Inspection on 06/09/05 for Mont Calm Folkestone

This inspection was carried out on 6th September 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 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 28/07/06

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 Chris Randall Announced Inspection 6 September 2005 : 09.30 th 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 V239615 060905 stage 4.doc Version 1.40 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) 01303 251600 Mont Calm Folkestone Mrs Bronwyn Elizabeth Parsfield Care Home 28 Category(ies) of DE (E) Dementia-over 65 registration, with number of places Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28.04.05 Brief Description of the Service: Mont Calm is a care home for 28 older people with dementia care needs. The premises comprise a large old period building, which is located in a residential area of Folkestone, near to good local facilities, and a short walk to the popular area of The Lees. The building is set over 4 floors and adaptations have been made to promote and protect the safety and security of the service users. There is a ramped wheelchair access, but is is necessary to climb some stairs to the front door to request this door to be opened. There is an a patio area which is accessible to service users who have reasonable mobility as there is one step to manoeuvre. There is also a garden area but currently this is not accessible to service users and is in need of tidying. There is a good atmosphere within the home and a range of activities are provided to stimulate the service users. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took 19.5 hours, (13.08 hours in the home plus preparation time), and was held over 2 days. The inspector was accompanied for the first hour and a half by a pharmacy inspector. Her comments will be reported to the home separately, her time in the home has been included in the overall timings of the inspection. The inspection consisted of a tour of the building, chatting generally to most service users, talking to 14 staff, and to 3 visitors, one who spoke on behalf of herself and another visitor who was unable to be present. The registered manager was on holiday on the day of the inspection and the under manager and administrative officer led the inspection on behalf of the home. Requirements have been made regarding recruitment procedures, staffing levels, staff training and supervision, environmental and health and safety issues, medication, and registered provider visits. The home was clean, and the odour previously reported was at a much improved level with fairly low levels of residual odour. Service users appeared happy and contented and looked well cared for. There was a good atmosphere within the home and the relationships between service users and staff were good. Food served was balanced and nutritious. Visitors commented, “it is a happy home” and “there is a nice atmosphere”, and staff commented, “I am really happy as long as the clients are happy”, “it’s a good home – the people are friendly”, and “the atmosphere is the best thing”. What the service does well: The home has an interesting and stimulating activities programme, and involves interested families in activities. The staff are cheerful and friendly, mix well with service users, and spend time talking to and stimulating them. There is generally a happy atmosphere in the home. The food in the home is freshly cooked, well presented, and nutritionally balanced. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 6 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. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 7 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 V239615 060905 stage 4.doc Version 1.40 Page 8 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 V239615 060905 stage 4.doc Version 1.40 Page 9 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 Prospective service users needs are assessed, and all stay for a trial period, to ensure the home can meet their needs. EVIDENCE: The manager of the home, or her deputy, visits all prospective service users at home or in hospital and an initial assessment is made of their needs. For service users under the care management scheme this is backed up by the comprehensive joint assessment and plan of care, which is provided, to the home. These documents are used to formulate the homes own individual care plan for the service user. The home is registered to cater for service users with dementia, and staffs have an understanding of the needs of this category of service user although many still need formal training in this subject and this is addressed under staffing. Support is gained from the C.P.N who visits the home monthly and the Mental Health Team are involved in resident care and assessment whenever necessary. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 10 All service users are admitted initially on a four-week trial or respite basis. This allows sufficient time for the service user to settle in and decide if this is the right environment for them, and for the home to assess if the needs of the new service user can be fully met by the staff and facilities available. This home does not provide the facility of intermediate care. