Inspection on 24/07/07 for Minsden

This inspection was carried out on 24th July 2007.

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

Minsden 29/11/06

Minsden 31/01/06

Minsden 11/08/05

Minsden 02/03/05

Minsden 08/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Minsden Wratten Road West Hitchin Hertfordshire SG5 2AU Lead Inspector Mrs Alison Butler Unannounced Inspection 24th July 2007 09:30 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 Minsden DS0000019470.V345523.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. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Minsden Address Wratten Road West Hitchin Hertfordshire SG5 2AU 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) 01462 450703 01462 427651 minsden@quantumcare.co.uk www.quantumcare.co.uk Quantum Care Limited Ms Elizabeth Grace Street Care Home 48 Category(ies) of Dementia - over 65 years of age (48), Old age, registration, with number not falling within any other category (48), of places Physical disability over 65 years of age (48) Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2006 Brief Description of the Service: Originally built in 1960, Minsden was first registered with Hertfordshire County Council on 1st July 1992. It was refurbished in the mid- 1990s. The fees for the service range from £450.00- £515 per week (these were correct as of 24th July 2007). The home is situated in a quiet residential area within walking distance of Hitchin town centre. The accommodation is on two floors served by a lift. On the ground floor there are 19 single bedrooms, quiet room, a lounge, dining room, Asian elders day centre, kitchen, laundry room, several offices, 3 bathrooms, 2 shower rooms and toilets. On the first floor are 22 single bedrooms, lounge, kitchen diner, quiet lounge, 3 bathrooms, 2 shower rooms and toilets. To the front of the building there is ample car parking and a medium size garden and patio to the rear. The Asian elders day centre is a particular feature of the home, providing a valuable resource for the local community, open Mondays to Fridays each week. The homes statement of purpose states that the emphasis is at all times on making service users feel that Minsden is their home. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been written following an unannounced site visit and information that has been known to the Commission. The majority of the time was spent observing and talking with those who use the service, staff and management. Care records were also examined. What the service does well: What has improved since the last inspection? What they could do better: A review of care plans is to take place to eliminate some of the areas of duplication; this will include individual risk assessments, which will be put in to the same format. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 6 The monthly reviews should be written with areas of the care plan taken into account and how these are being met or not. When short stay service users return to the home, risk assessments should be reviewed on every occasion to ensure there has not been a change in their needs whilst they have been away. 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. The summary of this inspection report can be made available in other formats on request. Minsden DS0000019470.V345523.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 Minsden DS0000019470.V345523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to Minsden. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have an assessment carried out to ensure their needs can be met, prior to a place being offered. EVIDENCE: Examination of the records of a newly admitted person to the home showed that an assessment had been carried out by the staff and additional information had been gathered from other professionals and family prior to admission to ensure that the service was able to meet their needs. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service receive a good quality of care and are supported by knowledgeable and experienced staff. Information recorded could be better and be consistent with the information provided. Medication procedures need to be monitored more closely. EVIDENCE: Staff were seen to provide good care ensuring people were given respect and their dignity promoted. This was particularly noticeable during the time when breakfast was being served. Staff were discreetly assisting those who needed support to eat their breakfast, offering extra drinks, and/or additional breakfast. Gentle chitchat was taking place between those who use the service and with staff. A selection of four care plans was examined and revealed detail on the action required by staff to meet the needs of individuals. It remains a recommendation that each page contains the individuals’ name and date of birth to eliminate any mistakes; if pages are removed for additional information to be added, this will also ensure that are returned to the correct Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 10 file. Risk assessments were looked at. One showed contradictory information, which the manger dealt with during the inspection. A couple of risk assessments relating to self medicating and the use of bed sides were not contained within the individuals care plan. They were found on request and are now to be included on the individual’s file. Monthly reviews still do not relate to the care plans. The plan relating to one person who has can get cross if they have to wait for the meals, had no detail on the action to be taken in this situation. The manager stated that this would be rectified. The manager also stated that care plans are being reviewed in the light of information gathered over time. This will be undertaken with other managers from the company. Four trolleys are in use for transporting the medication around the home. There are procedures in place for dealing with errors and if necessary, staff receive further training. A spot check was carried out, and some ‘as required’ records could not be reconciled. This will be addressed. Medication had been signed in on entering the home; dates on opening were in place to protect the medication from deteriation. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Autonomy and choice are promoted at the home. Those who use the service are able to take part in activities of their choice. EVIDENCE: Those spoken to during the inspection enjoyed their life at Minsden on the whole and stated the staff “are lovely girls and work really hard” and “couldn’t ask for better”. They were able to choose which activities they would like to take part in, a number enjoy quizzes and painting, whilst others were happy to watch the TV or spend time on their own. Most of those spoken to felt that there was a good standard of food and alternatives offered, whilst others felt food was ‘OK’ and understood it can be difficult to cater for a large number of people and please them all. Meetings take place in the home were menus are usually one of the topics covered to try to ensure that are discussed and problems are dealt with promptly. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service have their views listened to and acted upon through the complaints procedure that is in place. EVIDENCE: A copy of the complaints procedure is available to all people who use or have contact with the service. Those spoken to felt that they have their views listened to and they are acted upon and were complimentary about the care they receive at Minsden. The Director of Care is currently dealing with a complaint. This has resulted in a number of unannounced visits to the home being carried out by senior staff. It has also led to some changes that will improve the lives of those who use the service. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well cleaned and maintained. Regular checks are carried out on services and equipment. EVIDENCE: Whilst carrying out the inspection, a quick tour was undertaken. During the tour, it was noted that the home was clean and free from any odours. Since the last inspection, the corridors have been decorated and the dining area on the ground floor is now used only as a dining area, (it was previously used as a lounge/diner). There are two lounges available one providing a TV and the other a seating area to provide a quiet and relaxing room. Friends and relatives are able to use these areas when visiting the home. . Laundry facilities are suitable and those spoken to during the inspection were happy with the service. Policies, procedures and training is in place that covers the prevention of the spread of infection. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment procedures are in place to ensure that people are in safe hands as far as is reasonably possible. The service deploys sufficient staff to meet the needs of the individuals. EVIDENCE: Previous inspections have shown that staff personal files have had all the relevant information obtained prior to confirmation of appointment. The company has robust recruitment procedures in place. Therefore, this area was not examined on this occasion. Rota show nine carers per shift, who are also supported by a minimum of one care team manager. A deputy manager also covers weekend shifts. Staff were knowledgeable about the needs of those who use the service and, where possible, encouraged them to be as independent as possible. There is an on going training programme to ensure that staff continue to have up to date skills and knowledge of meeting the needs of those who use the service. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service benefit from a well-structured management team and can be assured that the health, safety and welfare of all who enter the home is protected. EVIDENCE: The manager at the home has the required skills to mange the service and is clear of her responsibilities and role. She has regular training to ensure that she remains up to date with current practise and knowledge on meeting the needs of elderly people. Robust policies and procedures are in place for safeguarding financial interest of individuals who reside at Minsden, previous inspections have shown that good recording takes place and the company employ an auditor who carries out an annual audit in all of their homes. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 16 Health, safety and welfare of all who enter the home is promoted and protected through a series of checks and any maintenance issues reported and recorded. Risk assessments are in place, although some need to be individualised as they are too generic and don’t relate to specific individuals. This was discussed with the manger at the time of the inspection. An annual forum is held when all who are associated with the home are invited to listen to any plans for the future and results of the annual questionnaire are discussed. This provides relatives and friends the opportunity to discuss areas of concern about the overall care in the home (issues relating to individual people are not discussed at this time). All statutory records were available for inspection and were well maintained. Minsden DS0000019470.V345523.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X 18 3 3 X X X X X X 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 X 3 X 3 X X 3 Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 18 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 Minsden DS0000019470.V345523.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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