CARE HOMES FOR OLDER PEOPLE
Millfields Residential Home Mill Lane Nevison Pontefract West Yorks WF8 2LS Lead Inspector
Tony Railton Unannounced Inspection 15th November 2005 2:30pm 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 Millfields Residential Home DS0000006200.V266025.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. Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Millfields Residential Home Address Mill Lane Nevison Pontefract West Yorks WF8 2LS 01977 690606 01977 690606 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr John Fieldhouse Mrs Jill Fieldhouse Mrs Jennifer Tucker Care Home 38 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (38), Old age, of places not falling within any other category (38), Physical disability over 65 years of age (7) Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st April 2005 Brief Description of the Service: Millfields continues to provide personal care and accommodation for up to 38 older people some of who may also have a physical disability or mental health problem. Set back in its own grounds the home is situated in a residential part of Pontefract and is only a few minutes journey from the town centre and all services and amenities. The accommodation is provided on two floors and all bedrooms are single and eight of these have en-suite facilities. The home provides two main lounges and a large dining room on the ground floor and there is a passenger lift and assisted bathing facilities for those who require them. The home also provides a smaller smokers lounge. There are pleasant gardens provided with garden furniture for the use of residents during the summer months. The home is close to a main bus route and close to the M62/M1/A1 link roads. Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a very positive and pleasing unannounced inspection. The inspector had the opportunity to speak to nearly all residents with the exception of a few enjoying an afternoon nap. There was also the opportunity to speak to eight friends and relatives visiting the home. Care staff including the manager, assistant manager, activities co-ordinator, administrator and kitchen staff also spoke to the inspector. The inspector would like to take the opportunity to thank everyone in the home for their hospitality and their positive contributions towards the inspection. Once again there was no failure to meet statutory requirements noted and the home continues to meet nearly all the minimum standards. This was a very good and positive inspection and the atmosphere created in the home is commendable. What the service does well: What has improved since the last inspection?
Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 6 On the day of the inspection the basic care provided to all residents was very good indeed. All female residents were appropriately dressed and their clothing was colour co-ordinated and everyone’s hair looked lovely. Male residents were clean, shaven and also appropriately dressed Everyone’s nails had been manicured and all spectacles were clean. Quite clearly all the residents in the home without exception demonstrated that they are cared for by an efficient, confident and competent staff team. The owners, registered manager, assistant manager, care staff, and activities co-ordinator and kitchen staff are to be commended for maintaining such a good standard of care within the home. The domestic staff also need to be commended for their efforts in maintaining such a good standard of cleanliness throughout the home. The inspector notes that the standard of care within the home has been consistently high for a number of years and in many ways need not be mentioned in this section of the report. However, the inspector understands how difficult keeping such high standards is and how hard everyone has to work to maintain them, well done everyone. 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. Millfields Residential Home DS0000006200.V266025.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 Millfields Residential Home DS0000006200.V266025.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): 3&6 All prospective residents have a comprehensive assessment of their personal and healthcare needs before they are admitted. EVIDENCE: Residents’ case files show that residents care needs are assessed before they are admitted. Records also show that most residents are admitted with an Integrated Care Management Programme Assessment. Standard 6 in not applicable as the home does not provide a specialist rehabilitation service. Millfields Residential Home DS0000006200.V266025.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): 7, 8,9 &10 Residents’ health, personal, and social care needs are set out in their individual plan and they also are supported and encouraged to make decisions about their daily lives. EVIDENCE: Residents care plans, risk assessments and daily records show that their personal care needs are identified, planned for and met. The medical records show that residents’ healthcare needs are met. Observation of residents and inspection of the home show that they are well cared for and receive the care and support they require. Discussion with residents and some of their relatives and friends indicate that care staff have a good understanding of residents personal care needs and that they are competent and efficient. The daily records do have some descriptive words to indicate when residents make decisions about their lives. The inspector suggests that the daily records may benefit by using descriptive words on a day to day basis to reflect residents choices and preferences. Through observation and inspection it was noted that there are positive relationships fostered between residents and care staff and that residents are treated with respect and dignity at all times.
