(E) and seven (7) Older People in the category OP. 2. Normally the home will accommodate up to twenty-four (24) Older People with Dementia in the category DE(E) and up to eight (8) Older People in the category OP. 3. One (1) Service User, over the age of 65 years, with a Mental Disorder may be accommodated in the category MD(E). 4. No more than thirty-two (32) Service Users may be accommodated in total. 5. That the manager of the home is only responsible for the management of personal care offered to Service Users accommodated at this establishment. Date of last inspection 12 January 2005 Brief Description of the Service: Mildred Stone House is a two-storey residential care home for older people and is managed by Norfolk County Council.The home is situated beside the river Yare within easy reach of the local amenities of Great Yarmouth.The home offers long and short-term care for older people. The accommodation comprises 32 single rooms with one having en-suite facilities. The home is divided into four living areas and can accommodate up to 8 older people and 24 older people with dementia.Attached to the building is a day centre that is separate from the main house, the manager is responsible for both entities. The home is surrounded by landscaped gardens with an enclosed area at the rear. There is ample parking at the front entrance. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two hours and was carried out as an unannounced inspection during the very early morning period. A partial tour of the premises took place, staff records and care records were examined. Three of the night staff on duty, plus the day Care Co-ordinator and seven of the twenty eight residents were spoken to. The residents that were up were well presented and the home was found to be clean, tidy and free from any odour, with breakfast being prepared by the kitchen staff. What the service does well: What has improved since the last inspection? The manager now has an updated record of staff training which is kept within the home as well as the local authority main office. The carpet has been replaced within the entrance hall. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 6 The home has arranged to obtain residents life histories to help care staff gain a better understanding of their needs. 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. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 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 standard(s) EVIDENCE: None of these standards were checked during this visit. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 Care plans and health needs of residents are identified, reviewed and met by knowledgeable staff having a good understanding of the residents needs. Further attention is required to write care plans as soon as possible after admission. EVIDENCE: Three care plans were examined with two having adequate detail of the residents personal, health and mental health needs. One of the care plans had not yet been written by the key worker of one of the residents who had been recently admitted. It is important to have care plans written as soon as possible after admission to enable care staff to properly look after the resident. Care plans are kept in individual folders with the daily records used as part of the staff handover. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 10 Due to the effects of dementia for the majority of residents, relatives have assisted with the details that have been included within the care plan. During the previous inspection it was suggested that the home should compile life histories of each resident, with this information being obtained from relatives or friends to be included as background information within the care records, so care staff can communicate and gain a deeper understanding of residents needs. During this early morning visit there were just a few residents who were up having a cup of tea. Several spoke with the Inspector and one stated ‘the staff help me get dressed so I can get ready for breakfast’. The majority of residents were in their rooms with staff attending to their needs when they woke up, to continue with their usual routine. One care staff confirmed ‘one resident goes to bed quite late, so he likes his lie in in the morning’ indicating that residents usual routine is followed. A sample of the Medication Charts were seen and were completed satisfactorily. The night staff only administer medication when it is required, all of the staff on duty had previously attended a medication update, so medication was distributed in a safe manner. Staff knocked on bedroom doors before entering during the morning, again respecting the privacy of the resident as an individual, which is very good practice. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 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 standard(s) 14,15 Residents are helped to make their own choices by knowledgeable staff. Meals are served in a sociable environment allowing those who wish to eat on their own to continue to do so. EVIDENCE: Several residents were ready for their breakfast having an early morning cup of tea, although the majority were in bed. Breakfast is usually served from 08.30am onwards. The kitchen staff were preparing a variety of dishes for breakfast for residents, a wide choice is available at breakfast time. Several residents prefer to have their breakfast in their own rooms although the majority seem to go to the main dining room or small dining room in Lawn Avenue unit. The dining rooms were set out to accommodate a number of residents, some seating two, four and six. One resident who was having her breakfast stated ‘the food is very good here’. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 16 The home has a satisfactory complaints system with evidence that residents and relatives views are listened to and acted upon. EVIDENCE: The home has a detailed complaints procedure and complaints are recorded with the necessary action taken. This is included within the written documents given out on admission and is displayed in the front hall. There were no complaints received from the residents who spoke to the Inspector during this visit. Staff confirmed that several residents have lost the ability to complain and rely on communication with them to acknowledge their moods to ascertain whether there is a problem and try various methods of communication to amend these. Relatives are regularly spoken with by staff to ensure that the residents are looked after to their satisfaction, which is good practice. The home has had no complaints directed to CSCI since the previous inspection. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19,20,25,26 In general the home is clean and tidy although some areas are in need of redecoration. EVIDENCE: The home has several communal lounges containing comfortable furniture. There are chairs situated in small alcoves to allow residents who walk round the corridors to sit down when they become tired. There is an outstanding requirement from the previous inspection to redecorate the lounge and dining room in Lawn Avenue unit, as well as the main dining room and some of the bedrooms. The Care Co-ordinator confirmed that some of this has commenced and will be completed within the timescale. There has been a new carpet laid at the front entrance that changes from blue to red which may be too significant a colour change for those residents who are guided by colour, so it may be more beneficial to have all the same colour carpet throughout the main corridor. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 14 The call bell system is being replaced, although at the time of this visit the majority of the home was currently not working. However this should be completed as soon as possible. The fire panel is situated quite high on the wall in reception and a requirement has been issued by the fire officer to lower this. The home in general was found to be clean, tidy and free from clutter with no unpleasant odour. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 Sufficient numbers of staff are on duty to meet resident’s needs, with extra staff brought in to cover busy periods. Staff are competent to meet the needs of those living at the home. EVIDENCE: There were three care staff on duty during the night, with five care staff and one Care Co-ordinator then came on duty at 07.30am. The ratio of night staff has recently been upgraded to three due to the amount of domestic tasks they attend to during the night and this is measured against domestic hours. Overall, the home has an adequate amount of staff on duty during the twenty four hour period. The staff team who were on duty were extremely friendly, polite and treated the residents with dignity and respect and should be praised for this. Training is planned to assist staff to attend to resident’s complex needs, including a good induction programme that includes a three day induction at the local authority office. The Care Co-ordinator confirmed that the majority of staff attend a dementia awareness training course as soon as possible to ensure that staff become skilled at tending to residents with degrees of dementia. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 16 The Care Co-ordinator has completed a dementia care mapping course in line with the current trend of caring for those with dementia. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Residents best interests are safeguarded and promoted by the home’s procedures and practice. EVIDENCE: The manager is supported by senior staff who manage the home in her absence. A sample of health and safety procedures were checked during this visit. The fire records were satisfactory and the night staff explained the procedure in full, although the fire panel is situated high on the wall in reception and a requirement has been issued by the fire officer to lower this to allow staff to reach up safely. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 18 Accidents are monitored and recorded satisfactorily. Risk assessments are in place to highlight those areas of concern. The local authority and the manager arranges both mandatory training and specialist training for staff to ensure they are adequately up to date and continue to develop their skills in looking after residents with dementia and should be commended. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 3 Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 20 Yes 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. 2. Standard 19 19 Regulation 16 23.2 d Requirement The call bell system must be complete and in working order. Timescale for action Immediate and ongoing By 30/10/05 3. 38 23 There are areas that require redecoration including the small dining room and lounge in Lawn Avenue and the main dining room. The fire panel must be lowered By to allow staff to reach this safely. 30/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 19 Good Practice Recommendations The care plans must be completed as soon possible after admission. The new blue carpet should be continued throughout the main corridor in line with current trend with dementia management. Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 Mildred Stone House I55 S34268 Mildred Stone House V230348 010605 Stage 4.doc Version 1.30 Page 22 - 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. 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