Inspection on 29/11/05 for Mill House

This inspection was carried out on 29th November 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

Mill House 04/06/10

Mill House 11/08/08

Mill House 13/08/07

Mill House 31/08/06

Mill House 21/04/05

Mill House 26/11/04

Mill House 07/07/04

Mill House 29/01/04

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

CARE HOMES FOR OLDER PEOPLE Mill House 51 Mount Pleasant Bilston Wolverhampton West Midlands WV14 7LS Lead Inspector Ian Harris Unannounced Inspection 29th November 2005 08:00 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 House DS0000030207.V261535.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 House DS0000030207.V261535.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mill House Address 51 Mount Pleasant Bilston Wolverhampton West Midlands WV14 7LS 01902 493436 01902 493436 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) Mr Ragavendrawo Ramdoo Mrs Bernadette Ameranmerion Ramdoo Janice Parker Care Home 24 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (24) of places Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st April 2005 Brief Description of the Service: Mill House provides care for twenty-four older people who have some form of Mental illness, but who are not in need of skilled nursing care. The home is located on a main road with ease of access to the local high street and all of its amenities. Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 5 hours. The main purpose of the inspection was to check the progress made by the home regarding the recommendations and requirements made in the last inspection report. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 5 of the 20 care staff were on duty, and 8 of the 24 residents were spoken to. All the residents who could express themselves in a meaningful way stated that they were happy and contented and, “well looked after” “The girl are very good” and “ I wouldn’t know how I manage without them” were some of the comments made. What the service does well: What has improved since the last inspection? There is a good rolling programme of maintenance within and outside the home and it was noted that 5 bedroom have been re-carpeted, radiator covers have been fitted throughout the home, new floor covering has been fitted to Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 6 the hairdressing room, and more pictures and bedside lighting has been provided. Also a new staff-training programme has been introduced to the home and the service user guide has been updated. 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 House DS0000030207.V261535.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 House DS0000030207.V261535.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): 2 and 4 The home provides clear and accurate information to prospective residents on the services provided, enabling them to make a properly informed choice about the home. All residents are given a written contract on admission to the home. EVIDENCE: Each resident is provided with a detailed service users guide and statement of terms and conditions when they move into the home. Residents are encouraged to visit the home prior to admission. An introductory visit is always offered to prospective residents, on some occasions the visits are declined and relatives visit on behalf of the prospective resident prior to admission. A trial period is included in the statement of terms and conditions of residence and the homes contracts. It was confirmed by a resident recently admitted to the home that they had been invited to the home for lunch before moving in. A trial period is included in the statement of terms and conditions of residence and the homes contracts. Mill House DS0000030207.V261535.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, and 9 Each resident has a comprehensive, individual care plan that is reviewed on a monthly basis. The home has good contact with local G.P. s. local hospitals and paramedical services, which ensures that resident’s health needs are met. The systems for the administration of medication are good with clear and comprehensive recording arrangements are in place to ensure resident’s medication needs are met. EVIDENCE: The home provides a comprehensive Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out and reviewed on a monthly basis. Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 10 The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures that, these services are provided by local practitioners. The records indicate that resident’s medical needs are being met. Medication is administered by means of a monitored dosage system. From observations made and inspection of the records, the system appears to be working very well. The home receives good support from the local pharmacist however three monthly audit of the homes medication are not taking place. All Care Staff have been trained to use the system before they are allowed to administer medication. The home has very good policies and procedures which are an integral part of the staff induction programme. Mill House DS0000030207.V261535.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): 12 and 13 The home provides a good programme of social activities within and outside of the home, which are designed to meet the resident’s capabilities. The meals in the home are good, offering both choice and variety and also catering for special dietary needs EVIDENCE: There was evidence that the home provides an activities programme in accordance with the service users’ choices, preferences and capacities in relation to – social and leisure activities and cultural interests. Records of activities enjoyed by the service users are maintained. They include Musical evenings, Music and movement, Church services, shopping trips to the local shops and Pub Lunches. There was evidence to show that the home welcome the service users’ relatives and friends to visit the home at reasonable times. The visitors’ book showed considerable activity. All relatives and friends who spoke to the Inspector said they are given a warm friendly welcome by all the staff whenever they visit. The observations made, examination of menus and the comments received from the residents and their relatives confirmed that particular attention is given to the residents’ individual preferences. Comments made by residents Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 12 regarding the quality, quantity and variety of food provided were highly complimentary. Mill House DS0000030207.V261535.