Inspection on 18/10/07 for Mont Calm

This inspection was carried out on 18th October 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mont Calm 14/07/08

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 Mont Calm 3 Clifton Crescent Folkestone Kent CT20 2EL Lead Inspector Paul Stibbons Key Unannounced Inspection 18th October 2007 12:00 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 Mont Calm DS0000069999.V347175.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.V347175.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 Anthony Castellani Mrs Susan Elizabeth King Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Mont Calm DS0000069999.V347175.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 Brief Description of the Service: Mont Calm is a Grade 2 listed, detached, Victorian-style building, situated in a quiet residential area of Folkestone. It backs on to a well-known grassed area known as ‘The Leas’, which overlooks the cliffs and the sea. There are spectacular views from the bedrooms to the rear of the property. 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 easy access to all floors including the top floor where work is in progress to provide an additional lounge and kitchenette. The fees at this service range between £350 and £430 with additional charges for chiropody and hairdressing. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 5 Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over a period of 3.5 hours and the registered manager was present. A completed Annual Quality Assurance Assessment (AQAA) had been completed and returned to the CSCI prior to this visit. A tour of the building was carried out and a variety of records and documents were examined. Discussions were held with the manager, members of staff and two residents during the visit. Two care managers and two relatives were spoken with by telephone following this visit. What the service does well: What has improved since the last inspection? 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.V347175.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.V347175.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): 1,2,3,4,5 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 provided to enable them to make an informed choice as to whether the home will meet their needs. People considering living at the home have a comprehensive assessment of their needs prior to a permanent placement to ensure the home can meet their requirements and expectations. People have the opportunity to visit and assess the quality, facilities and suitability of the home prior to accepting a permanent placement. People living in the home have the security of an individual written contract of terms and conditions in the home. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 9 EVIDENCE: The Statement of Purpose and Service User guide gives people considering moving into the home written information on what life in the home might be like and the facilities available. In addition people are encouraged to visit with friends and family and spend time with existing residents and staff before committing to a permanent move. Residents spoken with could not remember whether they had made any visits before moving into the home. One relative spoken with confirmed they had indeed made visits prior to moving in. Three individual written contracts were viewed and they had been drawn up with the previous provider (Wyndham). The manager has agreed to revise these and add additional information, for example, room numbers and fees payable. Three care plans were examined and each contained written assessments of people’s needs and guidance for staff members in meeting those needs. Records indicate that families and other health care professionals have been involved in the assessment process. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from having individual care plans that set out their health, personal and social care needs. People living in the home are supported in managing their medication safely and are protected by the home’s policies and procedures for dealing with medication. People living in the home are treated with respect and dignity and their right to privacy is upheld. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three care plans were examined and each contained detailed assessments of people’s needs and clear guidelines for staff members to follow. There is evidence of input from other health care professionals by way of referrals and visits that are recorded in daily records. There is also a review form that records the monthly review of care plans and risk assessments. The manager states in the Annual Quality Assurance Assessment (AQAA) that residents are involved in their care planning but intends to involve them more than at present. This will need to be evidenced through signatures of the residents. Confidential records are securely stored in the manager’s office. Medication is appropriately stored in a drugs cabinet with residents’ prescriptions clearly marked. Examination of the administering records identified that some signatures are missing from the records, the manager is to speak with staff member concerned. It is recommended that medication record sheets are checked as part of the shift handover procedure in order to rectify errors at an early stage should they occur. One resident manages their own medication and the home has recorded a risk assessment to ensure the safe management of medication for this person. Training records viewed indicate that those members of staff responsible for dealing with medication have received appropriate training in the safe handling of medication. Residents spoken with state that staff are “kind”, “caring” and “nice girls”. Observation of practice confirmed that staff treated the residents with respect and patience. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home would benefit from more opportunities to access the wider community and stimulating indoor activities. People benefit from living in a home where they are supported to maintain contact with family and friends. People living in the home enjoy a varied and balanced diet according to the choices they make. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 13 EVIDENCE: Activity records indicate that indoor activity includes bingo, jigsaw puzzles, skittles, films and cards. The home’s manager has identified through the AQAA a need for more in-house entertainment and has organised for a weekly musician/singer session to take place. The manager is asking residents to express their preferences for activities at resident meetings. One resident spoken with states that he likes to go for a walk on his own and does so every day weather permitting. A relative spoken with after this visit states that although their relative is “generally happy” there are concerns around a lack of activities and being able to be taken for walks due to a lack of staff. A local clergyman calls to the home to give communion. The home’s AQAA identifies as to what they could do better as more daily walks, more outside activities, more indoor games that residents prefer. No activities were observed during the visit. Relatives spoken with state that they are made welcome and can come at any time. One relative spoken with states “very happy with care given”, “staff team are excellent and look after mum”. The manager is trying to encourage family and friends to stay for meals more often. Menus viewed were varied and nutritious and are made up for a four-week cycle. There is a menu board and residents make a daily choice, this was confirmed during conversation with residents who when also asked about the meals state “its alright” and “the foods good”. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home and their representatives can be confident that their complaints will be listened to, taken seriously and acted upon, and they are protected from abuse. EVIDENCE: The home has a clear complaints policy in place and details are in each service users guide. There has been one complaint from a resident in the last 12 months and this was resolved and upheld by the home. Two residents spoken with said they would have no difficulty in raising concerns with staff members and one relative spoken with felt the same. The manager states that residents are encouraged to raise any concerns at resident meetings and have been issued with a sheet giving information about complaints in addition to information in the Service users guide. Staff training records indicate that the majority of staff have received training around safeguarding vulnerable adults and those that have not are booked on courses. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 15 Four residents manage their own finances and the manager deals with three for which auditable records are kept. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a home undergoing refurbishment and they benefit from the areas that are completed. People living in the home benefit from having good sized bedrooms that suit their needs with their own possessions around them. People who live and work in the home could potentially be placed at risk through a lack of health and safety and infection control awareness. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home has recently been decorated and new carpets laid through the ground floor and stairway. The main entrance is welcoming with registration certificate and insurance certificate on display. The lounge/diner area is pleasantly decorated with comfortable furniture and creates a relaxing area for residents to enjoy. Bedrooms that are occupied are of a good size and adequate to meet the needs of the resident. The en-suites in some bedrooms require new flooring for hygiene and safety purposes and the manager states this is part of the refurbishment programme. A relative spoken with made the comment that progress with the refurbishment is “rather slow” and the en-suite flooring in their relatives room has needed replacing for some time. One resident spoken with was very happy with her room and had many personal possessions on display, also her own cat that stays with her. Some of the bathrooms viewed had splashes of paint and lime scale marks in the baths that need to be addressed by the cleaners. One bedroom in particular has a very soiled carpet and the manager states the home is looking to temporarily move the resident to another room so that the room can be refurbished, this was later confirmed by the care manager who the home have advised. The attic area is being converted into a second lounge with sea views for residents to enjoy accessible by passenger lift and stairway. At present it is a building project in progress and there is restricted access to residents. The hoists viewed have been serviced within the LOLER regulations. There was no evidence that portable appliance testing had been carried out and fire extinguishers have not been serviced since 2005 or April 2006, this must be addressed as a matter of urgency as people living and working in the home could be at risk should they fail to operate correctly. The kitchen is of commercial design and appropriate food safety checks are carried out, for example, storage temperatures and the dating of cooked or opened food. The laundry and sluice are in the basement and whilst appropriate equipment is provided the area is not readily cleanable and sinks are full of discarded items. Action should be taken to ensure floor finishes are impermeable and these and wall finishes are readily cleanable in the interests of hygiene and infection control. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from being supported by staff who are trained and competent to do their job. People who live in the home are in safe hands at all times and they are protected by the home’s robust recruitment policies and practices. EVIDENCE: Staffing rotas viewed evidenced adequate numbers of staff to meet the needs of the current number of residents. The manager has agreed that the staffing requirements will be reviewed as and when more residents are admitted to the home. Staff members spoken with expressed the view that there was sufficient numbers on duty to fulfil their roles. The home is in the process of recruiting someone to the cleaning position. Three training records were examined and they indicated training that included health and safety, food hygiene and manual handling. Infection control Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 19 training is in need of updating. Eleven members of staff have achieved NVQ Level 2 in care and three staff are enrolled on level 3. Three staff files viewed contained evidence of appropriate checks being carried out prior to employment including, two satisfactory references and a CRB/POVA check. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People benefit from living in a home that is run and managed by a person who is fit to be in charge and runs the home in the best interests of people living there. The financial interests of people living in the home are safeguarded. People living in the home are potentially at risk from a lack of health and safety awareness and implementation of control measures. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home’s manager has been registered with the CSCI and is enrolling with a local college to achieve the NVQ 4 in care. Safeguarding vulnerable adults training has been completed as well as supervision and appraisal of staff. Staff members spoken with state that the manager gives leadership and is approachable. The staff team has not been receiving regular supervision and the manager states this will be rectified now she has completed the appropriate training. Four residents manage their own finances and the home’s manager keeps detailed records of expenditure and receipts for three others. As identified within the report there are areas of health and safety that need addressing to ensure the safety of people living and working in the home that includes the regular servicing of fire equipment, the testing of all portable electrical appliances and measures to control the risk of cross infection. The manager was unable to produce a current mains electrical test certificate. The home’s provider has not been recording findings from visits to the home. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 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 3 2 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 2 2 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 3 3 X 3 2 X 1 Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A New Service 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 Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 17 (3)(a) Schedule 3. (3)(i) Requirement Timescale for action 23/12/07 2. OP19 23 (2)(b) 3. OP19 23 (4)(c) (iv) 4. OP26 13 (3) The registered person shall keep up to date a record of all medicines and the date on which they were administered to the service user. In this context signatures not present on administration records. The registered person shall 23/12/07 ensure that the care home is kept in a good state of repair externally and internally. In this context damaged flooring in ensuites. The registered person shall after 23/12/07 consultation with the fire authority make adequate arrangements for the maintenance of all fire equipment. In this context the servicing and testing of fire extinguishers. The registered person shall make 23/02/08 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. In this context the laundry floor finishes are impermeable and these and wall finishes are readily cleanable. DS0000069999.V347175.R01.S.doc Version 5.2 Mont Calm Page 24 5. OP38 13 (4) Washing sinks should be kept clean. The registered person ensures the health and safety of service users and staff. In this context maintenance of electrical systems and electrical equipment. 23/12/07 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. Refer to Standard OP2 OP12 Good Practice Recommendations Written service user contracts should be revised to reflect the new company Service users’ interests should be recorded to facilitate opportunities in and outside the home which suit their needs, preferences and capacities. Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local 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. Extracts may not be used or reproduced without the express permission of CSCI Mont Calm DS0000069999.V347175.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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