Inspection on 28/07/06 for Mont Calm Folkestone

This inspection was carried out on 28th July 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Mont Calm Folkestone 15/01/09

Mont Calm Folkestone 12/11/07

Mont Calm Folkestone 06/09/05

Mont Calm Folkestone 28/04/05

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 Wendy Jones Unannounced Inspection 10:00 28th July 2006 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 Folkestone DS0000063034.V300335.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 Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 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 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 251600 Mont Calm Folkestone Mrs Bronwyn Elizabeth Parsfield Care Home 28 Category(ies) of Dementia - over 65 years of age (28) registration, with number of places Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Mont Calm is a care home providing care for up to 28 people over the age of 65 years with a diagnosis of dementia. The home is situated in an avenue,. a short walk from the popular Leas area of Folkestone. There is a mainline railway station and local bus routes nearby. The home has a statement of purpose that gives information about their service. A copy can be obtained from the home. Currently the scale of fees is between £367.82 and £500 per week. Hairdressing, chiropody and toiletries are at an additional charge. Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Wendy Jones, Regulatory Inspector, carried out this key inspection. It was carried out over a period of time and concluded with a site visit to the home between 10:00am and 12:20pm on 28 July 2006 and 9:45am and 12.00midday on 31 July 2006. A range of evidence has been used to inform this report and judgements have been made based on this evidence. Evidence used includes concerns, complaints, allegations and other information received, reports of incidents and deaths that have occurred since the last inspection, a tour of the home, inspection of some records, comments received from GPs, residents and their relatives and discussion with the manager, deputy manager, residents and staff. What the service does well: What has improved since the last inspection? Actions required from the pharmacist inspector’s visit have been put in place and residents are now protected by the medication procedures of the home. Staff recruitment is now robust and protects the residents. POVA first checks as well as CRB and all other checks required are carried out. There were no offensive odours in the home. The water damage that had occurred in one bedroom has been repaired and the room redecorated. Carpeting has been fitted on the concrete floor just inside the front door leading to the external ramp. Staff have received training and now know how to use the hoist that is on loan to the home. Staffing levels are no longer reduced at weekends and are the same as in the week. A large part of the training required for staff at the last inspection has Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 6 been provided and further training is planned to make sure that all staff receive this training. 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 DS0000063034.V300335.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 Folkestone DS0000063034.V300335.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective residents have all the information they need to decide whether the home is for them. EVIDENCE: The manager, or her deputy carries out initial assessments, before potential residents move into the home. These are used, along with assessments from care managers and mental health and other healthcare professionals to develop individual care plans for the residents. Staff have a clear understanding of dementia needs. Some training has taken place since the last inspection, but a number of staff still need formal training. Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 9 Residents’ comments received prior to the site visit stated that they had been able to visit on a trial basis, had enough information to decide whether to move into the home and have received a contract telling them of the terms and conditions of the home. Mont Calm Folkestone DS0000063034.V300335.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 - 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents’ general health and personal care needs are met. EVIDENCE: Care plans were clear and easy to follow. Needs and risk assessments were comprehensive and clearly identified the need or risk. They outlined the action staff are to take to meet these needs and reduce or remove any risk. However, none seen contained specific risk assessments for residents who like to use the patio area outside the staff office. This area raises a number of risk. Although staff spoken with were clear about their role and how to ensure the residents are safe when they go out there, risk assessments need to be added to their care plans. Care plans had been reviewed monthly and comprehensive daily records were being kept. They also contained details of when the resident had seen their doctor, or district nurse and of optician, dentist etc appointments. Residents Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 11 are weighed regularly and the care plan seen for one resident showed that their weight had increased and stabilised since moving into the home. Actions required from the pharmacy inspector’s visit at the time of the last inspection had been carried out. Medication was being stored at the correct temperature and the temperature of the fridge was being checked and recorded. Medication administration records were up to date and had been completed accurately. Signatures of the staff responsible for medication were seen. However, it was suggested that their initials are also recorded to help when checking these records. Medication is now kept in a medication trolley as recommended. There had been a review of medication and staff training provided by Boots in February 2006. Staff spoken with who had responsibility for medication were clear about changes to the medication procedure following this review. Staff were polite and caring to residents. The staff on duty at the time of the site visit clearly understood the needs of the residents and treated them with respect and courtesy. Mont Calm Folkestone DS0000063034.V300335.