Inspection on 31/01/08 for Monread Lodge

This inspection was carried out on 31st January 2008.

CSCI found this care home to be providing an Excellent service.

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

Monread Lodge 19/06/06

Monread Lodge 28/11/05

Monread Lodge 29/06/05

Monread Lodge 07/12/04

Monread Lodge 20/07/04

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 Monread Lodge London Road Woolmer Green Hertfordshire SG3 6HG Lead Inspector Patricia Rogan Unannounced Inspection 31st January 2008 2:00 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 Monread Lodge DS0000019472.V358770.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. Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Monread Lodge Address London Road Woolmer Green Hertfordshire SG3 6HG 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) 01438 817466 01438 817484 monread@lineone.net Monread Lodge Nursing Home Limited Mrs Anna Marrah Care Home 64 Category(ies) of Old age, not falling within any other category registration, with number (64) of places Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th June 2006 Brief Description of the Service: Monread Lodge is registered to provide residential care and general nursing care to older people. The single storey building is situated between the villages of Woolmer Green and Knebworth. There are good parking facilities for visitors and a local bus service stops very near to the entrance to the home. All accommodation is in single rooms with en-suite facilities, including a shower, wash hand basin and toilet. Assisted baths and toilets are also provided. There are a variety of lounges and quiet areas around the home with a central conservatory and a dining area. At the time of this inspection report, the care fees range from £507.89 per week to £800.00 per week. Fees are based upon a comprehensive assessment of need and this is explained in the Service User Guide, which can be obtained by contacting the service. Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This inspection included a visit to the home where time was spent meeting privately with people living in the home and their visitors, so that we could find out what they thought about the care provided. The way that staff interacted with people in the home was also observed during a tour of the building. Case files, staff records and some policies and procedures were also inspected, to see whether these were relevant and up to date. Additional information was also gathered from the Annual Quality Assurance Assessment, which was completed by the manager. Some professionals who are familiar with this service were also asked for their views about the management of the home. What the service does well: What has improved since the last inspection? The premises have always been maintained to a high standard and there has been an audit of furnishing and equipment to identify where improvements are needed. As a result, there has been a great deal of investment so that people living in this home have fully reburbushed bedrooms and additonal Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 6 entertainment equipment such as large screen televisions and large playing cards for people with visual impairment have been provided. A requirement was made at the last inspection because some members of staff did not always protect the dignity of people living in the home. The manager responded to this immediately in order to ensure that everyone was respected. Care plans are now signed by the person being assessed, or their representative where appropriate, to show that they have been involved in making the assessment and have agreed with its contents. 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. The summary of this inspection report can be made available in other formats on request. Monread Lodge DS0000019472.V358770.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 Monread Lodge DS0000019472.V358770.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 this service.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have sufficient information about the home to assist them in making informed choices. People know that they will have their needs assessed before moving into the home. EVIDENCE: The statement of purpose and individual service contract explains clearly how care and support will be provided. People who are considering moving into Monread Lodge are given an information brochure and invited to view the home. When a pre-admission assessment is being completed, the person being assessed and their friend or family where appropriate, are closely involved so that their views are recorded. The response in a questionnaire was, They really made us feel that our opinions counted. All those involved sign the assessments, to show that an agreement has been reached that the service is able to meet his or her needs in the way they wish to be supported. Monread Lodge DS0000019472.V358770.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can be sure that they are supported in the way they would like to be supported. Medication practices are sufficiently robust to fully protect people. EVIDENCE: Care plans specifying all aspects of care and support needs and they are user friendly and easy to read. The person who is being assessed is encouraged to have their family or representative with them if they choose. This is so that people feel involved in the development and review of care plans. Qualified nurses are responsible for assessing and providing nursing care and there are qualified nurses on duty throughout the twenty four hours. The management of risk is positive in addressing safety issues without being too restrictive. Medication is administered in accordance with guidelines and rules by qualified Registered General Nurses. People using this service spoke highly of the staff, saying, They treat us with respect. and They are always polite. Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Monread Lodge have opportunities to participate in activities that are appropriate to their needs and they are supported to maintain contact with family and friends. People have a varied diet that they enjoy. EVIDENCE: The service now has three activity co-ordinators so that people take part in a wide variety of group or individual activities throughout each day and evening. Many favourable comments included, I never feel bored here. Theres no pressure to join in, but there is always something to do. An improved ariel system and large screen televisions have been wall mounted in the communal areas and other visual aids such as large sized playing cards have been purchased. Several people using this service said that they were really pleased with the new televisions because they are so easy to see. The service supports people who wish to follow a spiritual and religious faith, for example, a local church choir visits the home every week. The menu is varied and people living in the home said, I love the food here. Others said they liked the choice of food and the flexibility of meal times. People having specialist medical foods or liquids are monitored by qualified nursing staff. Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 11 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that they will be listened to if they have a complaint or a concern and that action will be taken to resolve it. EVIDENCE: People who live in the home and their family or representative said they feel safe and well supported by the manager and people who work in the service. I would never hesitate to speak to someone if I was worried, was one comment. The manager emphasises the need for an open culture that allows people to express their views and concerns in a safe and understanding environment. There is a focus on ensuring a prompt response to all concerns or issues, which arise so that they can be resolved as soon as possible. The complaints procedure is well publicised throughout the home, there are copies in each persons room, in the service user guide and in the home information brochure. Staff have been trained in safeguarding adults procedures and know what to do if a complaint is made. The home keeps a full record of complaints and this includes details of the investigation and any actions taken. Regular consultations with people using this service also serves to check the level of satisfaction with the service provision. Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 12 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Monread Lodge benefit from a comfortable environment that is well maintained and clean. EVIDENCE: People using this service have a high standard of accommodation because there is an ongoing refurbishment, redecoration and maintenance programme. This includes new soft furnishing, carpets, arm chairs and refurnished bedrooms throughout the home. People using this service described the home as A lovely place. A new laundry system has been established which incorporates the latest infection control system to reduce the risk of cross infection. The home is fully accessible for people with poor mobility and people using wheelchairs. Several people described the home as Wonderfully clean. In addition to regular cleaning, carpets and kitchen areas are deep cleaned on a regular basis to ensure that the home is hygienic and safe to live in. Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 13 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who uise this service can be confident that they are protected by the homes policies and procedures regarding recruitment and staff training. EVIDENCE: The turnover of staff is low and the use of agency staff is rare. This provides continuity of service for people living in Monread Lodge, resulting in comments such as, I like it that the staff know me and I feel relaxed with them. Policy and practice around recruitment is strictly followed and all vetting, references and prior qualifications are checked before a post is offered so that people are protected by these procedures. The staff rota ensures that there are sufficient numbers of trained care staff and qualified nurses on duty to meet the needs of people in the home. Staff training is planned in advance and if learning needs are identified during staff appraisals and supervisions, this can be incorporated in the training schedule so that the people working in the home have the confidence and increasing knowledge to provide a safe, high standard of care. Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 14 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 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using this service can be confident that they live in a home that is well managed and where they will be able to express their views. EVIDENCE: The managers leadership provides a good quality service which is person centred and safe. In order to ensure that this continues, quality assurance systems are used, including resident and relative consultations, questionnaires and staff meetings. The manager completed the Annual Quality Assurance Assessment and this showed her understanding of best practice in standards of care, equality and diversity and peoples rights. Contracts are in place so that all equipment is regularly serviced. Inspections by fire safety officers and environmental health officers have had positive outcomes. This is further evidence that the safety and wellbeing of people using this service is taken seriously by the registered manager and by the registered provider. Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 15 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 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 x x 4 Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 16 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 Monread Lodge DS0000019472.V358770.R01.S.doc Version 5.2 Page 17 Commission for Social Care Inspection Inspection 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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