Millfields Residential Home DS0000006200.V266025.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): 12,13,14 & 15 Residents are encouraged and supported to make decisions about their own lives and find the lifestyle experienced in the home matches their expectations. Residents are also encouraged to maintain contact with positive relationships with their relatives and friends. EVIDENCE: Discussion with residents and their relatives and friends show that they are more than happy with the care provided by the home. Residents said that they are well cared for one said that the care staff are “excellent”, another male resident said that its “home from home” and that he has “everything he needs”. One relative said that the care staff are “very good indeed” and that they are “always made to feel welcome”. Another relative said that they have never had to make a complaint about the care provided for their mum and that the home is “great”. Residents spoken to said that the meals provided are very good and that they have a choice. The kitchen staff said that all residents are offered a choice and everyone is asked on a daily basis which menu they prefer. The dining room is decorated to a good standard and all tables were set with flowers and condiments, indeed, it looked really nice. Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 11 Residents records and discussion with the manager and activities co-ordinator show that activities are organised on a regular basis for those who wish to attend. On the day of the inspection some residents were enjoying a ‘craft session’ and were making Christmas decorations for a display to be put in the reception area. The female residents said that they were sworn to secrecy as the theme for the display is a surprise. Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 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 the following standard(s): 16 & 18 Residents and their relatives and friends are confident that their complaints will be listened to and acted upon. Residents are also protected from abuse and neglect. EVIDENCE: Discussion with residents and their relatives show that they are confident that if they had any concerns about the home that they will be listened to acted upon. On relative said that she has never had reason to complain about anything and she had been visiting the home for over two years. Another said that if her mum had any complaints she would definitely complain. The inspector was impressed with the frankness and openness of the residents and their relatives who obviously feel confident that their concerns would be dealt with. Discussion with the registered manager confirmed that a recent complaint had been received and appropriately, investigated and action taken as a result. It was also noted that the home continues to provide a copy of Wakefield Social Services and Health Multidisciplinary Adult Abuse and Protection Policy and Procedure which forms part of the induction training for new staff. Millfields Residential Home DS0000006200.V266025.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): 19,20,21,22,23,24,25 & 26 Residents enjoy living in a home which is homely, comfortable and safe. EVIDENCE: Inspection of the home including lounges, dining room, bedrooms, toilets, bath and shower rooms show that residents benefit from living in a well decorated and well maintained home. Residents spoken to said that they liked their rooms and that they have everything they need. Residents are encouraged to bring some of their belongings into the home with them. Residents were observed being comfortable and happy surrounded by their own possessions. The home provides and maintains a very high standard of decoration and cleanliness and the care staff and in particular domestic staff are to be commended for their efforts in maintaining such a good standard of cleanliness throughout the home. Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 14 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 Residents care needs are met by confident, competent and experienced staff in sufficient numbers to meet residents personal and healthcare needs. However, residents may benefit from having more NVQ qualified staff. EVIDENCE: On the day of the inspection, the inspector was impressed with the standard of care delivered by the home. After observing and speaking to nearly all the residents with the exception of four it was clear that residents are well cared for, happy and comfortable. Speaking to eight relatives and friends of residents showed that care staff are held in esteem. One relative said that the care staff are “excellent” and that they are “caring and understanding”. Throughout the inspection positive relationships were observed between care staff and residents. Discussion with the manager, assistant manager and training records indicate that some staff do have a National Vocational Qualification Level 2 or above. However, the manager said they do their own NVQ training and assessing. Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 15 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): 31,34,35 and 38 Residents’ benefit from living in a well run home where the manager exhibits a leadership style which was noted to be inclusive and supportive to residents and staff. EVIDENCE: Discussion with residents, their relatives, friends and care staff and observation of the care practices within the home it was established that residents benefit from living in a well run home. It also showed that the home is run in the best interests of residents and safeguards their best interests. Examination of residents’ case files show that the care management systems within the home are good. The homes records, policies, procedures and practices show that the health safety and welfare of service users and care staff are promoted and protected. Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X 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 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 X 3 3 X X 3 Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 17 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. 1 Refer to Standard OP28 Good Practice Recommendations A minimum ratio of 50 of care staff should have a National Vocational Qualification Level 2 or above. Millfields Residential Home DS0000006200.V266025.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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