Inspection on 20/11/05 for Minshull Court Nursing Home

This inspection was carried out on 20th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Minshull Court Nursing Home 25/07/07

Minshull Court Nursing Home 22/01/07

Minshull Court Nursing Home 08/08/05

Minshull Court Nursing Home 15/11/04

Minshull Court Nursing Home 12/05/04

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

CARE HOMES FOR OLDER PEOPLE Minshull Court Nursing Home Minshull New Road Crewe Cheshire CW1 3PP Lead Inspector Anthony Cliffe Unannounced Inspection 24th November 2005 08:15 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 Minshull Court Nursing Home DS0000018755.V265339.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. Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Minshull Court Nursing Home Address Minshull New Road Crewe Cheshire CW1 3PP 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) 01270 257917 01270 500614 Mr Christopher Chawner Margaret Niblett Care Home 34 Category(ies) of Dementia (34) registration, with number of places Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. This home is registered for a maximum of 34 service users to include: * Up to 34 service users in the category of DE(E) (dementia over the age of 65) The manager must have fourteen hours supernumerary a week Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 8th August 2005 4. Date of last inspection Brief Description of the Service: Minshull Court care home is a converted detached two-storey property situated in its own grounds approximately two miles form the centre of Crewe. The home provides care with nursing for adults aged over 65 years of age diagnosed with dementia. There is a passenger lift and internal staircases and wheelchair access throughout the home. The home has two lounges and two dining rooms. Bedroom accommodation comprises of 34 single rooms all with hand-wash basins. There are no en-suite facilities. There is an enclosed garden and patio area to the rear and with ample car parking at the front. The home is on a bus route and the main railway at Crewe town centre. Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours. It included inspection of records, observation of staff practice and discussion with residents, staff and a relative. Feedback was given to the manager at the end of the inspection. One requirement remains outstanding from the previous visit. What the service does well: What has improved since the last inspection? What they could do better: Recruitment procedures must improve to ensure residents are protected. Communication between the registered person and the manager must improve to ensure residents are protected and receive a quality service. Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 6 The provision of activities needs to improve to ensure residents have opportunities to participate in activities appropriate to their needs. Residents’ care plan reviews need to be more informative and detail if the care plan is effective or not. Staff should be provided with the General Social Care Council Code of Practice to ensure they understand their role in protecting vulnerable adults. Radiator guards should be fitted to radiators in public places. Management and monitoring of the management and administration of records and practice needs to improve to demonstrate that Minshull Court is managed in the best interests of residents’ health and welfare. 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. Minshull Court Nursing Home DS0000018755.V265339.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 Minshull Court Nursing Home DS0000018755.V265339.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): These standards were not assessed. EVIDENCE: Minshull Court Nursing Home DS0000018755.V265339.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 and 10 Residents’ care plans ensure their health care needs are identified and met but improvements in the review and recording of outcomes needs to improve to demonstrate if they are effective. Residents’ health needs are met. Residents’ personal items are respected. EVIDENCE: Care plans showed a range of completed assessment documents, with a care plan to address individual identified needs. Care plans record residents` physical and mental health needs. Each care plan provided a pre admission assessment by staff and an assessment by the social worker. The care plan document is under review and being transferred to a need, outcome and action plan format to enable the informed recording of residents’ needs. Care plans transferred to this format have improved in recording residents’ needs. Improvements in the action plan to meet residents’ needs must improve to demonstrate that care staff can follow it. Qualified staff reviewing care plans need to demonstrate in recording outcomes that care plans remain effective or not. The current format does not allow staff to write detailed action plans and uses a tick box format. Reviews of the care plans recorded ‘continue as planed’ or ‘ plan remains effective’. This does not detail if residents’ health or welfare is improving or not. A visitor to the home talked about the standard of health and personal care her mother receives. She said ‘at the other home my mum had a urine infection Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 10 and I had to insist they did something about it. She also had a fall and fractured her hip. Since moving to Minshull Court she has never had an infection and she is always clean and well cared for. She is well looked after. Her room is always clean and tidy. Her possessions and clothing are cared for and put away. I am involved in her care. Staff ask me about doctors appointments and tell me if she is not well. We discussed when she needed bed rails. She leans to one side and could fall out of bed. They only put them on when I asked and made sure the covers were on them. They keep me well informed about her health and her care. I looked at other homes but chose here because I was really welcomed and they answered all my questions. The residents looked well cared for and happy. They looked like they were looked after. The care is a good standard. I have peace of mind and don’t worry about mum’. See recommendation 1. Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14 Residents must be offered the opportunity to participate in activities based on their preferences, interests and needs. Visitors are welcomed and can visit at reasonable times. Residents are supported to make choices and decisions about their lives EVIDENCE: Staff were seen spending time talking to residents and offering them choices about where they wished to send their day and discretely confirming arrangements for personal care. The manager stated that in the afternoon staff are encouraged to spend social time with residents. This is on an ad hoc basis as there is no regular plan of activities in place. She said afternoon activities consist of staff reading newspapers to residents or playing dominoes, board games or bingo with them. The manager arranges regular external entertainers to visit Minshull Court. An activities coordinator has not employed since before 2002, so there are no planned activities based on residents’ choices, preferences or needs. Residents’ religious preferences are recorded and representatives of the different religious denominations visit Minshull Court. There was little social stimulation for residents other than residents reading daily newspapers and books. A visitor to the home said ‘I can visit mum at any time. I am invited to any events that take place but I am not informed about the entertainers that visit. The only improvements could be informing me about them and more activities. I know its difficult for mum to join in but she can still see and listen’. See requirement 1. Minshull Court Nursing Home DS0000018755.V265339.