Inspection on 13/06/06 for Millfield

This inspection was carried out on 13th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Millfield 23/07/08

Millfield 13/08/07

Millfield 21/10/05

Millfield 03/06/05

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Millfield 9 St Catherine`s Road Littlehampton West Sussex BN17 5HS Lead Inspector Mrs H Church Unannounced Inspection 13th June 2006 09:00 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 Millfield DS0000063418.V299841.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. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Millfield Address 9 St Catherine`s Road Littlehampton West Sussex BN17 5HS 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) 01903 714992 Mrs Pauline Anne Shanahan Mrs Pauline Ann Shanahan Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 11 service users in the category old age (OP) not falling within any other category. 21st October 2005 Date of last inspection Brief Description of the Service: Millfield is an existing private care home registered to accommodate up to eleven service users in the category of Older People. Millfield is a semidetached Edwardian house located in the town of Littlehampton. The house overlooks a park and is a few minutes walk from the towns shops, public transport, local amenities and the sea front. The accommodation is provided on three main and two mezzanine floor levels with a lift providing access between the lower floor and the first main floor. The service is privately owned and managed by Mrs Pauline Shanahan. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place over one day and planned to take part in the morning and over the lunch time period. The manager was present for the majority of the visit and ably assisted the inspector with all of her enquiries. The inspector noted that during the site visit, staff were spending quality time with individual residents, either in the lounge or their rooms. A homely, friendly and relaxed atmosphere prevailed and the inspector was made welcome at all times. Although it was early summer and a fine day, it was still too cold for residents to be out in the garden to enjoy the sunshine. For the site visit, the inspector examined previous information and the Statement of Purpose and Service Users Guide that informs residents about the service. During the inspection, seven residents, three visitors and a district nurse gave their views to the inspector. Without exception all comments were enthusiastic about the way staff provide care and the opportunities for residents to live individual lives there. Two members of care staff said they felt very supported by their manager and carried out their duties in a relaxed and positive manner. The care plans showed that the care provided is appropriate according to the needs of the residents and the right amount of support to maintain independence and ensure resident’s lives continue to improve was given. There were no requirements or recommendations made at this inspection. What the service does well: Millfield provides a care home with the emphasis on being warm, friendly and homely. It also provides an excellent safe and spacious environment for residents with some rooms that exceed the National Minimum Standards. The manager has continued improve outcomes for residents by maintaining a high standard of individual care, receiving daily feedback on any concerns of residents and by providing a continuous open, positive and inclusive atmosphere and management style for staff at all times. Under her direction, the care staff continue to ensure residents receive the care needed without impeding independence. The food continues to be of a very high quality with fresh vegetables and homemade dishes provided daily. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 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. Millfield DS0000063418.V299841.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 Millfield DS0000063418.V299841.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): 1,2,3,4,5. All new residents had been assessed before moving into the home. The staff at the home are meeting the residents identified needs. Relatives were given enough information to help them decide the home would be suitable Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The Statement of Purpose and Service Users Guide requires updating in that on one page the staff had changed. The manager agreed to send this updated page to the Commission for Social Care Inspection when changed. Four residents, two new and two existing residents were case-tracked. The manager prior to their admission to the home had assessed all the residents and the two new residents had confirmed that the home’s information had been sent or given to them prior to them being initially assessed for Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 9 admittance. Two residents have been admitted for respite care but all of the home’s procedures were carried out as for residents requiring long term or permanent residency. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10. All residents had an individual care plan set out for staff to follow. The home operates a policy where all medication is managed by care staff. Care staff are meeting the health care needs of the residents in a respectful manner. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Four care plans and assessments were examined and were seen to include the health, care and social needs of the resident. Risk assessments and nutritional assessments formed part of the care plans. Generally the home takes responsibility for managing medication but if a resident wishes to self-medicate, staff monitor this closely. One resident is currently self-medicating. The home’s medication procedures ensure safe Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 11 practice with the handling, administration, storage and disposal of medicines. Staff who administer the medicines to the residents have been assessed as competent to undertake the procedure. On examining MAR charts they were generally accurate and no gaps noted in recording of administration of medicines. Where district nurses are providing a service, the information was current and relevant to the care being provided. Where specialist equipment had been identified, this had been provided. The inspector spoke to a health care professional about referrals and following their instructions. The response was very positive and the district nurse full of praise for their care. All residents praised the staff care. Residents and/or their relatives are involved in the initial care plan and reviews and sign their agreement to these. Care plans reflect the needs of residents and the risks to their health, safety and welfare, including falls and pressure areas. Records are completed and care plans include all information on health care needs. Care plans were up to date and reviewed regularly. The staff on duty were well informed about the care needed for the four residents case tracked. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15. Activities are suitable for current residents, visiting is positively encouraged and residents are served meals that are nutritious and appetising. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: There are ten residents living in the home at present and as care staffing hours have been increased, care staff are able to spend individual time with them. Visitors are always made welcome and this was confirmed by the visitor’s book. Four separate visitors were visiting throughout the inspection process and all appeared to be well informed about their relative’s care needs and the inspector observed signatures on care plans showing their involvement. A programme of activities was observed and residents confirmed this was provided. Currently, activities are based on resident’s wishes and abilities with a new activity being provided from residents’ requests. Activities range from Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 13 individual to group activities and range from music and movement sessions to craft sessions, where residents paint to trips out for shopping or local outside places of interest. The inspector noted many residents enjoy a game of cards and this has become a regular activity in the dining room. Residents commented on their enjoyment of the range of activities. The resident’s comments included lavish praise for the home cooked food. The inspector observed the high quality of the home-made meal prepared from fresh ingredients. The menus are changed regularly according to feedback and alternatives provided when preferred. It was clear that meals are a high focus for all residents. Where residents are unwell or prefer to eat in their rooms, individual trays are laid with napkins, drinks condiments and a good range of cutlery. Staff assistance was provided in two cases where residents were unable to manage without help. From discussion with residents, the food provided is fulfilling with good choices. The inspectors spoke with the manager and it could be seen that dishes were prepared according needs and wishes of the residents. Dietary needs are recorded in the individual care plans and these are taken into consideration when planning meals. The manager told the inspectors that relatives and visitors are welcomed into the main dining room at any time and room is always made for them to join the residents. One relative confirmed that he had been asked to stay for a meal on many occasions but had never done so. Weight charts showed that all aspects of health care and meal planning are linked. