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Inspection on 12/08/05 for Milldene Nursing Home

Also see our care home review for Milldene Nursing Home for more information

This inspection was carried out on 12th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and staff make visitors very welcome and are relaxed and articulate when describing what the home has to offer and the care needs of residents. The premises are pleasant, very clean and tidy with good personal touches to bedrooms and lounge areas. Staff are well trained and supported and they speak highly of the manager and her hands on input and approachability. Information about staff is well recorded and record keeping in general is very well organised and presented. Residents, comments included: `I am very happy here` `All the staff are kind and take good care of me`. Health and social care needs are appreciated, well understood and efficiently managed. Residents` monies are handled correctly.

What has improved since the last inspection?

The manager has made impressive improvements to the running and efficiency of the home. Progress has been made with care planning and how care is delivered. Record keeping is better and more organised. The staff situation is more stable and staff are happy and feel valued and well supported. Also they are receiving good training that helps them to do their jobs well and keep residents safe and well cared for. Plans for improvements to the premises are in place and have been shared with CSCI.

CARE HOMES FOR OLDER PEOPLE Milldene Nursing Home 34 Field Street Off Station Road, South Gosforth Newcastle upon Tyne NE3 1RY Lead Inspector Kathryn Reid Unannounced 12 August 2005 10:00 th 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 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. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Milldene Nursing Home Address 34 Field Street Off Station Road South Gosforth Newcastle upon Tyne NE3 1RY 0191 284 6999 0191 213 1521 allison.dewet@anchor.org.uk Anchor Trust Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Allison Mercie De Wet CRH 13 Category(ies) of MD - Mental Disorder (13) registration, with number of places Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28th February 2005 Brief Description of the Service: Milldene is a care home with nursing, providing care for 13 adults with enduring mental health problems. The home is owned and managed by Anchor Housing Trust a large national provider of services to vulnerable client groups. Care in the home is provided by Registered Mental Nurses supported by care staff. The home is situated in South Gosforth in the city of Newcastle upon Tyne close to local shops and good public transport links. The building comprises two floors with single bedrooms all with en-suite facilities. The home has a suitable passenger lift facility. There is a large dining and sitting room on the ground floor and a small room designated for smoking. Residents have access to a communal bathroom and a shower facility. The philosophy of care in the home is to support the residents in their activities of daily living and ensure their mental health treatment needs are being met. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection went from late–morning to mid-afternoon and lasted three and a half hours. Time was mainly spent with the manager and two staff were interviewed. Records and in-house procedures were examined. Residents were seen either in their rooms or in the communal areas. The premises were looked at and the lunchtime meal observed during the walk around the home. All of the residents were in reasonable health and were present at the home. The turnover over of residents is very low. What the service does well: What has improved since the last inspection? What they could do better: The content of meals needs to be reviewed to encourage residents to eat healthily and help them to lose weight. Staff must receive training in adult protection and there must be evidence of suitable, regular supervision. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 6 Any need for staff to manhandle heavy objects must be fully assessed and managed. 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. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 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 standard(s) 1,2,and 3 Good information is available for prospective residents and their families and they can be confident that the home will meet their needs. Each resident has a statement of terms and conditions. Nursing needs are fully assessed before admission. EVIDENCE: A copy of the new Anchor statement of purpose was provided and the manager is to forward a copy of the new service user guide when she has completed it. All of the residents now have suitable terms and condition of residence. The nurse assessors have assessed four residents as high dependency. A new pre-admission assessment document was planned for. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 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 standard(s) 7,8 and 9 Comprehensive, individual care plans are in place. Health and personal care needs are met in accordance with residents’ wishes and appropriate staff intervention. Residents are protected by efficient medication procedures. EVIDENCE: All residents have up to date mental health assessments. Mental health conditions are generally stable and there is minimal need for any specialist input. The only health concern was that some residents were overweight and input from a dietician; chairobics and increased walking were being used to combat this. Exercise and dance is actively encouraged. New care plan formats had been introduced and details had been reviewed, updated and indexed to provide comprehensive well organised individual information. The manager advised that there had been no change to the satisfactory medication arrangements and she was hopeful that the relocation of medicines to a new dedicated medicines room would soon commence. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 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 standard(s) 12 and 15 Residents’ social and recreational interests and needs are met. are not always provided but meet residents’ wishes. EVIDENCE: A social and recreational folder is kept up to date and activities are planned and provided in keeping with the residents’ wishes on the day. External entertainers are used and there have been some group outings to local places such as Alnwick Gardens. The lunchtime meal options were fish and chips, curry or spam fritters. Healthy meals Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 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 standard(s) 16 and 18 The home has a satisfactory complaints system and residents feel that their views are listened to. Residents will be better protected from abuse when staff are fully trained. EVIDENCE: A recent complaint had been unsubstantiated and fully resolved with full cooperation and input from the home manager. As yet none of the staff have received formal training in adult protection and this must be addressed. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 12 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 standard(s) 19, 24 and 26 The premises are safe and well maintained and all areas are pleasant, welcoming and very clean. Hygiene standards can be further improved. Residents live in very comfortable bedrooms with their own possessions around them. EVIDENCE: The manager advised that there had been no change to the premises. The Anchor surveyor had been assessing proposals to improve facilities and has sent details to CSCI. Otherwise the premises were found to be in a satisfactory condition, extremely clean and tidy but homely, welcoming and fresh smelling throughout. Some bedrooms were visited and observed to be satisfactory and individual to the resident. A fire inspection was scheduled for that day. A maintenance and garden person is shared with another home and this appears to be sufficient. In order to avoid and minimise infection serious consideration should be given to providing soap and paper towel dispensers in all en-suites. Clinical and household waste is stored securely. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 There is now a good match of well-qualified staff offering consistency and good standards of care within the home. Residents are kept safe and supported by efficient recruitment procedures and well-trained, competent staff. EVIDENCE: The manager was on duty with another nurse and two care assistants all of whom work regularly at the home. The manager described her management support. She also reported problems with staff recruitment and this was thought to be due to the wage on offer. Staff do receive enhancements for additional qualifications such as NVQ. There are currently nurse and one-carer vacancies. Agency staff have to be used at times. Domestic input is supplied by an agency. The carers do laundry duties and the kitchen staff have a oneday overlap. Eighty-eight percent of the carers have achieved NVQ and this is an excellent achievement. Staff described comprehensive and relevant induction and ongoing training. There are plans for mental health update in the future and these should be pursued. Training in infection control should also be pursued. The nursing team take the lead in specialist areas such as wound and back care and first aid. Staff photographs are now in place and all the requirements for safe and efficient recruitment are met. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36 and 38 The manager is impressive and has a clear development plan and vision for the home. She is well supported by her staff and provides clear leadership that benefits the residents. The home is run in the residents’ best interests and financial are safeguarded. Staff are not receiving adequate formal supervision. Good health and safety standards are promoted and staff will be better protected with additional assessment of handling risks. EVIDENCE: The manager is well qualified and is scheduled to attend adult protection training for managers. Staff described her as relaxed, approachable and good. Satisfaction questionnaires have been issued once and various feedback did not highlight any concerns. The management of residents’ personal monies and any valuables held for safe keeping was examined and found to be satisfactory and efficiently managed. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 15 Staff supervision was not up to date and some of the records seen were inadequate and demonstrated shortfalls in the supervisor’s awareness and practice. Mandatory training is up to date. The manhandling of the large household bins requires risk assessment and review. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x x 3 x 2 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 4 3 3 x 4 1 x 2 Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 17 No 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. 3. Standard 18 36 38 Regulation 13(6) 18(2) 13(5) Requirement Provide all staff with suitable training in adult protection Care staff must receive formal, suitably recorded supervision at least six times a year. Risk assess and review the movement of the household waste bins in and out of the secure area. Timescale for action 30th November 2005 30th November 2005 30 September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 1 15 26 30 Good Practice Recommendations Provide CSCI with an up to date copy of the service user guide. Review and revise menus to provide appealing, healthy options at all mealtimes. Give serious consideration to the urgent provision of soap and paper towel dispensers in the en-suites. Pursue plans for mental health training and infection control update and training. Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 18 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 Milldene Nursing Home B53-B03 S426 Milldene V234848 120805 Stage4.doc Version 1.30 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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