Inspection on 28/04/05 for Mont Calm Folkestone

This inspection was carried out on 28th April 2005.

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

The inspector 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 Folkestone 15/01/09

Mont Calm Folkestone 12/11/07

Mont Calm Folkestone 28/07/06

Mont Calm Folkestone 06/09/05

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

CARE HOMES FOR OLDER PEOPLE Mont Calm Folkestone 24/26 Earls Avenue Folkestone Kent CT20 2HE Lead Inspector Chris Randall Unannounced 28 April 2005 09:15 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 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 Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mont Calm Folkestone Address 24/26 Earls Avenue, Folkestone, Kent CT20 2HE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303251600 Mr Castellani Mrs B Parsfield Care Home 28 Category(ies) of Dementia (E) - (28) registration, with number of places Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 07.09.04 Brief Description of the Service: Mont Calm is a home for up to 28 people with dementia care needs. The premises comprise of a large period building in a residential area of Folkestone, near to good local facilities and resources and a short walk to popular area of The Lees. The building is set over 4 floors and adaptations have been made to promote and protect the safety of the residents. To the rear of the property there is an accessible patio area and a small private garden with agreed access to a pleasant adjoining large lawned area. The home provides a wide range of activities for all residents. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over 14 hours, 7 of these being spent in the home. This was the first inspection since the new providers have taken over the home. Time spent in the home comprised of a tour of the building, talking to residents, visitors and staff, observation of lunch being taken, observation of a medication round, and examination of records. The manager was not available on the day of the inspection but the under manager was able to help and provide information. What the service does well: What has improved since the last inspection? There have been alterations made to move one of the lounges from the top floor to the ground floor. The new provider has introduced new policies and procedures into the home. The under manager has completed her NVQ 4 in management and care and is awaiting verification and issue of her certificates. Training has increased significantly, although there are still major shortfalls in some training areas. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 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. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 4 & 5 The home has an effective admission assessment in place, and a trial period is offered. Residents assessed needs are supported by appropriately trained staff and by visiting professionals. EVIDENCE: Care managers supply a comprehensive assessment for residents who they place. All prospective residents are visited in their own home or in their current place of residence by the manager or under manager this enables them to gain information to form a suitable assessment as the basis of a care plan Mont Calm is a care home catering for residents with dementia. To support this 8 of the care staff have undertaken dementia training, a C.P.N. visits the home monthly and the Mental Health Team are involved in resident care and assessment whenever necessary. Initially all residents are admitted on a respite/trial basis for 4 weeks. This period allows time to settle and decide if the home is right for them, and for the home to assess if they can fully meet the needs of the new resident. The home does not provide the facility for intermediate care. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 9 Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) y The clear and consistent care planning system provides staff with the information they need to meet service users needs and this is supplemented by regular multi-disciplinary working. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: The home produces comprehensive care plans which include detailed information on each resident, a record of visits by visiting professionals, detailed risk assessments including necessary actions, care needs and plans of care, weight chart, and daily record. Additional information on fluid and food intake, care manager reviews; correspondence with doctors; blood sugar levels for diabetics; details of any injuries; details of any pressure areas and the district nurse involvement, including any equipment provided is also included where necessary. Residents are able to register with the doctor of their choice and have regular contact with the mental health team, a CPN visits monthly, the continence nurse visits when requested, and there are regular chiropodist, optician and dentist visits Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 11 The majority of medication is supplied to the home in a monitored dosage system. Non MDS medication currently in use is stored in containers individually labelled for each resident. The medication administration record sheets were completed with only very minor shortfalls. The MAR folder had been organised with a laminated page containing a photograph and name of the resident in front of each medication sheet. The home has a pharmacy refrigerator. Currently there are no controlled drugs prescribed, and on the occasional incident when such drugs are prescribed they are stored in a locked box in the homes safe and are double signed for. Medication received and disposed of was witnessed as being properly recorded to provide an audit trail. Residents expressed, and demonstrated by their actions and manner, their satisfaction with the staff at the home. Appropriate relationships between residents and staff were observed throughout the day of the inspection. Residents all looked clean and well cared for. Residents who wish and are able can use the pay phone in the home. There is also a cordless telephone on which residents can receive incoming calls from family and friends. Medical examinations are carried out in the privacy of the residents’ own room and this was witnessed when a doctor called to see one resident on the day of the inspection. Where there are shared rooms screening is provided to maintain privacy and dignity. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, &15 Residents are encouraged to actively participate in life at Mont Calm. Family and friends are welcomed into the home. Residents are encouraged to exercise choice and control over their lives with the help of families and friends. A wholesome appealing and balanced diet is provided. EVIDENCE: Residents at Mont Calm are able to join in a varied activities programme. On the day of the inspection an aroma-therapist who visits every 2 weeks was giving hand and knee massage and it was obvious that this was being enjoyed. A visiting guitarist/singer entertains the residents monthly, a hairdresser visits fortnightly, and monthly communion with hymns is celebrated for those who wish to participate. In home activities include a weekly activities afternoon and music in both lounges. Games and activities with residents and staff are a regular part of daily life. In addition the manager has produced personal folders for each resident with laminated photos and reminders of life experiences and visitors and staff spend 1:1 time looking through these and stimulating the memory of residents. There are photographs all around the home of the various activities that have taken place. Visitors are actively encouraged although the home does prefer them to leave by 8.30 p.m. to avoid disturbance to other residents. The wives of two residents help with the weekly activities afternoons. One resident’s daughter Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 13 explained how she visits with lunch to share with her parent as a treat and how the staff support her in this. Visitors all spoke highly of the home and of the care provided. Residents families normally deal with their financial affairs although the home does look after some personal allowances. The homes recording system for these personal allowances was seen to be sound with double signing of all payments, regular auditing by management, and balance sheets regularly sent to families for information. The residents receive a wholesome and nutritious diet with 3 meals a day supplemented by drinks and snacks. The cook produces a 4 week basic menu which she adapts on a week to week basis and wherever possible the food is freshly prepared. All food, including liquefied meals, is nicely presented and special diets and personal choices are catered for. The mealtime that was witnessed was unhurried with staff giving assistance sensitively where it was needed. The majority of the residents ate their meal in the dining room but meals are also served to residents in their rooms at their request and two residents took advantage of this on the day of the inspection. One resident had lunch brought in by a family member, and one resident had a lunch served later in the day to meet particular needs and circumstances. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents complaints are listened to, investigated, and appropriate action is taken. EVIDENCE: The home has a clear and accessible complaints procedure in place and all residents and their representatives are made aware of this on admission. Since the last inspection there have been no complaints made to the home. However, one anonymous complaint, which was passed to the Adult Protection team for investigation, was made direct to the Commission for Social Care Inspection. The complaint was divided into 13 parts. 8 parts of the complaint were found to be unsubstantiated, 4 parts were unresolved and 1 part was partially upheld. Since the time of the investigation the partially upheld section has been addressed by the relocation of the lounge from the top floor to the ground floor Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19, 21, & 26 With the exception of two rooms, residents are generally cared for in a safe, well maintained, clean environment with sufficient facilities to meet their needs. EVIDENCE: The home is laid out over 4 floors. Recent alterations have brought all communal rooms on to the two lower floors. Bedrooms are on the ground and two upper floors. The basement houses the kitchen, dining room, quiet lounge laundry and staff room. Toilet facilities are provided in each area and are well signed, and there are two assisted bathrooms suitably adapted for residents use. A shaft lift is available for residents to move between floors and all of the stairways are fitted with keypad entry gates for security and safety. The home employs a dedicated maintenance person who deals with routine maintenance. One room on the top floor had some water damage and loose wallpaper and this needs urgent attention to prevent further deterioration. Residents have access through the office to a patio area where they can sit and are able to smoke if they wish. The lower garden area needed the lawn to be Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 16 mowed on the day of the inspection. There is also access to a very pleasant large lawned area directly behind the home. Generally the home was clean and well maintained and problem areas were dealt with quickly and efficiently on the day of the inspection. However, there is one room on the ground floor with a lasting offensive odour that needs addressing. There are suitable laundry facilities provided and the home has a washing machine with a sluice facility. Hand washing facilities are available to enable effective infection control to be practiced. Infection control policies and procedures are correctly followed. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The residents are not being properly protected and their needs are not being adequately met due to the shortfalls in recruitment procedures and staff training. EVIDENCE: There is a recorded staff rota demonstrating sufficient numbers of care staff on duty, both day and night, to meet the assessed needs of the residents. (5:5:3). In addition there are sufficient domestic and catering staff and the home employs an administrative assistant The files of 3 staff recently employed were witnessed and it was found that all of these staff had been employed before CRB and POVA checks had been received and that in one case only one reference had been received. This situation must be addressed urgently to safeguard the residents. The homes training matrix demonstrated that, although training has increased recently, there are still major shortfalls particularly with regard to fire training, manual handling, adult protection, food hygiene, and infection control. A new induction programme complying with NTO requirements has been received but has yet to be implemented. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33,& 38 Residents and staff are put at risk due to the inadequate management of the home with regard to health and safety and training issues. EVIDENCE: Although standard 31 was not fully assessed it was confirmed that the registered manager has not yet commenced her NVQ4 in management and care. The under manager has recently completed these courses and is awaiting verification. The new provider of the home has introduced quality assurance strategies and will be submitting the findings to CSCI. Although the provider visits the home twice a week he has not yet produced the Regulation 26 reports of these visits that are required. It was found that there are several shortfalls in health and safety practices. The home does test its fire alarm system weekly and the emergency lighting Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 19 quarterly, however records show that regular fire training is not being given and that some staff have never received fire training. Residents are also being put at risk through inadequate staff training in moving and handling procedures. There is a hoist in the home but it was reported as not working and staff confirmed that they physically lift residents who fall thus putting themselves and the residents at risk. It was noticed that the footwear worn by some staff would not be appropriate for moving and handling procedures and would be contrary to good practice under Health & Safety. Training in first aid, food hygiene and infection control are not up to date for all staff. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 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 2 x 3 x x x x 2 STAFFING Standard No Score 27 3 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 2 x 2 x x x x 1 Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 21 No Are there any outstanding requirements from the last inspection? 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. 2. 3. Standard 19 26 29 Regulation 23 (2) (b) Requirement Timescale for action 30/06/05 30/06/05 31/05/05 4. 29 5. 30 6. 30 7. 30 The bedroom with water damage needs to be repaired and the decorations properly reinstated. 16 (2) (k) The premises must be kept clean, hygienic and free from offensive odours 19 (4) (c), Two written references must be & obtained before appointing any Schedule member of staff, and any gaps in 2 (3), & employment records must be (4) explored. 19 (1) New staff must only be (b), & confirmed in post following Schedule completion of a satisfactory 2 (2) (a), police check and satisfactory & 7 (a) check of the Protection of Vulnerable Adults register. 18 (1) (c) All members of staff must (i) receive induction training to NTO specification within 6 weeks of appointment to their posts. 18(1) (c) All staff receive foundation (i) training to NTO specification within the first six months of appointment, which equips them to meet the assessed needs of the service users accommodated. (to include dementia and adult protection), 18 (1) (c) iAll staff shall receive a minimum (ii) of three paid days training per H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc 31/05/05 31/06/05 31/07/05 30/04/06 Page 22 Mont Calm Folkestone Version 1.30 8. 31 9. 38 10. 38 11. 38 year (including in-house training) and have an individual training and development assessment profile. 9 (2) (i) The registered manager, must commence her qualification at level 4 NVQ in management and care, or equivalent. 23 (4) (d) Fire training must be attended & (e) by all staff at least once in every 12 month period. All new staff must undergo fire training on induction. 13 (4) (c), Appropriate equipment should be (5), & 18 supplied and maintained in good (1) (c) (i) working order to ensure the safe moving and handling of residents. All staff should be trained in the use of this equipment. 18 (1) (c) All staff shall be trained in (i) moving and handling techniques and such training shall be renewed annually 31/05/05 30/06/05 30/06/05 30/06/05 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 33 38 Good Practice Recommendations The registered provider shall provide a copy of a monthly Regulation 26 report to the Commission for Social Care Inspection In the interests of health and safety all staff should wear appropriate footwear. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V224103 280405 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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