Inspection on 16/11/06 for Mill House

This inspection was carried out on 16th November 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

Mill House 14/11/08

Mill House 27/09/05

Mill House 14/04/05

Mill House 29/09/04

Mill House 09/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Mill House Salters Lane Faversham Kent ME13 8ND Lead Inspector Graham Cummings Key Unannounced Inspection 16th November 2006 09:30 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 Mill House DS0000023494.V320332.R01.S.doc Version 5.2 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 House DS0000023494.V320332.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mill House Address Salters Lane Faversham Kent ME13 8ND 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) 01795 533276 Mrs Renuha Francis Mr Niranjan Romand Francis Mrs Heather Karslake Care Home 24 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (23) of places Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2005 Brief Description of the Service: Mill House is a large detached property, which is a listed building situated a few minutes from Faversham town centre. Faversham is a town steeped in history with a railway service to most parts of Kent. The M2 motorway is nearby and there is a shop within walking distance of the Home. The Home is registered to provide personal care and support to 24 Service users who are over the age of 65 years. The property has been adapted for its present use and the Provider has completed an extension and alterations to provide further en suite bedrooms. Most of the accommodation is provided in single rooms, however there are three rooms for shared occupancy. All bedrooms have a call bell system, telephone point and television point. The Home has a large rear garden with an ornamental fishpond, bird aviary and seating for Residents. There is off road parking for several cars. The individual fees range from £370 to £400 per week. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key Inspection site visit was carried out on the 16th November 2006. Prior to the site visit the Inspector had looked at previous inspections and the completed Pre Inspection Questionnaire. The Inspector then completed the Inspection Record. During the Site visit the Inspector viewed 4 Service User and 2 Staff files. The Inspector spoke to the Manager and 3 Service Users and was able to observe the contact and interaction between staff and Service Users for most of the site visit. The home is registered for 24 and presently has 21 Service Users residing. The latest admission was on the 8/11/06 and the Inspector saw a pre placement assessment carried out by the Manager and a funding authority assessment of need. The Manager has agreed a probation period for the placement to ensure compatibility with other Service Users. The Inspector looked at 4 care plans and found that they contained adequate information for staff to be able to meet their individual needs of Service Users, the plans had been reviewed at regular intervals. The latest admission had the 2 assessments in place with the care plan being written and would be completed in the very near future. The home recorded daily activities that Service Users participated in and the Inspector observed and witnessed some of these activities taking place. These included listening and singing to music, catch and Velcro darts. Neither the home nor Commission have received any complaints or concerns since the last inspection. The Inspector looked through the environmental risk assessments and found them to be comprehensive and informative. The home has put a fire risk assessment in place for each bedroom outlining the mobility of the Service User and the location of the bedroom. There were risk assessments in place for the cleaner and handy person. Regular weekly checks of the hot water temperature were also carried out. Some redecoration of skirting boards would beneficial as they have been chipped and scraped by the use of moving aids. The home is now fully staffed and 2 staff files were looked at, 1 file had no identification photo and the 2nd one had a CRB from the previous employer. The Manager said that a new CRB would be applied for immediately and that a photo would be on file as soon as possible. Supervisions were being carried out for 1 staff member the 2nd had only 3 supervision notes on file since January 2006. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 6 Staff training is good and the Manager has an Induction training programme that they complete with all new members of staff. The training matrix showed that approximately 75 of staff had an NVQ level 2 or above in care. The Manager has successfully completed their NVQ 4. The Manager is to have a meeting with the provider to plan the training required for next year, the Inspector and Manager agreed that it would be essential for all staff to attend training in Dementia care as some Service Users were being assessed with the onset of dementia. The staff rota showed that there are 3 staff on duty from 8am to 8pm with the Manager supporting the staff when required. It appears that the Manager does spend a considerable amount of time supporting the staff team in caring for the Service Users and has some difficulty in completing the management tasks required. The home could benefit from looking at the staff structure in place and reorganise it to give the Manager more support. The Manager has recently completed a Quality Assurance survey with Service Users about the care they receive and how it could be improved, results have been acted upon and a wider range of activities have been purchased. The overall results of the survey showed that Service Users were happy and enjoyed living at Mill House. The Inspector recommended that the month and year should be included on the document as there was no evidence of when it was completed. What the service does well: What has improved since the last inspection? Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 7 The home did not have any Requirements from the last inspection and had 3 Recommendations. The home has addressed all 3 with 1)activities being recorded and filed in individual files. 2) The complaints policy and procedures are available by the front door with extra copies for visitors to take. 3) The Manager has been monitoring the staffing and meeting of Service User needs and is looking to meet with the Provider in the new year to discuss training and management support. Some bedrooms have been redecorated and 2 new televisions purchased. The home have also bought another hoist. 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. The summary of this inspection report can be made available in other formats on request. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 8 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 House DS0000023494.V320332.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5,6 Quality in this outcome area is good. Prospective Service Users have the information required to make an informed choice. Service Users have written contracts and pre placement assessments are carried out prior to placement. Prospective Service Users and relatives are able to visit the home prior to any placement. The home does not take intermediate care Service Users. This judgement has been made using available evidence including a visit to this service. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 10 EVIDENCE: The home has a Statement of Purpose and Service User Guide that reflects the care provided. The Inspector spoke to the Manager and looked at 4 Service User files and found that they all contained contracts and terms and conditions along with pre placement assessments carried out by the Manager. The Inspector was informed that following the assessments, Service Users and their relatives were invited to view the home, this allowed for existing Service Users to meet with the prospective Service User as well. The home does not cater for Service Users requiring Intermediate care. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. Service Users’ health, personal and social care needs are fully set out in an individual plan of care. Service Users’ wishes regarding illness and death are recorded and their health care needs are fully met. Service Users do not self medicate and they are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector looked at 4 Care plans and found them to contain adequate information that would give a new member of staff good information about the care that an individual required. Pre placement Assessments, funding authority assessments were on file, risk assessments with information about how the Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 12 risk could be reduced and activity charts were on all files seen. A few of the documents seen were not signed or dated. All of the Service Users are registered with a local GP, Dentist and Optician, none of the Service Users self medicate, the home does have a policy and procedure in place should this ever change. The Inspector saw the comments and wishes of Service Users regarding their death recorded on their files. The Inspector was based in the dining area for a lot of the Inspection and was able to observe staff and Service User interaction. Staff were polite and asked Service Users if they wished to participate in the activities on offer and also reacted in a positive manner to individual needs of Service Users who required support with eating their breakfast. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Service Users’ lifestyle matches their expectations and preferences. Service Users maintain contact with family and friends and are supported in to exercise choice over their lives. Service Users receive a wholesome and nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users were observed being offered and participating in several activities during the morning, this included a game of catch/throwing and Velcro darts. The activities caused some laughter and positive communication with Service Users enjoying sometimes missing the target and hitting the staff member. Some Service users go out by themselves and let the staff know an approximate return time, these outings are usually to the same place and staff know where they can be located in an emergency. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 14 Service Users families can visit at any time and during the inspection several visitors arrived to spend time with their relative or friend. Service Users also go out with family, usually into Faversham town, a Service User spoken to said ‘the problem about going out is that someone has to push the wheelchair, we now get a taxi to and from town’. One of the visitors had brought a small dog with them and a Service User was very happy to have the dog on his lap and stroke it. The menu was on display in the dining area and it was down as roast chicken, potatoes and vegetables followed by fruit crumble, tea was spaghetti on toast. One Service User spoken to said, ‘the food is always good’. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Service Users can be confident that the home takes all complaints seriously. Service Users can be confident that they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a supply of Complaint forms with policies and procedures by the front door so that they are available to relatives and friends. The Inspector looked at risk assessments on 4 Service User files and the environmental risk assessments that were in place to protect Service Users and found them to have been evaluated at regular intervals. Staff training also was looked at and in the near future staff will need to attend a refresher course on Protecting Vulnerable Adults. As the needs of the Service User group changes, the staff team will need to be prepared and trained to met these needs, mainly in dementia care. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. Service Users live in a clean, hygienic, safe, well-maintained and comfortable surroundings. Service Users have sufficient bathrooms and specialist equipment to meet their needs. Service Users benefit from having access to ample communal areas. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector did not tour the home fully, this was carried out at the last inspection and the manager informed the Inspector that nothing had changed. The downstairs area was clean and tidy and there were no offensive odours. The home has 6 bathrooms and 12 of the bedrooms are en-suite. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 17 The Inspector looked at environmental risk assessments that were reviewed 3 monthly with the next due date being tomorrow 16/11/06. Health and Safety checks that included hot water temperature and fire alarm tests were carried out weekly. The home had also got risk assessments for the Cleaner and Handyperson. A new hoist has been purchased and has improved the comfort and ability of moving Service Users to different areas of the home with minimal disruption. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Service Users are mainly protected by the home’s recruitment policy. Service Users have their needs met by a staff team that are trained and competent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is now fully staffed and 2 staff files were looked at, 1 file had no identification photo and the 2nd one had a CRB from the previous employer. The Manager said that a new CRB would be applied for immediately and that a photo would be on file as soon as possible. Apart from this the files were complete and met with all other standards. The staff team have access to good training and have over 60 of staff with an NVQ. The Manager is meeting with the provider in the New Year to plan the training requirements for staff. The Manager and Inspector agreed that it was essential for all staff to attend training in Dementia care and Adult Protection. Training that has taken place in the last few months include 1st Aid and Fire protection. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 19 The Manager has an Induction training package that covered all of the required areas, the training is overseen by the Manager. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is good. Service Users live in a home that is well managed and run in their best interests. Service Users can be confident that their financial interests are protected. The quality of care of Service Users may be compromised because not all staff have regular supervision. Service Users’ best interests are safeguarded by the home’s record keeping. Service Users health, safety and welfare are promoted and protected. This judgement has been made using available evidence including a visit to this service. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 21 EVIDENCE: The Service Users spoken to said that they were happy at the home and that the Manager was ‘very nice’. The Manager has now completed their NVQ level4 and has the certificate on display. The Inspector spent some time talking to the Manager about the home and the support they received. The Manager is looking to meet with the provider in early January 2007 to discuss the staffing structure at the home and look at ways of strengthening it. Supervisions were being carried out for 1 staff member but the 2nd had only 3 supervision notes on file since January 2006. The Manager needs to ensure that all staff receive a minimum of 6 supervisions a year. The records seen were good and the daily reports were very detailed. The Manager had completed a Service User survey to look at their wishes and try to implement them. The survey was anonymous but there was also no date of when it was carried out. The Inspector judged that Service Users health, safety and welfare are being promoted and protected. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 22 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 3 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 3 Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 23 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, Carehome’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19(1)(b) Requirement The Registered person shall not employ a person to work at the care home unless – they have obtained the documents specified in Schedule 2. The registered person shall ensure that the persons working at the care home are appropriately supervised to a minimum of 6 times a year. Timescale for action 31/01/07 2. OP36 18(2) 31/01/07 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. Refer to Standard OP19 OP30 OP31 Good Practice Recommendations The home would benefit from the skirting boards being repainted. That staff would benefit from having training in caring for Service Users diagnosed with Dementia. The Manager, and therefore the home, would benefit from a staffing structure that included more Management support. DS0000023494.V320332.R01.S.doc Version 5.2 Page 24 Mill House 4. OP37 That all documents should be signed and dated to show when they were completed and enable evaluation dates to booked in the diary. Mill House DS0000023494.V320332.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 House DS0000023494.V320332.R01.S.doc Version 5.2 Page 26 - 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!