Inspection on 02/12/05 for Mill Brow Care Home

This inspection was carried out on 2nd December 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 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

Mill Brow Care Home 28/06/07

Mill Brow Care Home 17/07/06

Mill Brow Care Home 28/06/05

Mill Brow Care Home 11/01/05

Mill Brow Care Home 22/07/04

Mill Brow Care Home 11/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Mill Brow Care Home Mill Brow Care Home Mill Brow Road Widnes Cheshire WA8 6QT Lead Inspector Wendy Smith Unannounced Inspection 2nd December 2005 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Mill Brow Care Home DS0000005173.V266963.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. Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mill Brow Care Home Address Mill Brow Care Home Mill Brow Road Widnes Cheshire WA8 6QT 0151 420 4859 0151 424 0186 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) Laudcare Ltd (a wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Elizabeth Carson Care Home 52 Category(ies) of Dementia (1), Old age, not falling within any registration, with number other category (52), Physical disability (2) of places Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to a maximum of 52 service users in the OP (older pesons) category may be accommodated. * Within the 52, 1 named service user in the DE(E) (dementia over 65 years of age) category may be accommodated. * Within the 52, 1 named service user in the category PD (physical disability) over the age of 39 years may be accommodated. * Within the 52, 1 named service user in the category PD (physical disability) over the age of 50 years may be accommodated. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection. 28th June 2005 2. 3. Date of last inspection Brief Description of the Service: Mill Brow is a purpose built two-storey care home situated in the Mill Brow area of Widnes. The home is within a mile of Widnes town centre and is close to local shops and other amenities. It is accessible by public transport and convenient for the motorway network. The home provides care for older people requiring either nursing or personal care. It is registered to accommodate 52 residents, however the maximum is usually 47 as rooms that were formerly shared by two people are now singly occupied. On the ground floor there is a large lounge and a spacious dining room. On the first floor there is a lounge and a hairdressing room. There is a car park to the front of the home and a garden to the rear. Mill Brow Care Home DS0000005173.V266963.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 on 2nd December 2005 over a period of four hours as part of the Commission for Social Care Inspection’s statutory inspection programme. A tour of the building, including all communal areas and a number of bedrooms, was completed. The arrangements for the handling of residents’ money were examined with the home’s administrator. Staff training records were inspected. The storage and handling of medicines were inspected. On the day of the inspection 39 residents were living at the home. Of these, 24 were receiving nursing care and 15 were receiving personal care. A number of staff and residents were spoken with. Information was provided by the registered manager. What the service does well: What has improved since the last inspection? There have been some improvements to the environment including remedial work in the grounds, new flooring in the dining room, and refurbishment of a number of bedrooms. The standard of the care plans had improved. There was evidence to show that plant and equipment in the home was serviced and maintained as required, and the records were more orderly. Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 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. Mill Brow Care Home DS0000005173.V266963.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 Mill Brow Care Home DS0000005173.V266963.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): Not inspected on this visit. EVIDENCE: Mill Brow Care Home DS0000005173.V266963.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, 9 and 10. Each resident has a care plan and the care plans inspected had been completed to a good standard. Nursing staff do not always meet the requirements for the handling, storage and recording of medicines. The privacy and dignity of residents are respected. EVIDENCE: A sample of care plans was inspected. The care plans are kept in the offices on the ground and first floors. All of the care plans looked at contained evidence that the resident had been assessed prior to admission and then a full assessment had been carried out following admission; these assessment documents had been reviewed each month. Daily entries made in the care plans contained relevant comments and provided evidence that staff were monitoring residents health and well-being on a daily basis. They also recorded visits from health care professionals. Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 Page 10 Four Seasons Healthcare provides policies and procedures relating to medicines. Medicines are handled and administered only by qualified nurses, however there are plans in place for senior care staff to receive training that will enable them to administer medicines to residents receiving personal care. Arrangements for ordering, receipt, storage, administration and disposal of medicines were reviewed. Repeat prescriptions are ordered monthly from GP surgeries and the prescriptions are checked at the home before being sent to the pharmacy. A monitored dosage system is in use. All items received had been signed in on the medicine administration record sheet and quantities received were recorded. Storage facilities were tidy. A controlled drug was being stored in the ground floor medicine trolley and the recording of controlled drugs was unsatisfactory. Only one signature had been recorded in the controlled drugs book on a date earlier in the week, and the controlled drugs book had been filled in and signed by 1pm, ahead of the evening dose being administered. The manager said that she would pursue this as a disciplinary matter with the nurse concerned. See requirement Administration records were satisfactory apart from a small number of missing signatures. Eye drops had not been dated on opening there was some old stock of discontinued medicines still in the trolleys. Records are kept of unused items returned to the pharmacy. See recommendation Staff were observed to have a pleasant and respectful attitude towards residents and residents spoken with expressed their satisfaction with the staff and with the manner in which care was delivered to them. Mill Brow Care Home DS0000005173.V266963.