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 11 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) 7, 8, 10, & 11 The health and personal care needs of service users are met and their rights to privacy and dignity are upheld. EVIDENCE: The home has comprehensive care plans which detail the care needed for each service user and these include personal needs assessment, personal and environmental risk assessments, visits of or to professionals, weight charts, waterlow tissue viability assessments, body maps, dietary needs, falls charts, and a daily report. There was good evidence of these plans being reviewed on a regular basis. One staff member said “I update the care plans every week”. A very high proportion of service users in Mont Calm need assistance with all aspects of daily care, however independence is encouraged in line with service users capabilities. All incidences, or risks, of pressure areas are reported to the district nurses who advise, treat and supply appropriate equipment to the home to minimise the problems. The continence advisor visits regularly. There are lots of opportunities for appropriate exercise and physical activity from good security to enable service users to wander around the home without the fear of them wandering out of the home, to games with balloons and balls, and service users being encouraged to get up and dance when music is Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 12 playing. Weights are recorded monthly and the home has sit on scales to ensure that all service users can be weighed. It was witnessed that G.P’s had been contacted when the home was concerned about weight loss. Service users who move from the locality retain their own G.P. and for those who move in from out of area their families usually choose which doctor they should register with. The pharmacy inspector attended the inspection specifically to look at the homes medication procedures. She will be reporting her findings on a separate additional visit letter, and therefore this standard will not be shown as assessed on this report. However the pharmacy inspector has asked for one general requirement regarding medication to be added to this report to reflect her attendance on the day. Service users are treated with dignity. Staffs were witnessed to be calling service users by the names they preferred, to be giving them choices, and to be interacting appropriately with them. All shared rooms have screens or curtains in order to maintain privacy and dignity whilst personal care is being given. The homes procedures for death and dying reflect the sensitivity of this time in a service users life. Wherever possible the service user is supported to stay at home until the end, and the district nurses and G.P.’s are very supportive to both the service user and the home at this time. Visitors are welcome at any time, day or night, in accordance with the service users wishes. These visitors are given support, are made comfortable, and are offered drinks and snacks as appropriate. Staffs make every effort to attend the funerals of deceased service users and there is always at least one representative of the home. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 13 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 Service users daily lives are enhanced by a variety of activities, ongoing contact with families and friends and provision of a healthy diet. EVIDENCE: The home has a good programme of activities, formal and informal, for the service users. There is music playing in the two lounges most of the time. Staffs interact on both group and a one-to-one basis with service users. On Wednesday afternoons there is an activities session where the wives of two of the service users assist the manager with various activities such as drawing, pinning things on a board, giant snakes and ladders on the floor, safe darts etc. A visitor said, “The residents have a laugh”. A visiting entertainer gives song and dance entertainment monthly and a visitor commented, “a lot of the residents get up and dance when Tony sings and plays”. An aroma therapist visits the home fortnightly to give hand and knee massage. Holy communion is held monthly for those who wish to attend. In addition the staffs play balls, skittles, and balloons, look at service users personal files with them, look at books, magazines and newspapers, and take residents out to the garden when possible. Visitors commented, “the staff have time for everyone, even when they are rushed off their feet”, and “I help with the activities on a Wednesday afternoon” and staff commented, “the residents like the activities, there is always something going on”, and “we sit in the garden with them when there is time”. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 14 Visitors are made welcome to the home; they can see the service users in the lounge or quiet lounge or in their own bedrooms and spend as much or little time with them as they choose. Visitors’ comments included, “I am always in and out”, “I often bring in food to tempt my father”, “I come at least 3 times a week”, and “I like to spend some time with my husband in his room”. Service users are encouraged to exercise as much choice over their lives as they are able, and as their mental state allows. Many of the service users or their families have brought in personal possessions, and these help them to settle and to get used to their new environment. The food produced in the home is freshly cooked, uses fresh meat, vegetables and fruit, and is balanced, wholesome, and nutritious. All meals, including liquidised meals, are attractively served. The cook commented, “presentation is very important”. The cook keeps a list of likes and dislikes of service users and alternatives are always available. The only special diets currently catered for are diabetic and liquidised meals. The cook is slowly introducing changes to the menu to take into account seasonal availability, and the changing tastes of the service users. During meal times staffs are readily available to assist and give help sensitively to those service users who need assistance. Staff comments included, “the clients enjoy everything”, “we know their likes and dislikes”, “I don’t like using frozen vegetables, they don’t have so much goodness”, and “most things are home made”. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 15 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, 17, & 18 The home has a satisfactory complaints policy and procedure, however at present the service users safety is being put at risk through poor recruitment practices. EVIDENCE: The home has a clear complaints procedure. There have been no complaints logged since the last inspection. Evidence was seen that previous complaints were investigated properly and a response issued to the complainant. Service users legal rights are protected. They are able to continue with their right to vote with the majority having postal or proxy votes. The home ensures that all service users names are added to the Register of Electors annually. Currently service users are not being protected from abuse as they should, as the home has been employing staffs without first checking on the Protection of Vulnerable Adults register. No staff should be employed in the home in any capacity until 2 written references have been received, a criminal record bureau enhanced disclosure has been sent for, and a satisfactory check has been made of the POVA register. Once the satisfactory POVA first is obtained staff should then work under supervision until the satisfactory enhanced disclosure has been received. Two immediate requirements have been made to ensure that in future proper procedures are followed and no staffs are employed until all appropriate checks have been made. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 16 Staffs are made aware of abuse during their induction and they demonstrated that they have an awareness of abuse and adult protection. The home has both adult protection and whistle blowing policies. A staff member commented, “I am doing an adult abuse course next week”. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 17 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, 20, 21, 22, 23, 24, 25, & 26 The home requires work to be carried out to bring it up to the standards required. EVIDENCE: The home is in a convenient location, not far from local amenities and within easy walking distance of ‘The Leas’. The handyman is responsible for not only the routine maintenance but also all of the redecorations and the garden and this does mean that he is overstretched. The room that was reported as having water damage on the last inspection report has not yet been repaired although the service user has been moved out, and the room has been put out of action, until the work is completed. The requirement has been repeated on this report. The quiet lounge has recently been redecorated and looks very attractive. However decoration of the ground floor lounge has started but as the handyman is expected to carry out this task on his own he had not managed to finish it before going on holiday. On the day of the inspection there was paper Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 18 off of some of the walls and it did not appear as comfortable, homely and inviting place for service users to sit as it should be. Visitors’ comments included, “the residents were in the lounge whilst the paper was being stripped off”, and “The handyman was doing most of the work on his own – he is overstretched”. A staff member commented, “the maintenance man from one of the other homes was going to help with the decorating of the lounge, but this did not happen”. A recommendation has been added that when communal rooms are redecorated or refurbished additional assistance is arranged to ensure that the works are completed as quickly as possible and with minimum disruption to the service users. Both the downstairs and the upstairs lounges are arranged with closely placed seating around the outer walls, giving the service users the look of ‘wallflowers’. The home does have the facility of a ramped access, however this is dependent on someone with good mobility being with the person who requires to use the ramp, as they need to climb the steps to the front door and ring the bell for assistance to enable staff to open the door at the top of the ramp. It is recommended that a system for alerting the staff that assistance is required from pavement level is investigated. The floor inside the door at the top of the ramp is currently exposed concrete and it is required that proper flooring be fitted. There is a small patio which is accessed through the office and which has a step to manoeuvre thus making it unsuitable for wheelchair users, and a garden to which access through the lounge is unsafe and therefore kept locked. A requirement is made that the home and grounds are accessible to service users. The garden at the rear of the home is looking untidy and in need of some attention, and the patio area is currently being used to store unused armchairs, thus cutting down even further the outside space available for service users. A recommendation has been added that the grounds are kept tidy, safe and accessible to service users at all times.. The dining room has recently been redecorated and refurbished. The new chairs have ‘ski’s’ making them easier for movement. In addition half of the new chairs have ‘carver’ arms to stop less able service users from toppling sideways and falling off the chair. The small lounge, which on the last report was reported as having been moved from an upper floor to the ground floor has now been moved back up and the service users seem much happier with the revised arrangements. Lighting and heating in communal areas is appropriate to the needs of the service users. The fireplace in the downstairs lounge is in the process of being blocked up and the hearth removed as part of the redecoration programme. The home has sufficient toilet, washing and bathing facilities to meet the needs of service users and staff. There are no bedrooms currently with en-suite toilet facilities. The home has not had an assessment of the premises and facilities by a qualified