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 14 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. Residents are confident that complaints are taken seriously and acted upon appropriately. Staff have had in-house training in adult protection procedures so are equipped to protect residents from abuse. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The complaints procedure was displayed in the hallway with the Visitor’s Book and included in the Statement of Purpose and Service Users Guide. The complaints log was examined but there had been no complaints recorded. Four visitors were visiting a relative at the time of the inspection with two asked about the process for complaints or concerns. Both said they had no complaints but would speak to the manager initially if they had any. Two residents told the inspector if there was anything they were unhappy with anything, they would tell the staff or manager. The staff confirmed that in-house training for Adult Protection Training had been given and the Care Training Consortium would be consolidating this. The West Sussex Multi Agency Guideline was present in the office. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 15 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): 19,20,21,22,23,24,25,26. The indoor and outdoor areas used by residents are clean, safe and homely with good access to all parts. Resident’s rooms are suitable and homely. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The inspector toured the building and examined specialist equipment to ensure residents are safe and enjoy surroundings. The indoor communal areas, garden and individual room areas are safe and well arranged to maximise independence without compromising a sense of freedom. Throughout the tour the home presented as clean, pleasant and hygienic, equipment to being maintained and the redecoration, refurbishment Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 16 programme continues. Radiators are guarded and thermostatic valves in place to restrict water temperatures to safe levels and protect residents from burns and scalds. Following a leak in the inner hall ceiling, this area had been redecorated and was awaiting new carpeting to complete the repairs. As residents leave rooms, these are well decorated according to the residents wishes, furnished and arranged to the needs of residents. One resident had moved to a larger vacant room with an en-suite and this had been redecorated in a very pleasing manner. The first floor bathroom could be improved by being re-equipped and re-arranged to improve outcomes for residents and assist staff in a restricted area but the home are providing the assisted bath agreed. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 17 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 duty rota indicated that sufficient staff with a suitable mix of skills and experience are on duty over the 24 hours period to ensure needs can be met. Recruitment processes were in place to ensure residents are protected. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The inspector examined the staffing rota in conjunction with care plans and noted that staffing levels are sufficient to meet residents needs at all times. The inspector observed staff spending quality time with residents in the communal areas and with residents who chose to remain in their rooms. During the fieldwork, the inspector spoke to residents about the time spent with staff and all of the comments were good. Residents also felt their privacy and dignity is maintained and three residents commented that “staff were kind and thoughtful”. The homes use of agency staff is minimal as staffing absences are generally covered by existing staff but if needed, the manager has authorised access to monies for this at all times. The inspector observed that domestic and catering roles are staffed separately with staff having clearly defined roles for these. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 18 The inspector did not examine recruitment procedures for consistency as no new staff have been recruited since that inspection. Training records were examined and two staff are completing National Vocational Qualification level 2 and two staff level 3. Recent certificates were seen for Moving and Handling and Medication training. All staff had completed induction and foundation training on registration and mandatory training provided at appropriate intervals to ensure all staff have up-to-date skills and knowledge. Periphery courses on the needs of this group of residents had also been provided. Staff on duty confirmed that they had only been employed following a Protection of Vulnerable Adults check and Criminal Records Bureau clearance. Two staff confirmed that training has been received and training identified in supervision. Both staff had received training applicable to their roles and level of expertise. Protection of Vulnerable Adults training had been arranged through the Care Training Consortium for in-depth training. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35,36,38. The home is run in the best interests of the residents whose health, safety and welfare is promoted and protected. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The manager has committed herself to the National Vocational Qualifications level 4 in Care to complement her City and Guilds Management qualification. A Quality Assurance System has been identified to take place this year following registration. To ensure resident’s views are implemented, Mrs Shanahan holds regular meetings with residents and is planning a Community Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 20 Open Day for people in the community to see the home and meet the residents. All of the residents agreed to this and are looking forward to this event. The inspector observed the informal and on-going system of seeking views from residents and visitors at every opportunity during the site visit. Residents are encouraged to manage their own finances or if this is not viable and a representative of the resident take on the responsibilities for this. The home does not hold any monies for residents. The two members of staff confirmed that supervision is provided at the required intervals and that training needs are identified from this procedure. The manager confirmed the procedure. The inspector tracked one accident as recorded in the care plans and noted that the documents meet the Data Protection Act. Accidents are to be audited and this would be carried out regularly. Health and safety is maintained through training and servicing of necessary equipment. All equipment checks and servicing is carried out within the safe guidelines. Good moving and handling practise was observed that minimises risks to residents’ health safety and welfare. Policies and procedures were in place and had been updated recently. Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 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 3 3 3 3 3 X 3 Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, 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 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 Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Millfield DS0000063418.V299841.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!