Inspection on 24/11/05 for Mill House, The

This inspection was carried out on 24th 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 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, The 04/12/06

Mill House, The 09/08/05

Mill House, The 15/02/05

Mill House, The 16/09/04

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

CARE HOMES FOR OLDER PEOPLE Mill House, The Kington Flyford Flavell Worcestershire WR7 4DG Lead Inspector Y South Unannounced Inspection 24th November 2005 09:10 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, The DS0000018688.V261929.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, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mill House, The Address Kington Flyford Flavell Worcestershire WR7 4DG 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) 01386 793110 01386 793110 Mrs Joanne Carroll Mr Anthony William Carroll Mrs Sandra Ann Wills Care Home 30 Category(ies) of Dementia - over 65 years of age (30) registration, with number of places Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may also accommodate people over 65 years of age who have an additional physical disability. 9th August 2005 Date of last inspection Brief Description of the Service: The Mill House is a care home for older people that currently provides residential accommodation for a maximum of 30 older people of either sex who have dementia related illnesses and may also have physical disabilities associated with old age. The home is situated in the countryside near to the village of Flyford Flavell. The building has been adapted and extended to meet the special needs of the people who live there. There are thirty single bedrooms each with en-suite facilities, four communal lounges, a dining room, a conservatory and two enclosed gardens. There is a shaft lift to enable access between floors. The home is privately owned by Mr and Mrs Carroll and is managed by Mrs Wills. Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place over two and a half hours from 9.10am until 11.45am. The inspector was assisted by senior care assistant Liz Cowell. She also spoke to three residents, and two members of staff. A partial tour of the building and a range of documents were seen. The focus of the inspection was on standards concerned with protection and rights, the premises, infection control, staffing and safety. A service questionnaire was completed by the home prior to this inspection and returned to the Commission for Social Care Inspection. The manager was asked to distribute other questionnaires regarding the service to residents, relatives and health care professionals. The completion of these is voluntary but proves useful in assessing the various views that are held. Five responses were received from relatives and one from a doctor. Service users were considered to be unable to comprehend the content and purpose of the questionnaire. What the service does well: The home provides a safe secure environment in which people with dementia illnesses are able to live in comfort and freedom. The house is spacious, clean, well maintained and furnished. The staff are kind, considerate and understanding. They receive excellent encouragement and access to training, which enables them to develop their knowledge and skills to care. Comments received in the questionnaire responses were: “Very satisfied. All wonderful. When my mother was ill the staff cared for her like their own relative. The home is excellent. I am very happy with the care my mother receives. A lovely environment. Kind, caring and happy. There is an understanding and sympathetic approach to both relatives and patients’ needs.” Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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, The DS0000018688.V261929.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, The DS0000018688.V261929.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): EVIDENCE: These standards were not assessed during this inspection. Mill House, The DS0000018688.V261929.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): EVIDENCE: These standards were not assessed during this inspection. However documents were seen that contained good records of care and health needs that had been met and the chiropodist and district nurse visited during the course of the morning to attend to service users. Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 10 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): EVIDENCE: These standards were not assessed during this inspection. Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 11 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, 17, 18 People have the information they need to advise them how to raise any concerns they may have. Policies, procedures and systems are in use to protect the interests of the service users. EVIDENCE: An acceptable complaint procedure was available but the complaint record was not. The service pre inspection questionnaire indicated that one complaint had been received in the past twelve months. The legal rights of service users’ were respected but it was acknowledge that they would not be able to comprehend the election process. None of the service users had an advocate but they had all given their Power of Attorney to a supporter. The home did not manage money for anyone. Invoices were raised and submitted for any expenditure. Policies, procedures and staff training were available to protect the service users from the risk of abuse. All staff had been suitably recruited. Risk assessments and care plans were available to advise and guide staff. Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 12 There was suitable secure storage for valuables and staff had received instructions not to accept gifts or bequests, or assist in the making of wills. Advice for relatives and service users regarding the insurance of their personal property was not seen but should be available. Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The service users are provided with the accommodation and facilities they need to enable them to live in comfort and security. Despite good training and systems risks of cross infection were raised by the condition of the laundry. EVIDENCE: A partial tour of the premises was undertaken. The home was clean, well maintained, decorated and furnished. The service users were wandering around and using the rooms according to their inclinations. Staff were visible and assisting them. Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 14 Policies and procedures were available relating to infection control and staff had received training. Liquid soap was not available in all communal bathrooms and toilets but this was because the supply had not yet been replenished that day. Appropriate laundry facilities and equipment were available but the laundry room was cluttered, untidy and in need of cleaning. The hand basin could not be reached. The walls were undergoing repair prior to retiling. A programme of routine maintenance and renewal of fabric and decoration was not available for inspection. Mill House, The DS0000018688.V261929.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, 28, 29, 30 The number of staff rostered on duty are able to meet the needs of the service users in the home. The recruitment process ensures suitable staff are appointed and appropriate training is provided to ensure the safety and care of service users. EVIDENCE: The home was appropriately staffed day and night to enable the service users to lead the life routines they chose. Care staff were supported by an ancillary staff team. The care staff team numbered 25 persons, 15 of whom were qualified to NVQ level 2 or above. A wide range of training had been achieved this year and individual training records had been maintained by the staff. The analysis of training achievements and a training and development programme were not available for inspection so it was not possible to see what the full picture was. The staff confirmed that they had or were receiving induction training and regularly received further training in excess of three days a year. There was no access to staff files but the senior care assistant confirmed that she had been recruited through an acceptable process. Mill House, The DS0000018688.V261929.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): 33, 35, 36, 38 The quality assurance system and policies and procedures, ensure that acceptable standards of care and service are provided. The service users’ are protected by the policies and procedures used in relation to finance. Staff would benefit from regular individual supervision to provide personal support and development. Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 17 EVIDENCE: Policies and procedures were available relating to the quality assurance system in use and it was confirmed that surveys were undertaken with relatives to discover their perception of the quality of the service. It was not known if the views of health care professional were also sought The audit and questionnaires were not available for the inspector to see. Nor was the annual development plan for the home. The senior care assistant confirmed that the manager was in the process of reviewing the contents of the policy and procedure manual. The home did not hold or manage monies for the service users. If they required any items, for example toiletries, these would be purchased and an invoice would be raised for the person holding power of attorney for the service user. Secure storage was available for items held in safekeeping and an entry was made in the service user’s care plan. The staff were not receiving supervision at the required frequency. A senior had recently received training and guidance and would be undertaking this responsibility. Able assistance was given to the inspector by the senior care assistant and the staff on duty. However it was apparent during this inspection that the senior staff did not have access to all the documentation referred to in Regulation 17 and listed in the schedules as is required in the legislation. It was advised that access should be made available and a location list be compiled to assist everyone in future. The inspector was informed the day after the inspection that this advice had been accepted and all relevant documents were now available. Therefore requirements and recommendations in relation to this have not been made in this report. The service pre-inspection questionnaire indicated that the equipment and systems in the home were being appropriately serviced and monitored. The fire log was not available to assess but the senior care assistant confirmed that the fire alarms were tested weekly and training scenarios were undertaken. Attendance records were seen for two fire drills. Training records for the quarterly fire safety training were not available. The other training records indicated that training was undertaken in health and safety matters. However it was not known how many of the staff had undertaken the four-day First Aid at Work course. This is the course necessary to qualify as a ‘First Aider’ and at least one such person should be on duty at all times. Mill House, The DS0000018688.V261929.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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 2 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 3 3 3 3 2 X X Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP26 OP36 Regulation 13 18 Requirement Laundry facilities must be maintained with due regard for the risks of cross infection. Care staff must received formal supervision at least six times a year. Timescale for action 30/11/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Mill House, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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, The DS0000018688.V261929.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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