Inspection on 31/08/06 for Mill House

This inspection was carried out on 31st August 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 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 29/11/05

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 Mr Ian Harris Key Unannounced Inspection 31st August 2006 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.V297493.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 DS0000030207.V297493.R01.S.doc Version 5.2 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.V297493.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 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. It was noted that the fees per week range from £295 to £307 Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection and took place over 5. hours in the presence of the Deputy Manager. 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. 2 members of staff 6 residents and 2 relatives were spoken to. On the day of inspection the atmosphere within the home was found to be warm, friendly and comfortable with contented residents. All the residents spoken who could express themselves in a meaning full way expressed their satisfaction with the care they received and there were comments as follows “ the food is good here” “We are well looked after here” “ The staff are very good they are like family and 2 residents said “this is a very nice home.” What the service does well: What has improved since the last inspection? Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 6 There is a good rolling programme of maintenance within and outside the home and it was noted that 3 bedroom and the ground floor lounge have been re-carpeted, radiator covers have been fitted throughout the home, new floor covering has been fitted to the hairdressing room. 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.V297493.R01.S.doc Version 5.2 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.V297493.R01.S.doc Version 5.2 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): 3 and 6 The home has a satisfactory admissions procedure ensuring the individual needs of the residents are fully met. The home does not provide intermediate care they only provide short stay and introductory stays when the home has a vacancy. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: All the residents who are funded by the Local Authority undergo a full multidisciplinary assessment prior to admission. The residents’ who are self funding are assessed by the Care Manager, using the homes assessment forms. Copies of the assessment, Care Plan and Reviews are on the residents’ files. The six care plans inspected contained pre admission assessments of the persons needs, both from assessments by the home’s staff and other relevant professionals. Mill House DS0000030207.V297493.R01.S.doc Version 5.2 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): 6, 7, 8, and 9 Each resident has a good comprehensive, individual care plan that ensues that residents’ health and social needs are met. 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 being in place to ensure resident’s medication needs are met. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. 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.V297493.R01.S.doc Version 5.2 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. The Care Manager said that the G.P. surgery is very close to the home and where possible residents are escorted to the surgery for appointments. 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. Medication is administered by means of a monitored dosage system. The system appears to be working very well. The home receives good support from the pharmacist who does a three monthly audit of the homes medication. All Senior Care Staff have been trained to use the system and Safe Handling of Medication before they are allowed to administer medication. The home has very good policies and procedures, which are used as an integral part of the staff induction programme. Mill House DS0000030207.V297493.R01.S.doc Version 5.2 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, 13, 14, and 15 The home provides a good programme of social activities within the home, which are designed to meet the resident’s capabilities, which, the staff encourage residents to pursue. However it was noted that there is very little take up by the residents and no outings have been provided this year. The Care Manager and staff encourage family and friends to maintain good contact with their relatives at the home. The meals in the home are good offering both choice and variety and also catering for special dietary needs. The quality outcome in this area is adequate. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home does not have a staff member designated to organise social and leisure activities. However the key-workers identify interests that the residents wish to pursue. It was also noted that shopping trips or outings outside of the home were not taking place. The staff at the home encourage relatives and friends to maintain good contact with the residents and during the inspection there were two visitor in the home and they confirmed that they are always made welcome when they visit the Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 12 home. They also stated that this was a very good home and particularly with good caring staff. The observations made, examination of menus and the comments received from the residents and relatives confirmed that there is a good choice at meal times and particular attention is given to the residents’ individual preferences. Mill House DS0000030207.V297493.R01.S.doc Version 5.2 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 18 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 The home has good policies and procedures regarding protection from abuse, which includes a whistle blowing policy. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home has a very good 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, which a copy is issued on admission to the home. Also a copy is placed in the reception hall. The home has a complaints book in which all complaints are recorded. It was noted that the home has not received any formal complaints since the last inspection all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. These issues are also covered in internal and N.V.Q. training, which all care Staff is undergoing. Mill House DS0000030207.V297493.R01.S.doc Version 5.2 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 is good providing the residents with a comfortable, homely and safe place to live. The home was found to be clean tidy and free of unpleasant odour. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home is long established and has undergone alterations over the years in order to provide appropriate accommodation for older people. All the bedrooms are of good size with en-suite facilities. The home is maintained to a good standard. There are plan in hand to extend the home and any major redecoration work is on hold until to extension has been completed. However new floor covering has been fitted to 3 bedrooms, the ground floor lounge and the hairdressing room. It was noted that the floor covering in room 9 and 21 needs replacing and the ground floor lounge should be redecorated. It was also noted that the Patio flagstones in the rear garden are very uneven and Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 15 need to be relayed. A bin store should be provided to screen the bins and keep them safe and improve the view in the garden. 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. From observations and discussions with staff they appeared to be conscious of the dangers of cross infection. Mill House DS0000030207.V297493.R01.S.doc Version 5.2 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): 27, 28, 29, and 30 The home is well staffed with adequate numbers and skill mix of staff. The staff have a very good understanding of the residents support needs. The home has good policies and procedures regarding the recruitment of staff. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The inspection of staff rotas and discussions with staff indicated that the home is well staffed. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career. It was noted that there have been minimal staff changes since the last inspection The home operates an acceptable recruitment procedure. On inspecting 6 staff files, there was evidence within them that all C.R.B. checks are being carried out. The Care Manager and staff are committed to developing their knowledge and skill through training. The home has a very good induction programme and training programme. In addition to the N.V.Q. 2, 3 and 4 training programme the Manager is undergoing the Registered Managers Award. Also all of the care staff have attended training courses on the following subjects. Safe handling of medication, Risk assessment, Dementia care, Manual Handling, First- Aid, Infection and Fire Prevention. Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 17 Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 18 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, 33, 35, and 38 The home is well managed, where service users interests and welfare is promoted. The home is operating a good system to assist residents with the safe handling and keeping of their personal finances and good records are being kept of all transactions made. The records inspected, were found to be well ordered and maintained. The home has good policies and procedures regarding Health and safety The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home is well managed by the Care Manager who is qualified in both practice and management and has considerable experience in caring for older people in residential homes There are clear lines of accountability within the home and is very supportive of both staff and residents. Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 19 Observations made and discussions with residents’ and staff indicated that the Care Manager is very approachable and operates an open door policy. The staff and service users who could express themselves stated that they are happy to approach the Care Manager and staff with any problems they might have and were confident that they would be responded to. There is a good staff supervision system in place and there is evidence that the staff have regular supervision meetings. 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 using photographs where necessary and this was confirmed by the residents who could express themselves in a meaningful way. There are regular residents and relatives meetings where residents are consulted about menus and entertainment etc. All the Financial records and administrative procedures within the home that were, inspected were found to be well ordered and maintained. The home has a good heath and safety policy and all staff are aware of their responsibilities regarding these issues and a number of staff have received training on these issues. All recommendations and requirements made at the last inspections of the Fire Prevention Officer and Environmental Health Officer have been actioned. All safety equipment is regularly checked and well maintained. Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 20 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Mill House DS0000030207.V297493.R01.S.doc Version 5.2 Page 21 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. 1. Standard OP22 Regulation 16,23 Requirement 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. The Registered Providers must ensure that the ground floor lounge is redecorated. The Register Providers must ensure that the floor covering in rooms 9, and 21 are replaced. The Registered Person must provide a bin store in the rear garden to protect the bin and improve the view in the garden. The Registered Person must ensure that residents are give the opportunity of regular outings and trips outside of the home. The Registered Person must ensure that the broken and uneven Patio flagstones in the DS0000030207.V297493.R01.S.doc Timescale for action 01/10/06 2. OP19 23 01/10/06 3. OP19 23 01/10/06 4 OP19 23 01/10/06 5 OP13 16 (2) (m) 01/10/06 6 OP19 23 01/10/06 Mill House Version 5.2 Page 22 rear garden are replaced and relayed. 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.V297493.R01.S.doc Version 5.2 Page 23 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. 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