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): 16 and 17 The home has a satisfactory complaints system and there is evidence that residents’ and their families feel that their views are listened to and acted upon All residents are assisted to exercise their legal rights, either by family, staff or where appropriate by an advocate provided by Care Aware. EVIDENCE: The home has a comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence the service users guide and copies are also placed on the notice board in the hall. The home has a complaints file in which all complaints are recorded. It was noted that the home has not received any formal complaint since the last inspection and all minor complaints are dealt with appropriately and quickly. Residents are assisted to exercise their legal rights, either by family or care staff. All permanent residents are registered on the electoral register to vote. They may vote if they wish either by post, or they are assisted to go to the polling station if this is requested and most residents voted in the last general election. Mill House DS0000030207.V261535.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 and 26 The standard of the environment within the home and the garden is very high providing the residents with a very attractive, comfortable, homely and safe place to live. The home was found to be clean tidy and free of unpleasant odour. EVIDENCE: The home is well established and has undergone alterations over the years in order to provide appropriate accommodation for 24 older people. The home has a rolling programme of redecoration and refurbishment and is maintained to a high standard, as are the gardens and grounds and provides a very comfortable homely and safe atmosphere. It was noted the home has not yet undertaken an assessment in all of the premises and facilities by suitably qualified persons including an Occupational Therapist and that a suitable loop system is also provided in the home. The home was found to be clean and tidy and free from odour. The home has good policies and procedures regarding infection control and the staff have received training in food hygiene and Infection Control. Mill House DS0000030207.V261535.R01.S.doc Version 5.0 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 and 30 The home is staffed to a level that ensures that service users’ needs are met at all times. There is a stable staff group working positively and enthusiastically to provide the residents with a quality of life that meets their individual requirements and aspirations There is a good training programme in place that ensures the staff are competent to do their job. EVIDENCE: The inspection of staff rotas and discussions with residents and relatives all indicated that the home is well staffed by caring competent staff. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career. All staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training activities. The home has a programme of N.V.Q. training has now exceeded the minimum standard. Also the care staff have attended courses on Safe handling of medication, Risk, Dementia care, and Moving and lifting, Emergency First Aid, Dealing with Challenging Behaviour and Fire Prevention. However it was noted that does not have any staff trained in First Aid at work. Mill House DS0000030207.V261535.R01.S.doc Version 5.0 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): 31,32, 34 and 36 The manager has very good leadership skills and has a clear development plan and vision for the home, which she has effectively communicated to the residents’, staff and relatives. The home is well managed, where service users interests and welfare are well processed and promoted. The home is operating a good system to assist residents with the safe handling and keeping of their personal finances EVIDENCE: The Care Manager is a qualified in both practice and management and has considerable experience in caring for older people in a residential home settings. She has very good links with other agencies whom she consults with in order to improve the service provided by the home. There are clear lines of accountability within the home and the manager is very supportive of staff and residents. Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 17 Observations made and discussions with residents and staff indcated that the Care Manager is very approachable and operates an open door policy. The staff and residents who could express themselves stated that they are happy to approach the Care Manager with any problems they might have. The routines and activities within the home are flexible and built around the needs of the residents. There was also evidence to show that staff consult with the residents regarding the choice of meals and activities within the home. The home has introduced a quality assurance system into the home to monitor performance. However it was noted that copies of the regulation 26 visits to the home are not being sent to the commission. All the Financial records and administrative procedures within the home that were, inspected were found to be well ordered and maintained Mill House DS0000030207.V261535.R01.S.doc Version 5.0 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 X 3 X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 X 2 X X Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 01/03/06 1. OP22 2. OP30 3. OP33 The Registered Providers must ensure that an assessment of the premises and facilities is undertaken by a suitably qualified persons, including an Occupational Therapist, and that a suitable loop system is installed in the lounges. 12, 13, 16 The Registered Providers must and 23 ensure that there is a fully qualified First-Aider on duty on all shifts. 26 The registered person must ensure that a copy of the the report of the monthly regulation 26 visits to the home is sent to the commission. 16,23 01/03/06 01/01/06 Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 20 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 Mill House DS0000030207.V261535.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 House DS0000030207.V261535.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. 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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