Inspection on 14/07/08 for Mont Calm

This inspection was carried out on 14th July 2008.

CSCI found this care home to be providing an Good 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

Mont Calm 18/10/07

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 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Mont Calm 3 Clifton Crescent Folkestone Kent CT20 2EL Lead Inspector Christine Lawrence Unannounced Inspection 14th July 2008 10:30 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 Mont Calm DS0000069999.V367593.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. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mont Calm Address 3 Clifton Crescent Folkestone Kent CT20 2EL 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) 01303 242940 Mr Stephen Castellani Mrs Susan King Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP) The maximum number of service users to be accommodated is 20. Date of last inspection 18 October 2007 Brief Description of the Service: Mont Calm is a detached building, situated in a quiet residential area of Folkestone. It backs on to a grassed area known as ‘The Leas’, which overlooks the cliffs and the sea. Accommodation is provided in mainly single rooms for up to 20 older people, with bedrooms arranged over 3 floors and a mezzanine area. Most bedrooms are fitted with en suite toilet and washbasin facilities and some have their own bath. The lower ground floor contains the kitchen, laundry, staff room and a large lounge/dining room with access to a small patio area. There is also a larger patio area at ground floor level. There is a shaft lift which provides access to all floors. The fees range between £328.15 and £521.30. Further information about the home will be given on request. Mont Calm DS0000069999.V367593.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 2 star. This means the people who use this service experience good quality outcomes. The inspection visit was unannounced and started at 10.30 and finished at 15.40. We, that is the commission for social care inspection (CSCI) looked at various records in the home and also used information sent to us by the manager through her completion of the Annual Quality Assurance Assessment (AQAA). We received surveys from people who live in the home, as well as staff, and information from these surveys is included in this report. Information from the previous inspection was also referred to. A tour of parts of the building was undertaken in the company of the manager. We observed staff interacting with residents and we spoke to staff on duty as well as the manager. The area manager visited during the inspection and she also provided some information. We chatted to some residents and made observations of how they responded to staff. What the service does well: What has improved since the last inspection? The manager monitors completion of the medication records. A great deal of work has been undertaken regarding the refurbishment and redecorating within the home including improvements to the laundry. Fire equipment checks have been updated, as has the periodic inspection of the electrical installation. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 6 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. Mont Calm DS0000069999.V367593.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 Mont Calm DS0000069999.V367593.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home judges that it can meet their needs because it assesses their needs before they move in. EVIDENCE: We looked at three individual records for this inspection. They showed that information is gathered before admission about what someone’s needs are. This assessment is carried out by the manager. There was an example of information being provided by the placing authority and all three records seen showed that the people who use the service, as well as relatives if appropriate, are involved in the process. The information is used to compile a care plan. Mont Calm DS0000069999.V367593.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the home’s procedures for dealing with medication and they can be confident that they will be treated with respect. EVIDENCE: As noted previously care plans are compiled from assessments carried out before somebody is admitted. The care plans contain up to date information about the needs and wishes somebody has. The care plan specifics ask the question ‘What are your assessed needs?’ as well as identifying what the objectives are through asking ‘What do you want to achieve?’. The care plan also specifies what actions need to be taken and by who. The three plans seen were up to date and contained a checklist to note reviews and changes if any. Changes are highlighted in red so staff can see at a glance if anything different is required. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 10 The individual records also provide information and guidance about residents’ health care needs. Guidelines to staff reflect that it is important to encourage people to be as independent as possible so guidelines include ‘needs prompting’ rather than assuming everything needs to be done for someone. Individuals’ weight is monitored. A record is kept of the involvement of health care professionals such as GPs, continence nurse advisors, opticians and hospital appointments. Information given to the home by hospitals forms part of the ongoing care plan. There is a section within the individual record for recording and monitoring any falls as well as a range of other health needs. There are risk assessments as part of the individual record, with an emphasis on how any risk can be reduced. The medication storage and recording was satisfactory, including those relating to controlled drugs. The pharmacy provider has recently undertaken an audit and this was satisfactory. Staff have received training and the manager said that she checks competency from time to time. Policies and procedures relating to medication were updated in August 2007. We observed staff being polite and respectful to residents when supporting them or interacting. Residents spoken to said that their privacy was respected and staff knocked on doors before entering rooms. Staff spoken to said that respecting people’s privacy and dignity was an important part of providing personal care. Mont Calm DS0000069999.V367593.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 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be identified and responded to and that they will be enabled to maintain contact with friends and family. Residents will be enabled to make choices and they will benefit from healthy, well-presented food at a time and place to suit them. EVIDENCE: A ‘care report’ (daily record) is maintained for each person and those seen showed that people have different routines, such as times to get up and go to bed and what to have at mealtimes. One resident was out for lunch at the time of this inspection and another person said that they go out and about as they choose. It was also clear that people choose to be in their rooms or spend time in communal areas. After lunch one person was playing piano, another was doing a puzzle, one was watching television in the lounge and one was dozing. A person newly arrived was having a late lunch that had been saved for them. Information about a person’s interests is noted within their individual record. The surveys completed by residents said ‘usually’ and ‘sometimes’ in answer to the question about activities they can join in. The manager has identified that this is still an area for further improvement. One Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 12 member of staff said she thought this would be better now they have a cleaner and a cook in post. Communion is provided within the home by visiting clergy and the manager said if with