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service The daily routines and activities provided meet residents’ needs and are flexible. Residents keep in contact with their family and friends. EVIDENCE: The manager organises and carries out a range of activities for the residents. Photographs are taken of residents enjoying games, arts and crafts, parties where the staff dress up and visiting entertainers. These photographs are displayed throughout the home and have also been put into a folder for each resident. The manager explained that the residents enjoy looking through these folders and talking about the things they have done. Residents were enjoying music in both lounges and some were singing along. There was laughter and both residents and staff were clearly enjoying themselves. There are no televisions in either of the main lounges. The manager explained that residents have televisions in their own rooms, but if they want to watch with other residents there is a television in a smaller, quieter room in the basement, next to the dining room. Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 13 A number of people came to see residents during the site visit. Relatives who returned survey forms said they felt welcomed any time and could visit in private. Comments included “there is plenty of laughter from helpers and music is very relaxing for …”. Copies of menus had been received before the site visit. These and other records seen showed that residents have a balanced, nutritious diet that gives them variety and choice. Some residents had the midday meal in the dining room. Staff brought others theirs in their room. Mont Calm Folkestone DS0000063034.V300335.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 inspected at least once during a 12 month period. 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. Residents and their relatives’ complaints are taken seriously and investigated. Staff will take the correct action to safeguard residents from abuse. EVIDENCE: Information received before the site visit showed that no complaints had been received since the last inspection. At that inspection there was a clear complaints procedure and evidence was seen that previous complaints had been investigated properly. More staff have been trained in adult protection and those spoken with were clear about what to do if they suspected a resident was being abused in any way. The manager explained that further training is to be provided for staff who have not yet received this training. Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 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 the following standard(s): 19 –22, 23 - 26 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and comfortable home with private and communal rooms that meet their needs. EVIDENCE: All areas of the home were attractively decorated. They were pleasant and reasonably airy despite it being a very hot day and there were no unpleasant odours. There is a lift for residents to reach all floors of the home. A staircase also reaches all floors but access is restricted for residents for their safety. There are two lounges with music systems and comfortable seating. The dining room is in the basement next to the kitchen. There is a patio leading from the staff Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 16 office with a garden table, chairs and an umbrella and benches for residents to use. Staff said that to be sure that residents are safe they cannot use this area without staff supervision. This area is the only access from the home into the garden. There are steps into this area and currently residents in wheelchairs cannot make use of it. Work has started to clear the garden. However, the only access to this area is from the patio down a flight of very steep concrete steps. The previous requirement for the grounds to be accessible to all residents remains. The area inside the wheelchair access door at the front of the building has now been carpeted for residents’ safety. Residents’ rooms are individual to them and meet their needs and tastes. They have their own personal items including photos, pictures, televisions etc. There are twenty two single rooms and three double rooms. None of the rooms have en suite facilities. There are two communal bathrooms with bath hoists, and seven communal toilets. Those seen were clean and hygienic. There were three washing machines in the laundry. One new machine with a sluice facility had been installed recently. There is also one industrial and one domestic dryer and a roll press for pressing bedding. The laundry person explained how clean and dirty laundry is kept separate and was clear about the procedure to follow to control the spread of infection. Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s recruitment procedure. They are supported by staff who have the skills to meet their needs. EVIDENCE: Staffing rotas received before the site visit showed staffing numbers were appropriate at all times including weekends. At the time of the site visit there were five care staff on duty two of which were senior staff. This was enough staff to meet the needs of the 28 residents in the home at this time. Relatives who returned survey forms felt that there was usually sufficient staff on duty. But when they felt there were not “it doesn’t stop staff on duty doing their very best” At least 50 per cent of the care staff have been trained to NVQ level 2 or above and staff files contained copies of their certificates. Recruitment procedures are now robust and protect residents. All checks are carried out including POVA first and CRB checks and records of these were seen. Staff files confirmed that new staff had received appropriate induction training. Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 18 Training certificates displayed around the home and seen in staff files showed that training in manual handling and hoisting, fire and evacuation, dementia and infection control has been provided since the last inspection. Further training for staff who are still to receive training in dementia and infection control is planned for September and October 2006. Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 – 33, 35 - 38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-managed home that is run in their best interests and safeguards their rights. EVIDENCE: The manager has a number of years’ experience of managing a care home. She does not have the Registered Managers Award but the deputy manager has achieved this qualification. The manager, deputy manager and senior staff all have their own specific roles to play in the management of the home and there are clear lines of accountability. Relatives felt that the “home is very friendly place, all the staff treat you as friends” Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 20 On the first day of the site visit the manager and deputy manager were not on duty. But the home was being well run and the staff were welcoming. Staff said that they enjoyed working at the home and felt they all worked well together. They said that they are well supported by the manager and deputy manager and feel they have the skills and resources they need to do their jobs well. Quality assurance surveys are usually carried out twice a year. The last survey had been at the end of 2005. The deputy manager explained how she assesses the responses for themes and any action that needs to be taken. Although the provider visits the home regularly, at the last inspection there were no written reports of these visits, as required in regulation 26 of the Care Homes Regulations. The Commission has since received copies of reports for January to March 2006. However, no evidence that further reports have been completed has been found. The provider must prepare a written report for the manager of visits he makes to the home and copies must be available for the Commission to inspect. All records were safe and secure. Service users monies were recorded properly and stored individually and safely. Staff were clear of their roles and the needs of the residents. The manager and deputy advised that staff are supervised informally on a daily basis and they felt they had good communication with all staff. However, formal, recorded supervision was not being carried out on a regular basis. This should be done at least six times a year. Staff felt well supported by the management and said they were approachable at any time if they needed help or guidance. Staff said that they had been on fire awareness training recently and were clear and confident about what to do if the fire alarm sounded. Training records showed that staff had attended this training. Staff have now received manual handling training and have been trained in the use of the hoist on loan. Although there are a number of staff who have beem trained in first aid, some have let their qualification lapse. This means there may not be a qualified first aider on duty on every shift. First aid training must be provided as soon as Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 21 possible to ensure that a member of staff qualified in first aid is on duty at all times. Information received prior to the site visit showed that all relevant maintenance and checks have been done and are up to date. Mont Calm Folkestone DS0000063034.V300335.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 3 2 Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7.3 Regulation 13(4)(b) Requirement Risk assessments with regard individual residents accessing the patio area outside the staff room must be carried out. The grounds and outdoor space must be accessible and safe for all residents to use, including those in wheelchairs or with other mobility problems. This requirement is carried forward from the previous inspection. The provider must produce a written report of monthly, unannounced visits to the home in accordance with Regulation 26, which must be available for inspection by the Commission. This requirement is carried forward from the previous inspection. The provider must make suitable arrangements for enough staff to be trained in first aid to ensure that there is always a member of staff on duty trained in first aid. Timescale for action 28/08/06 2 OP20.3 23(2)(o) 28/09/06 3. OP33.1 26 28/08/06 4 OP38.2 13(4) 28/08/06 Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 24 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 OP36.2 OP30.1 Good Practice Recommendations Care staff should receive formal supervision at least 6 times a year. Training in dementia, infection control and adult protection should be provided as planned for staff who are still to receive this training. Mont Calm Folkestone DS0000063034.V300335.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 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 DS0000063034.V300335.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. 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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