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): 18 Staff training on adult abuse has improved to protect residents but staff need to know about the code of conduct, which underpins their practice and understand their role in protecting vulnerable adults. EVIDENCE: Six care staff attended the first day of a two day course on adult abuse and adult protection on 22nd November 2005. A follow up day is arranged for 6th January 2006. The registered person had engaged a training provider to provide training on ‘ No Secrets’ the guidance from the Department of Health on adult protection. Staff interviewed were able to demonstrate their knowledge of adult abuse and how to report it. In discussion about the responsibility to report their concerns staff were unaware of their responsibilities in the General Social Care Council Code of Practice. See recommendation 2. Minshull Court Nursing Home DS0000018755.V265339.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 and 25 The maintenance of the building has improved to ensure a safe environment for residents but health and safety could be improved to protect residents from unguarded radiators. EVIDENCE: A programme of maintenance is in place, which the manager identifies. This is given to the handyman for attention, on a monthly basis. The décor is kept in good condition. Externally the paintwork of the building remains in poor condition and has not been decorated as recommended at the last visit. The manager confirmed arrangements for the external decoration of the building in 2006. Windows identified at previous inspections as requiring replacement and repair have been completed. At the previous visit a requirement was revised to a recommendation to provide radiator covers on unguarded radiators in public corridors. The recommendation has not been completed and despite a risk assessment of them, they remain a hazard to residents. See recommendation 3. Minshull Court Nursing Home DS0000018755.V265339.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 and 29 The numbers and skill mix of staff are adequate to meet residents’ needs. The home’s recruitment procedures remain incomplete and do not ensure residents are protected. EVIDENCE: The manager, deputy, senior care and care assistants were on duty in sufficient numbers to meet the needs of residents. A core of staff have been employed at Minshull Court for a number of years, which provides consistent care to residents. There is a condition of registration that the manager has fourteen supernumerary hours a week and she demonstrated she is putting these on the staff rota. Discussion with the manager and examination of records of employment, found recruitment procedures remained incomplete for a staff member employed in June 2005 without a POVA First check being obtained. The home had accepted a Criminal Records Bureau check from a previous employer. POVA First confirmation and a Criminal Records Bureau Check were not on file and the manager was unable to verify they had been completed. This was identified as a requirement at the last visit. See requirement 2. Minshull Court Nursing Home DS0000018755.V265339.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, 33 and 35. The manager has made improvements, but improved communication between the manager and registered person would ensure the manager is able to discharge her responsibilities in full. Quality assurance monitoring must improve to ensure that Minshull Court is run in the best interest of residents. Residents can have control of their own finances and their financial interests are safeguarded. EVIDENCE: The manager has made improvements in the standard of record keeping and identified that qualified staff would benefit from additional training on care planning and stated this is to be arranged for the near future. The manager was unable to verify if a POVA First and Criminal Records Bureau check on a staff member employed in June 2005 had been completed. She explained that she is responsible for recruiting and interviewing staff but not recruitment administration. She confirmed this is the role of the company administrator whose line manager is the registered person. Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 16 Minshull Court does not have a quality assurance management system. The manager completes a weekly health and safety check of the building. The findings of this are entered into the maintenance book for the attention of the handyman. The health and safety check includes monitoring of water outlet temperatures. The manager stated she completes audits of medicine administration, meals, laundry services and clothing storage. She was unable to provide evidence of audits, as she does not record her findings. Minshull Court uses a satisfaction questionnaire, which the manager stated is given to relatives and visiting professionals. The questionnaires are returned directly to the registered person. The manager said she is not given feedback on the comments or content in the questionnaires and is unaware of any complaints or areas for improvement. As required from three previous visits arrangements have been made for the storage and safekeeping of residents’ monies. Minshull Court does not handle residents’ finances except for personal spending money. Residents control their own money or have relatives who assist them. Residents have personal money in safekeeping. Residents’ money is kept in separate envelopes. The personal allowances of three residents subject to appointeeship of the local authority are the only monies kept at Minshull Court. See requirement 3 and recommendation 4. Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X X X X X 2 X STAFFING Standard No Score 27 3 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X X Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP12 Regulation 16(2)(M)( N) Requirement Timescale for action 01/02/06 2 OP29 19 3 OP31 12 The registered person must consult residents; their relatives or representatives about their social interests and about a programme of activities arranged by or on their behalf and provide activities in relation to recreation. The registered person must not 31/12/05 employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. Timescale 01/11/05 not met) The registered person must 31/12/05 ensure that the care home is conducted to make proper provision for the health and welfare of residents including good communications with the manager. Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP18 OP19OP25 OP33 Good Practice Recommendations The reviews of residents care plans should be more detailed to demonstrate if the care plan is effective or not. Recommendation from the previous inspection visit. Staff should be provided with the General Social Care Council Code of Practice. Radiators in the lounges and corridors should be fitted with guards. A quality assurance system should be introduced to monitor the management and administration of Minshull Court care home. Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Minshull Court Nursing Home DS0000018755.V265339.R01.S.doc Version 5.0 Page 21 - 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. 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