any new admissions there were particular wishes or needs identified then the home would respond. Examples were noted in the individual records and daily recordings of residents maintaining relationships with family and friends. The manager said there are no restrictions on people visiting the home – it is as the resident wishes. One person confirmed they could entertain their visitors and this was supported by the home. Information about an advocacy scheme is on display within the home for residents’ information. The manager stated that residents mostly manage their own finances, some with the support of representatives. Residents can be confident that their preferences will be identified and responded to and that they will be enabled to maintain contact with friends and family. Residents’ responses included in the completed surveys and in conversations during the inspection visit varied with regards to food and meals. People were mostly positive and those spoken to during the visit felt that things had improved since a cook had been appointed. The menu seen was varied and offered choices. People are encouraged to join others for meals but they can chose to eat in their own rooms if they wish. Staff and the cook are aware of individual’s preferences and needs and they demonstrated this through discussions with us. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 13 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints would be handled objectively and in keeping with the home’s appropriate procedures and residents/their representatives can be confident that any concerns will be listened to, taken seriously and responded to. Staff are aware of adult protection issues and there are systems in place which create an atmosphere for protecting residents from abuse. EVIDENCE: All of the people who completed surveys said ‘yes’ to the question about knowing how to make a complaint. This was also reflected in the staff surveys completed, with people confirming that they knew what to do if a resident or a relative had concerns about the home. The manager has facilities for recording complaints but there had been no complaints in the last 12 months. The information relating to complaints is contained within the service user guide and there are policies and procedures for staff to refer to if needed. Staff have received training/instruction regarding the protection of vulnerable adults and there are policies in place to underpin this such as whistle blowing (disclosure of abuse and bad practice), management of residents’ finances and valuables and safeguarding adults. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 14 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a safe, well-maintained home which is homely, clean, comfortable, pleasant and hygienic. EVIDENCE: We made a tour of most of the building, including the laundry and some of the residents’ rooms. A lot of work has been done including flooring in some en suite facilities and improvements to the laundry. There is still some work to do but this is planned and progressing. A newly refurbished lounge area on the fourth floor, accessible by passenger lift, will provide an attractive, comfortable area for residents. There is a small room off this lounge which will be a quiet area for residents. Any maintenance needs are noted and passed to the maintenance person. There are patio areas that residents can access. The home was clean and fresh at the time of this visit. A cleaner has now been appointed and this should ensure that standards will be maintained. Ten Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 15 people have received infection control training and there are policies and procedures in place to underpin this. We were informed that all staff have received safe food handling training. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 16 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient staff who are competent and trained. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: A rota is used to indicate who is on duty and what their role is, indicating that a senior carer is on duty for all shifts. Some concern had been expressed by staff completing surveys about the lack of a cook and a cleaner but these post have now been filled. Staff numbers will have to be reviewed as more residents are admitted and the manager confirmed that she will do this. Thirteen staff have achieved a national vocational qualification (NVQ) at level 2 or above and four are currently undertaking this. The deputy manager is currently working towards achieving the registered manager’s award. We looked at the records for three members of staff and they showed that the recruitment includes the use of an application form, face to face interviews, references, written terms and conditions of employment and criminal record bureau checks. The manager provided information about the training programme and copies of training certificates were seen. Induction training is provided and this needs to reflect the common induction standards devised by Skills for Care. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 17 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Residents’ financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. EVIDENCE: The manager, Sue King, has NVQ level 4 in management and has built upon her NVQ level 3 in care to achieve the registered managers award. She discussed how she keeps up to date with current practice through accessing the Internet. She is only responsible for one home; there is an area manager in post who provides a line management role. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 18 Questionnaires for residents and their representatives are used to ascertain satisfaction with the service and there are regular residents’ meetings. The manager is looking at other ways to encourage people to give comments about the home such as the introduction of a suggestion box and she wishes to improve the questionnaires which are sent out. She also said that either she or the deputy tries to ensure that they talk personally to each resident each day. Residents we spoke to for this inspection confirmed that they had the opportunity to talk to the manager on a regular basis. The area manager carries out visits to the home under Regulation 26 of the Care Home Regulations and she also speaks to residents to ascertain their satisfaction with the home. The manager completed an annual quality assurance assessment form in May and she identified areas for improvement within that. Policies and procedures were updated in August 2007 and a further review and update where appropriate, is planned for this year. Requirements from the last inspection have been met. There are policies in place regarding residents’ money and valuables and the manager described the processes for recording any involvement with residents’ finances. One record was seen for this visit. There is a programme of training which means that either staff have received the training or there is a plan for them to undertake this. The manager maintains a training matrix so she can monitor the training needs of the staff team. A spot check on the maintenance and service contracts showed them to be in keeping with the information provided in the AQAA. Health and safety training such as manual handling, fire safety and first aid form part of the programme noted above. Safety checks are carried out and recorded. Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 19 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 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 Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 20 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 Mont Calm DS0000069999.V367593.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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