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): 14 and 15. Residents are able to exercise choices in daily living. Residents receive a nutritious diet, however menus could be improved. EVIDENCE: Most residents have personalised their bedrooms with their own belongings including pictures, ornaments and items of furniture. Care plans record residents’ personal choices including preferred times of rising and retiring. Some residents were having lunch in the ground floor dining room, some in the first floor lounge and some in their bedrooms. Residents are encouraged to use the dining room but some choose not to. Lunch consisted of soup and sandwiches, the main meal is at 4:30pm. A resident spoken with said that there was ‘plenty of food’. Breakfast is served between 8am and 11am and a cooked breakfast is provided every day for any residents who wish to have this. There were no menus displayed for residents. The chef had copies of the Four Seasons menu that he followed. See recommendation Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 Page 12 The manager considered that a better choice of meals could be offered, for example the following day the choice of main meal was gammon or kedgeree, which may not suit the needs or preferences of many residents. The manager said that she intended to review the menus with the chef, and make changes where identified to meet the needs and preferences of residents. The chef also confirmed that, when a resident does not wish to have the meal on the menu, he is able to provide an alternative for them. See recommendation Mill Brow Care Home DS0000005173.V266963.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): 18. Residents are protected from abuse. EVIDENCE: Four Seasons Healthcare provides policies and procedures for adult protection and these are consistent with the Department of Health ‘No Secrets’ guidance. Four Seasons also provides a training package relating to abuse and all staff working in the home, with the exception of the two most recent members of staff, have received this training. Mill Brow Care Home DS0000005173.V266963.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): 19. Some improvements have been made to the environment, but there is room for further improvement in communal areas and to the grounds. EVIDENCE: Some remedial work has been carried out in the grounds, including re-building the steps to the kitchen, but a security fence planned to combat vandalism has not yet been erected. Parts of the grounds of the home need attention to keep them in a tidy condition and prevent them from being overgrown with weeds. See recommendation Some bedrooms have been redecorated, re-carpeted and have new furniture and this work is ongoing. New flooring has been laid in the dining room and the manager said that the two lounges and the dining room will be redecorated after Christmas. The upstairs corridor would benefit from redecoration and some parts of the corridors are poorly lit. See recommendation Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 Page 15 Two bathrooms on the first floor were being used for storage and one on the ground floor was out of use. One bathroom on each floor was identified as being in need of redecoration. See recommendation Mill Brow Care Home DS0000005173.V266963.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): 30. Staff receive training to enable them to carry out their work. EVIDENCE: Rotas showed that a sufficient number of staff is provided to meet the needs of residents. There is a registered nurse on duty at all times with six care staff in a morning, five in the afternoon/evening, and three at night. Two staff work in the kitchen throughout the day, there are two cleaners each day, and the laundry is staffed in a morning and evening. At the time of the inspection the nurse on duty administered medicines to all residents, but the manager said that senior care staff will receive appropriate training to enable them to administer medicines for residents receiving personal care. The home has two adaptation students who are overseas nurses working towards registration as nurses in the UK. Four Seasons Healthcare provides a programme of induction training for all new staff. Staff have received statutory training, and additional training from the continence service and from Age Concern. Four members of care staff are working towards NVQ level 2 and five more are intending to start in January 2006. Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 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 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): 33, 35 and 38 Quality assurance systems ensure that the home is run in the best interests of residents. Residents’ personal money is handled appropriately. Health and safety safeguards are in place. EVIDENCE: The home is being reorganised so that residents receiving personal care are accommodated on the ground floor and those receiving nursing care are on the first floor. A meeting was held for residents and their relatives to discuss the planned changes but this was poorly attended. Individual residents who have been directly affected by these changes, and their families, have been consulted at all stages of the process. Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 Page 18 Satisfaction surveys are carried out by Four Seasons. Visits required by regulation 26 of the Care Homes Regulations are carried out each month by the area manager. The manager carries pressure sores and medicines. The home inspection carried out out a weekly audit of ‘residents at risk’ which includes accidents, and a monthly audit of care plans and is also audited by Halton Borough Council and had a full by them in February 2005. The home does not handle any money belonging to residents except for personal spending money. This is deposited into a non-interest bank account and a float is kept in the home’s safe. Receipts are given to relatives who bring in money. Written and electronic records are kept and statements are sent out monthly by the home’s administrator. Two residents manage their own finances and one has appointeeship through social services. The home’s electrical installation certificate was renewed on 7th October 2005, and the gas safety certificate in July 2005. Hoists were serviced in June 2005 and the passenger lift in October 2005. A fire drill was held in November and fire training was arranged to be provided during December 2005 and January 2006. Manual handling training was provided for staff in May 2005 and was booked again for February 2006. A local college is providing health and safety training for the home. The first 12 members of staff have almost completed this training and the next group will start early in the new year. Health and safety records were kept in a more orderly and accessible form than at the last inspection. Mill Brow Care Home DS0000005173.V266963.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement Controlled drugs must always be stored and recorded to comply with the Misuse of Drugs Act 1971 Timescale for action 02/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP9 OP15 OP15 OP19 OP19 Good Practice Recommendations Eye drops should be dated with the date of opening to ensure that they are used within the recommended timescale. Menus should be reviewed to ensure that there is always a good choice available for residents. Menus should be displayed for residents. A programme of planned redecoration and refurbishment should continue. The grounds of the home should be improved to prevent unused areas from being overgrown with weeds. Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Mill Brow Care Home DS0000005173.V266963.R01.S.doc Version 5.0 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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