Inspection on 28/02/06 for Molyneux Park Rest Home

This inspection was carried out on 28th February 2006.

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

Molyneux Park Rest Home 06/06/08

Molyneux Park Rest Home 24/05/07

Molyneux Park Rest Home 09/11/06

Molyneux Park Rest Home 22/11/05

Molyneux Park Rest Home 15/02/05

Molyneux Park Rest Home 27/04/04

Molyneux Park Rest Home 14/10/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Molyneux Park Rest Home 38 Molyneux Park Road Tunbridge Wells Kent TN4 8DY Lead Inspector Debbie Sullivan Unannounced Inspection 28th February 2006 09:30 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 Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 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. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Molyneux Park Rest Home Address 38 Molyneux Park Road Tunbridge Wells Kent TN4 8DY 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) 01892 544322 Mr Colin Wallis Mrs Sheila Wallis Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: Molyneux Park Rest Home is registered to provide personal care and accommodation to sixteen older people. The home is located in a quiet residential area of Tunbridge Wells near to local shops. There is a nearby bus service into the centre of Tunbridge Wells; the town contains a large shopping centre and local facilities. The main line railway station is near the town centre. Accommodation at the home is on three levels with access to upper floors via stair lifts, there are ten single and three double rooms, one double room is used as a single. Communal areas consist of a lounge, dining room and conservatory. Three of the single rooms are equipped with en suite facilities. There is a staff call system and each room has a television point. A small garden and patio to the rear of the building with a lawned area are available for residents to use. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3 hours; time was spent with residents, the care staff on duty, the cook and cleaner and in speaking briefly with a visitor. A tour of the premises took place and information was also gained from reading documentation and some of the home’s policies and procedures. The manager of the home was not on duty at the time of the inspection. Whilst staff were very busy attending to residents and a number of callers they were helpful and friendly, made time to answer questions and provided information and maintained a relaxed atmosphere. Standards in relation to topics such as recruitment and training were not fully inspected, as the staff would not have had access to some of this information. At the time of the inspection there were 2 vacant beds and the resident group was all female. Comments made by residents spoken with included, “ They look after you very well” “ You could not better the food” “The bed is very comfortable” “Care is very good” “ No complaints” Comments from staff included, “ We work as a team” “The residents come first” What the service does well: Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 6 The home provides a relaxed and homely environment in well-maintained premises. Residents are only admitted after a ‘needs – assessment’. They are able to access information about the service and visit before making a decision about taking up a place. The staff group is well established and knowledgeable regarding the needs of individual residents. Health needs are recognised and well met. Residents are complimentary about the service and the care they receive. Meals are well cooked and nutritious. What has improved since the last inspection? What they could do better: Care plans continue to need to be broadened and put into an indexed format so that information can be more easily accessed. All radiators need to be fitted with guards or have low temperature surfaces for the protection of residents. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 7 Plans for fitting a new stair lift will increase the independence of residents, especially those on upper floors and need to be actioned as soon as possible. Care staff need to enrol upon NVQ courses as a priority in order for standards in respect of training to be met. Additional daytime staffing is required to ensure that sufficient care staff are on duty and there is sufficient cover in the event of illness or holidays. 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. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 8 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 Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 9 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): 3,4,5 and 6 Residents and their relatives are able to access information about the home so that they can make an informed choice. Needs are assessed prior to admission. EVIDENCE: The home has a statement of purpose and service user’s guide that includes a resident’s charter. This was fully inspected at the announced inspection in November 2005. A copy of the home’s aims and objectives is on display in the entrance hall. Residents and their relatives are able to visit the home prior to making a decision about moving in; residents spoken with said that relatives had viewed the home on their behalf, one resident had lived nearby and knew of the home and a relative visiting said that several services had been looked at before this home was chosen. The manager undertakes an assessment to ensure that needs can be met before offering a place and in the case of referrals received from social services, their assessment is also provided. The home does not offer intermediate care. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 10 Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 11 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 and 11 The health and personal care needs of residents are well met and care staff are well informed as to their individual needs. Care plans would benefit from being expanded upon. Medication recording procedures could be improved upon with the recording of any entries made in error. EVIDENCE: Several care plans were read; they included information on health needs, medical appointments, risk assessments, personal information and contacts, evidence of monthly reviews and a daily recording book for each resident was kept in the care plan folder. Whilst it was clear that reviews were taking place and any relevant information was being recorded, such as health concerns or Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 12 visits from outside professionals or family, the care plans should be expanded upon, particularly in the areas of recording of daily activities and risk assessment. Additionally, information in general, would be more easily accessible if it were put into an indexed folder. Care plans included information on consultation and referral to medical professionals, examples being an eye clinic appointment and recording of advice from a district nurse. During the morning a district nurse visited, a member of the care staff who discussed the health needs of a resident with the nurse was very aware of changes in the resident’s needs and gave relevant information. During the inspection, staff were seen to treat residents respectfully, attend to their needs in privacy and respond quickly when asked, even though they were very busy. Residents spoken with were all happy with their care. Medication is kept in a small lockable cupboard; the home does not have space for a dedicated medication room. The Nomad system is used, MAR sheets were inspected, each had a photograph of the resident and had been correctly completed with the exception of one space filled in error with the signature then crossed out. Residents near the end of their lives can remain at the home as long as their needs can be met. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 13 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 and 15. Residents are able to exercise choice and control over their daily lives. Contact with friends and relatives is supported. Meals are well cooked with choice available. EVIDENCE: Residents spoken with said that they were able to choose whether to spend time in their rooms or in the communal areas. Such areas comprise of the lounge, dining room and conservatory. Some residents were in the lounge, watching television in their rooms, or going to and fro. Residents felt that the routines of the home were flexible within the constraints of group living. Some activities are available, although at the last inspection the manager and staff stated that take up can be low. Residents said that a regular motivational session takes place and occasionally entertainers are provided. Those spoken with were happy to watch TV, listen to music or chat. A small dog owned by a member of staff is a very frequent visitor to the home, residents clearly enjoyed his presence and spoiling him and he was a source of conversation and interest. Contact with friends and family is supported; some residents spoke of going out with relatives and a relative visiting was made welcome. The home only Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 14 has space for a very small visitor’s room and as discussed at the last inspection, it will look at relocating the room if redevelopment should take place. The conservatory can also be used to receive visitors. Residents manage their own finances or are assisted by representatives. Residents were complimentary about the meals provided by the home and one said there was always a choice available, the cook takes account of individual likes and dislikes. The day’s menu was written on a board in the dining room, pancakes were the pudding at lunchtime as it was Shrove Tuesday. The meal was attractively presented and the atmosphere was relaxed with residents chatting over their meal. Nutritional needs are monitored; if a resident is admitted underweight, their weight is regularly monitored. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: These standards were not inspected on this occasion although the home has a complaints procedure available to residents, staff and relatives. A written copy of this is displayed in the hallway. Staff have access to the home’s and the most recent Kent and Medway Adult Protection procedures. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 16 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 and 26. The premises are clean, homely and well maintained. Equipment to aid independence is available and residents’ own rooms are personalised to individual taste. The fitting of guards on all radiators would enhance the safety of residents. EVIDENCE: The home was warm, clean and well maintained. There is a small garden and lawn area that residents are able to access in good weather. Shared facilities were well decorated and homely. As the property is a converted older style house, bedrooms vary in size and shape. All the bedrooms inspected were attractively decorated and had been personalised; one contained a slight odour, the cleaner explained the measures that are used to clean the room to try to prevent the odour. On admission, choice of room is offered if possible. A fairly newly admitted resident had chosen a ground floor room and another said that they had Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 17 moved from the top to the first floor by choice. Residents are only admitted to shared rooms if they choose to do so; one resident said they liked a shared room as they could chat with the other occupant before going to sleep. Bedrooms are located on the ground, first and second floors, a stair lift provides access to each floor although it does not reach the top stairs of the third floor, so residents on that level are not currently able to access other floors independently if they have problems with mobility. A member of the advised that a quote has been received for a new stair lift that will allow for more independence. Throughout the home equipment for individual or shared use was available. A small number of bedrooms have ensuite facilities. A radiator in the lounge and one in the dining room were unguarded and very hot, care staff said unguarded radiators were in the process of being fitted with guards. A small laundry area is situated near to the kitchen and food storage areas. This is not ideal, although again the building does not currently allow for another location for a laundry, a door separates the laundry from the kitchen. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 18 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, and 30 The staff group is well established and competent. Recruitment is necessary to increase the compliment of day care staff. Care staff must undertake NVQ training to comply with training standards. EVIDENCE: At the time of the last inspection in November 2005 the home had a vacancy for a member of the day care staff. Due to problems with recruitment, this position is unchanged. Currently two care staff are on duty during the day; the manager is covering some vacant care hours, and the two main members of the care staff are covering most of the other shifts. Consequently care staff are working a number of long days per week and there is little back up in case of illness or holidays. Care staff on duty were very committed to their role and knowledgeable about the running of the home, but recruitment should be pursued again as a priority to increase the number of staff available for shifts. The home also employs a cleaner and a cook. Care staff had not yet enrolled upon NVQ 2 or above courses. Staff spoken with and observed were confident, competent and managed all the interruptions of the morning well (district nurse, inspector, visitor, window cleaner, a number of phone calls) without compromising the needs of residents. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 19 Staff spoken with said that training is available provided by an outside agency that is relevant and useful. The cook was due to update food hygiene training in early March. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35,36, and 38. The home is well run in the best interests of residents. Additional staffing will enable more management time to be spent on staff supervision and development. EVIDENCE: There has been no change of management at the home; the employment of additional day care staff would provide the manager with more dedicated management time. The atmosphere is open and friendly and very much that of a family run service that treats residents as individuals and residents said they feel at home. A member of staff said that the staff group works as a team, supports each other and there is ample opportunity during the working day to consult the manager or each other about any problems or concerns about residents. Formal recorded supervision meetings are not yet in place, this was a requirement at the last inspection that was due to be implemented. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 21 Residents all manage their own finances or receive support from relatives or solicitors. Some of the homes policies and procedures were read; they are located in a communal area and accessible to staff and others. Staff had good knowledge of safe working practices and correct procedures, for example in respect of good hygiene, nutrition and health needs. Kitchen fridge and freezer temperatures are recorded daily and the home received a silver good hygiene award from Tunbridge Wells Borough Council Environmental Health Department in 2005. The home was observed to provide a safe environment with the exception of hazards being noted in terms of two very hot and unguarded radiators and bars of soap left one communal bathroom. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 22 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 2 3 3 2 3 STAFFING Standard No Score 27 2 28 1 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 1 X 2 Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 23 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 OP9 Regulation 13(2) Requirement “ The registered person shall make arrangements for the recording, safekeeping, safe administration and disposal of medicines. In that any errors or crossings out in recording on MAR sheets must be signed and documented as such. Timescale for action 01/05/06 2 OP22 23(2)(n) “ The registered person shall ensure that suitable adaptations are made, and such support, equipment and facilities, including passenger lifts as may be required are provided” In that the timescale for the stated proposed plan to fit a stair lift that allows access to and from the top floor be submitted to CSCI by the timescale stated for action. 01/05/06 3 OP38OP25 13(4)(c) “The registered person shall ensure that any unnecessary risks to the health or safety of DS0000023987.V283953.R01.S.doc 01/05/06 Molyneux Park Rest Home Version 5.1 Page 24 service users are identified and so far as possible eliminated”. In that all radiators must have low temperature surfaces or be fitted with guards. This requirement has been repeated from the last inspection. “ The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home” In that care staff must enrol upon NVQ or above training as an urgent priority to work towards complying with this standard. This requirement has been repeated from the last and previous inspections. “The registered person shall ensure that persons working in the care home are appropriately supervised” In that formalised and recorded supervision must be provided for all care staff at least six times a year. This requirement has been repeated from the last inspection. 4 OP28 18(1)(c) 01/05/06 5 OP36 18(2) 01/05/06 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 OP7 Good Practice Recommendations It is strongly recommended that the information in care DS0000023987.V283953.R01.S.doc Version 5.1 Page 25 Molyneux Park Rest Home 2 3 OP8 OP38 plans be expanded upon and that care plans be indexed and put in ring binders so that information is in order and easily accessible. It is recommended that when residents are weighed their weight be recorded on a chart. It is recommended that residents’ personal bars of soap be removed from communal bathrooms after each bath to prevent cross infection. Molyneux Park Rest Home DS0000023987.V283953.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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