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Inspection on 03/06/05 for Millfield

Also see our care home review for Millfield for more information

This inspection was carried out on 3rd June 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.

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

Millfield provides good information about the home to all existing and prospective residents. Staff enable residents to own it as their own home by listening to their comments and providing individual care and from resident`s comments and observing staff at work, it was clear that the outcomes fro residents are good with staff committed to treat residents with respect and dignity. Residents are encouraged to make suggestions or propose any changes they feel would improve their home or individual lives.

What has improved since the last inspection?

This is a new registration but it was clear that great changes had been made to improve the environment and outcomes for residents.

What the care home could do better:

Millfield are providing a home where residents are at the heart of the care provided. However, the paperwork has had to be designed from scratch so this was not of the same high standard as has been accomplished by refurbishment and redecoration. It was agreed that this would be inspected in full at the next inspection and the inspector would expect this to be improved to meet the standards in all aspects.

CARE HOMES FOR OLDER PEOPLE Millfield 9 st catherines road Littlehampton West Sussex Bn17 5HS Lead Inspector Mrs H Church Unannounced 03 June 2005 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. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Millfield Address 9 St Catherines road, Littlehampton, West Sussex, BN17 5hs 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 Pauline Ann Shanahan Mrs Pauline Ann Shanahan Care home (CRH) 11 Category(ies) of (OP) registration, with number of places Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Registration Brief Description of the Service: Millfield is an existing private care home registered to accommodate up to 11 service users in the category of Older People. The property has recently changed hands so is now considered to be a new registration. Millfield is a semi-detached Edwardian house located in the town of Littlehampton. The house overlooks a park and is a few minutes walk from the town’s 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 v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, one of two required under the Commission for Social Care Inspection was planned to observe the lunch and afternoon activities of the residents and inspect those items agreed by Mrs Shanahan to improve the property and outcomes for residents. The manager was present and one other member of staff. A number of residents were in the dining room socialising with each other before the lunch was due to be served. The residents were laughing and seemed generally happy and relaxed. One new resident told the inspector that she felt very much at home there. The workload is not high at this time but the inspector did expect an additional member of staff to be cooking the lunch, as per the agreement. However, the cook had gone off sick. In an emergency, additional staff were available from the proprietor’s other home in the near vicinity. The inspector noted that in spite of the lack of the cook, there was still time for the manager and her staff to play dominoes and join in the general social chitchat before serving lunch. Mrs Shanahan has provided new documents; the Statement of Purpose and Service Users Guide and these had been distributed to all interested parties. These give information on how the home is run and how changes can be made to improve residents lives there. During the inspection, eleven residents were being cared for. Seven residents were spoken with privately and four of these residents’ records examined to see if all care was being provided. All residents were able to give a clear account of their life at Millfield and without exception all comments were enthusiastic. It was clear that residents are encouraged to say what they like or don’t like about the home. Three visiting relatives were very enthusiastic about the care being provided, a visiting social worker gave very positive comments on the clear communication system for care needed and the district nurse gave very positive comments on the health care being provided. The residents were cheerful and clearly happy to be there. The member of staff gave high praise for the support received from her manager and the care plans showed that care is provided as required. There were no requirements or recommendations made at this inspection. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 6 What the service does well: 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 v230907 h60-h11 s63418 millfield v230907 030605 stage 4.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 Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.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) 1,2,3,4,5. The 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. EVIDENCE: The manager has provided extensive versions of the Statement of Purpose and Service Users Guide for all their residents, representatives and prospective residents. Four care plans, including a new resident’s records were examined and it was clear residents are being assessed prior to admittance to ensure the home would be able to meet their needs. The new resident confirmed this and had had two trial visits. Relevant risk assessments were in place and had been reviewed. Care plans to instruct staff how to meet identified needs had been written from the assessments and it was clear that staff are well informed about the care needed and updating records accordingly. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.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) 7,8,9,10. All residents had an individual care plan set out for staff to follow. No resident has elected to manage any part of their medication. Staff are meeting the health care needs of the residents in a respectful manner. EVIDENCE: Four care plans gave good, clear information of care needed with risk assessments giving staff good information about the risks and how to minimise these. Medication sheets were completed accurately and the district nurse confirmed that appropriate referrals are made regarding any nursing intervention required, assisting her when necessary and following up the care as directed by the primary health care team. Staff were observed speaking to and caring for the residents and treating them with respect. Staff knocked on doors before entering and then spoke to the residents in a caring manner. Four resident’s commented and said staff were “very kind”, “staff are lovely”, “staff are good” and “any problems and you can take them to P”. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.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) 12,13,14,15. Activities are suited to the conditions and dependency levels of each of the current residents. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising and these were highly regarded. EVIDENCE: Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 11 Activities are based on ability with staff assisting with these. Games are very popular and there was good evidence that the art and craft sessions are well attended. The inspector noted two residents playing dominoes and staff joining in before lunch. There are 11 residents living in the home at present but staff still seemed able to spend individual time with them and arrange group or individual activities. The visitors told the inspector they are always made welcome and it was clear from the visitor’s book that visitors come every day at all times of the ay and evening. The residents told the inspector that they really enjoyed their food. It was clear from the menus that these are changed regularly from feed back from each meal. Staff were aware of the likes and dislikes of each resident and the menus planned accordingly. One resident told the inspector that if they don’t like the meal they can have an alternative. The three course meal served during the inspection looked very appetising and residents said how much they enjoyed it. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 12 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) 16,17,18. Residents are confident that any complaints they may have are taken seriously and acted upon appropriately. Some residents voted at the last election. Staff training in adult protection procedures is up-to-date so staff are equipped to protect residents from abuse. EVIDENCE: The home has a complaints procedure displayed and included in the Statement of Purpose and Service Users Guide. One resident said they knew who to complain to, but had no occasion to do so. The manager told the inspector that voting had taken place for some residents at the last election. The West Sussex Multi Agency guideline was only available from their other home so the inspector advised they contact West Sussex County Council for another copy. Staff, when questioned appeared to know the procedures for protecting residents from abuse. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25,26. The indoor areas used by residents are clean, safe and homely with good access to the newly landscaped front garden. The resident’s rooms are suitable for their needs and are homely. EVIDENCE: During a tour of the home it was clear that residents are encouraged to move around the home as they wish and tend to congregate in the dining room where the fish tank is a great talking point and residents can help with setting the tables fro meals. The lounge has been refurbished and redecorated and residents declared it to be a lovely, homely room. There is a passenger lift for those residents whose rooms are upstairs. The rear garden is due to be redesigned to and enlarged to assist residents to take part in any gardening activity they wish. It is furnished with occasional garden furniture. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 14 There are enough toilets and assisted baths to meet the needs of residents and thermostatic valves protect residents from scalding water temperatures. Radiators are guarded and the home was clean and hygienic. Resident’s rooms were visited and were homely and comfortably furnished with their own possessions around them. Staff told the inspector that they have received training in fire safety procedures and fire risk assessments were in place. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 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 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) 27,28,29,30. There were sufficient staff on duty to meet needs of the residents and staff have received training. EVIDENCE: The inspector noted that in spite of the cook going off sick, staff still had time to play games and socialise with residents before and after their lunch. The member of staff spoken with said she had redone the induction training to satisfy the manager that she was skilled to meet the needs of the residents. She said she was happy to be working at the home and felt well supported by the manager. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 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 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) 31,32,33,34,35,37,38. The registered manager is Mrs Pauline Shanahan who is well experienced to manage the home and be actively involved in the care of residents on a daily basis. The home is run in the best interests of the residents whose health, safety and welfare is promoted and protected EVIDENCE: Mrs Shanahan has been accepted onto the National Vocational Qualification level 4 in Management and the Registered Managers Award. The member of staff said Mrs Shanahan supports the staff to carry out their roles and provides a good clear sense of direction that puts residents at the centre of all activities. All communal and residents rooms meet the National Minimum Standards giving resident’s sufficient space for them to have personal possessions or necessary equipment to support their care needs and move around their rooms safely. A robust financial procedure is in place. Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 17 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 x 3 3 Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 18 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. 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. 1. Refer to Standard Good Practice Recommendations Millfield v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 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 v230907 h60-h11 s63418 millfield v230907 030605 stage 4.doc Version 1.30 Page 20 - 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!