Inspection on 15/02/06 for Mildred Stone House

This inspection was carried out on 15th February 2006.

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 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

Mildred Stone House 30/08/07

Mildred Stone House 26/10/06

Mildred Stone House 01/06/05

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 Mrs Ginette Amis Unannounced Inspection 15th February 2006 10:30 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 Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 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. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Mildred Stone House Address Lawn Avenue Great Yarmouth Norfolk NR30 1QS 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) 01493 855797 01493 332128 mildredstone.socs@norfolk.gov.uk Norfolk County Council-Community Care Mrs Jane Christine Ziara Care Home 32 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (32) of places Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 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 32 people with dementia, all who may be older people but 5 of whom may be people who are not yet 65 years old. Attached to the building is a day centre that is separate from the main house and independently managed by NCC. 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 DS0000034268.V283451.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place from 10.30 am to 12.45 pm on Wednesday 15th February 2006. The manager and care co-ordinator assisted with the inspection process and were courteous and helpful. Other members of staff were spoken with informally and observed as they went about their duties. A number of residents were spoken with collectively in one of the lounges and one resident interviewed in private. What the service does well: What has improved since the last inspection? The dining rooms and one lounge had been redecorated. The call system was fully functioning and the fire alarm display panel had been lowered so that all members of staff could easily access it. The care home now had a registered manager and the day centre attached to Mildred Stone House was no longer her responsibility. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 6 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 DS0000034268.V283451.R01.S.doc Version 5.1 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 Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 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): 136 Prospective residents were offered useful information about the care home and had the opportunity to find out about life there first hand. Residents’ needs were suitably assessed. The needs and objectives of short stay residents were less well documented. EVIDENCE: A descriptive service user guide was available to all prospective residents. Residents were referred to Mildred Stone House by Norfolk Social Services. Social workers provided an initial assessment as to their needs. This assessment was followed up by a visit from the care home’s manager then a visit to the home by the would-be resident. One resident spoken with described the process and related how after spending a day at the care home he had reached the conclusion that he would like to live there, adding that he had never regretted his decision. Copies of the documented Terms of Residence were found in residents’ personal files and had been signed by them, or their representatives. Two places at the care home were routinely made available for short stay residents, although at the time of this inspection one of these places was Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 9 occupied by a person awaiting a permanent home there. The majority of short stay residents were well known to staff at Mildred Stone, as they were often persons who had frequented the day centre attached to the care home; but see Requirement Standard 7. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 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 10 The health and personal care needs of permanent residents were well documented in their care plans. Short Stay residents’ care needs were less well accounted for. Members of staff went about their duties in a friendly, respectful and understanding manner and demonstrated good rapport with residents. Provision of services tailored to the individual social and recreational needs of persons with dementia would be facilitated by an increase in staff time available. EVIDENCE: The personal files of 4 residents, including one short stay resident were examined. Those files belonging to permanent residents were found to contain care plans that took account of all aspects of health and personal care needs, including risk and moving and handling assessments together with some aspects of social need. These needs were periodically reviewed and adjustments made to care plans as necessary. However the file belonging to the short stay resident was found to lack so comprehensive a care plan and a requirement was made for more suitable care plans to be drawn up for any persons being admitted for short stays in future. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 11 It was understood that, as a result of staff shortages, the additional care planning, intended to consider the social and recreational needs particular to persons with advancing dementia and around which programmes of more specialist individual care could be designed had not yet taken place. For similar reasons, work on including some life histories in residents’ files, and around which activities with residents might be based had not come about either. See Requirement Standard 27 Residents spoken with affirmed how, as was observed, members of staff were kindly and respectful and went about their duties with great consideration. One resident described staff as “A great bunch” adding that they were invariably helpful and friendly and a constant source of support. The prompt way in which staff responded to any health care needs was remarked on by a resident and the manager was able to confirm that the care home was well supported by local health services. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 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 The care home sets out to meet the expectations of its’ residents. EVIDENCE: As a result of mental frailty, only one resident was able to offer an objective view as to whether his expectations of life at the care home were matched by the actuality and his was an unreservedly positive endorsement. Great attention had been paid to his preferences and recreational needs and he described an unrestricted lifestyle in which, for example, he went out into the town, got up and went to bed at times that suited him, held a key to his room and that his room was fitted with satellite TV and telephone. He said he took meals where and when he wished to and that refreshments were available on request. Residents had enjoyed a number of additional activities. These included trips out in the mini bus, visits to the sea front and music hall, a summer barbecue, trip on the Norfolk Broads and some musical entertainment. A member of staff recounted that reminiscence sessions had also been held. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 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): 16 18 Any complaints received by the care home were carefully examined in line with Norfolk County Council procedure and acted upon. Residents were safeguarded from abuse by the training all staff underwent on their induction to the care home. EVIDENCE: The care home had a complaints procedure in place. A resident was able to relate he would have no hesitation in approaching the manager about any concern he might have. All members of staff had undergone the Norfolk County Council training programme regarding the protection of vulnerable adults from abuse. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 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): 19 26 The care home was clean, comfortable but orderly and appeared to be well maintained. EVIDENCE: Requirements and recommendations made at the previous inspection with regard to the environment had all been acted upon. Redecoration had taken place in the dining rooms and lounge and new carpets had been laid. The fire alarm board had been lowered so staff could reach it more easily. Although the call system and security alarms were fully functional, the manager had recently commissioned additional security precautions in response to a perceived problem. At the time of this unannounced inspection all areas of the care home were found to be clean and tidy and well maintained. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 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 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 Although the personal and health care needs of residents were well catered for members of staff had insufficient time to spare in which to develop programmes of recreational activities that might benefit residents suffering from advancing dementia. Recruitment procedures were thorough. EVIDENCE: The care home was adequately staffed to meet the daily personal care needs of residents, with 3 members of staff on duty at night, a care co-ordinator and care staff on duty each day (5 care staff in the mornings and 4 in the afternoon and evenings). The manager generally worked office hours throughout the week. There were additional, domestic-staff on duty in adequate numbers and catering was contracted out. However, members of staff spoken with felt they had insufficient time in which to develop programmes designed to stimulate residents or offer enjoyable pass times in. While the care home had an activities room available this had yet to be stocked or staff time found in which to make proper use of it. As a result, a requirement was made for the provider to review staffing levels with a view to ensuring essential social care needs could be better met. Recruitment of any new staff was managed by a specialist unit of Norfolk County Council, that oversaw the checking of all application forms, collected references and CRB checks and arranged for staff induction to take place. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 16 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): 3133 35 The care home had an experienced registered manager in post. Review of the quality of the service by the provider has yet to be implemented. Any cash held in safe keeping by the care home for residents was appropriately recorded. EVIDENCE: Since the time of the previous inspection an experienced manager has been appointed to the care home and has been registered with CSCI. The care home’s manager no longer has additional responsibility for the day centre attached to Mildred Stone House as this is now separately managed. Preparations have been made to ask residents, their relatives and members of staff their views on the care home and these questionnaires must be issued without further delay. Some residents have cash held for them in safe keeping by the care home and this is managed by a well maintained recording system. Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 17 Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 18 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 3 X 3 X X 2 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X X Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 19 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. 2 Standard OP7 OP27 Regulation 15 18 (1)a Requirement Timescale for action 31/03/06 3 OP33 24 (1) a Short Stay residents must have a care plan composed that reflects their needs The provider must review staff 30/04/06 levels with a view to ensuring the social and recreational needs of residents with increasing dementia can be recognised and met The planned collection and 30/04/06 review of the views and opinions of the service of residents, their relatives and staff members must proceed as planned without further delay 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 Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 20 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 Mildred Stone House DS0000034268.V283451.R01.S.doc Version 5.1 Page 21 - 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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