occupational therapist and, particularly bearing in mind the disability Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 19 access problems, this is added as a recommendation. There are some facilities available in the home such as bath hoists, raised toilet seats, lift, and call systems. Currently the home has a loan hoist supplied for the use of a specific service user, however the previous requirement regarding the provision by the home of equipment for moving and handling of residents has not yet been met and is reiterated on this report The bedrooms vary in size and shape. Many service users have brought in their own belongings to personalise the rooms. The double rooms in the home all have appropriate screening available. The heating and lighting in bedrooms is appropriate to the needs of the service users and all radiators are covered. The home is intending to gradually redecorate all rooms and provide new beds but only one has been completed to date. The domestic staffs work hard at keeping the home clean and even shampoo some carpets daily, but unfortunately, although much improved since the last inspection, there was still a slight odour of urine in a couple of places and therefore the requirement of the last report has been repeated. One visitor commented, “Sometimes it does smell a bit”. The home has policies for the control of infection and appropriate hand washing facilities are provided throughout the home. The laundry has a washing machine with a sluicing facility and foul laundry is washed at appropriate temperatures. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 20 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, 28, 29, & 30 Due to poor recruitment procedures and lack of appropriate staffing the home is failing to protect service users adequately. EVIDENCE: Although the proposed staffing rotas indicate that the staffing numbers are appropriate to the assessed needs of the service users, comments from both staff and visitors indicate that the home is quite often short staffed, particularly at weekends. Comments included “9 out of 10 weekends they are short of staff”, “they are short handed quite a lot”, and “staff are short at weekends, usually because we are let down at the last minute and can’t even get agency staff to cover”. A requirement has been made that sufficient staff shall be employed to meet the needs of service users, and that this shall not be reduced at weekends. All staff who are employed in the home to provide personal care are at least 18 years of age and nobody under the age of 21 is left in charge of the home. Sufficient domestic and catering staff are employed at the home. Currently 38 of the care staffs are trained to NVQ level 2 or above and a further 3 are due to start the training which, if and when they complete, will bring the home up to the 50 requirement. A requirement has been made that there should be a minimum ratio of 50 of care staff trained to this level. Although the home has made some improvements to their recruitment processes by asking for a full employment history and by checking if applicants have been registered with a professional body, and they have also made Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 21 improvements in obtaining 2 written references, they have still not addressed the most important aspect. It is vitally important, in order to protect service users safety, to ensure that a criminal records bureau enhanced disclosure is applied for and a satisfactory POVA first is received prior to any member of staff being employed in any capacity within the home. Once the POVA check has been received staff must work under supervision until the satisfactory CRB check has been received. Two immediate requirements were made on the day of the inspection covering these issues and are shown as requirements on this report. Staff comments included, “I have been here 3 months ….my CRB check is in process at the moment” “I think it’s unfair that we have to pay for our own uniform and CRB checks – it’s the boss who needs to check up on us so why should we have to pay?” “I have been here since June, I have had a CRB done before but the one for here has just gone off”, and “I have been here 10 months, …….. my CRB is just being done”. New staffs receive induction training, but the foundation training is insufficient as, although fire training is now up to date, not all staff have received the mandatory training in first aid, moving and handling, infection control, basic food hygiene, and health and safety. In addition not all staff are trained in dementia care despite this being the type of care offered at the home, or in adult protection and abuse. A requirement has been made to address this issue. One staff member commented, “I go on any courses I can”. Despite the comments above a visitor commented, “the staff are very good with the residents” and staff comments included, “dementia care is more rewarding”, “I enjoy coming to work, its quite relaxed here”, “I love the job, all the staff are really good”, “I am starting college next week, one day a week”, and “we go out socially, we are mates as well as colleagues” Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 22 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, 32, 33, 35, 36, 37, & 38 Management practices in the home need to be tightened up to protect the service users. EVIDENCE: The manager of the home has been a manager for a number of years. She has not undertaken her NVQ4/RMA but in view of her mature years the Commission will not insist on this qualification. However she does need to be actively working towards addressing the requirements made in this report. The deputy manager has achieved her NVQ 4/RMA award. The manager, deputy manager and head of care all have their own specific roles to play in the management of the home and there are clear lines of accountability. All of the management staff in the home attends various training to update their skills and knowledge. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 23 The home projects an open, positive and inclusive ethos. Staff comments included, “I get support from the senior staff, you can speak to anyone”, “its well run”, “we have staff meetings regularly”, and “its very friendly with good team work” The home consults its service users by circulating quality assurance surveys, the last one having been circulated in February 2005. A discussion was held regarding extending quality assurance to include visiting professionals and sending a synopsis of the results of both surveys to CSCI, and a recommendation has been added regarding this. Management are about to implement a quarterly management audit check and this will be looked at during the next inspection. Unfortunately, despite being reminded at the last inspection the provider has failed to complete monthly regulation 26 visits as required and to provide a copy of the report of such visits to the home and the CSCI and a requirement has been added that this should be undertaken. The provider has been asked to provide details to the Commission regarding the current financial viability of the business and therefore this standard has not been assessed on this occasion. All records kept in the home are kept in a safe and secure location. Any service users monies held at the home for the purchase of incidentals are recorded properly and stored individually and safely. The administrator audits the records each month. Staff supervision and appraisal has not been carried out on a regular basis and a requirement has been added regarding this. The health and safety and safe working practices in the home are compromised by the lack of foundation training (first aid, moving and handling, health & safety, fire, infection control and basic food hygiene) mentioned previously in the section under staffing; and by the lack of appropriate equipment for moving and handling. The home currently has a loan hoist for one specific service user. The owner has promised to purchase a hoist for general use in the home, however this has not yet materialised, neither have the staff been trained in the use of the loan hoist. The home does have a health & safety policy, a health and safety poster is displayed, and accidents are recorded in the correct format. Staff comments included “The only problem is the two residents who need a lot of lifting”, and “we have a hoist here now but need training to use it” Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 24 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 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 1 3 1 3 3 3 2 STAFFING Standard No Score 27 1 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 1 2 3 1 x 3 1 1 1 Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 25 Yes 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. Standard 9.1-11 Regulation 12, 13, 14, & 17 Requirement Timescale for action 30/11/05 2. 18.1 & 29.3 3. 18.1 & 29.3 4. 19.1 & 4 5. 19.1 , 20.3 & 22.2 Medicines in the home are handled according to the requirements of the Medicines Act 1968, and the guidelines from the Royal Pharmacutical Society 12 (1) (a) No new staff should be employed 19 (4) (c) in the home in any capacity until & a satisfactory POVA first check Schedule has been received. 2 (5) (7) (Previous timescale of 31/05/05 & (8) not met) 12 (1) (a) No new staff should have their - (c) 19 employment confirmed until the (1) (a) home has received 2 satisfactory (c) (2) written references, a satisfactory (7) & enhanced disclosure (CRB Schedule check), and a satisfactory check 2 (5) (7) of the POVA register & (8) (Previous timescale of 31/05/05 not met) 23 (2) (b) The bedroom with water damage must be repaired and the decorations properly reinstated. No service user shall occupy this room until the works are completed satisfactorily (Previous timescale of 30/06/05 not met) 23.2 (n) & The manager shall ensure that (o) the home and grounds are H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc 07/09/05 07/09/05 31/12/05 31/12/05 Page 26 Mont Calm Folkestone Version 1.40 accessible to all service users. 6. 22.4 & 38.2 23 (2) (n) & 13 (5) Appropriate equipment should be supplied and maintained in good working order to ensure the safe moving and handling of service users. All staff should be trained in the use of this equipment (Previous timescale of 30/06/05 not met) 16 (2) (k) The premises must be kept free from offensive odours (Previous timescale of 30/06/05 not met) 13 (4) (a) Anti slip flooring or carpet shall be provided on the uncovered concrete area inside the doorway to the external ramp. 18 (1) (a) Staff shall be employed in sufficient numbers to meet the needs of service users, and this shall not be reduced at weekends 18 (1) (a) A minimum ratio of 50 of care & (c) staff employed in the home shall be trained to NVQ level 2 or above 12 (1) (a) All staff shall receive foundation (b) 18 (1) tgraining to TOPPS specifiction (a) (c) (i) with the first 6 months of their 13 (3) (4) appointment which equips them & TOPPS to meet the assessed needs of Standards the service users, this includes the mandatory training of first aid, moving and handling, infection control, basic food hygiene, health & safety, and fire safety, and should also include training in dementia care and adult protection (Previous timescale of 31/07/05 not met) 26 (1) (3) The reristered provider shall visit (4) (a) (b) the home on a monthly (c) (5) (a) unannounced basis to carry out a (b) visit in accordance with the provisions of Regulation 26, and shall provide a copy the report of H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc 30/11/05 7. 26.1 30/11/05 8. 19.1 30/11/05 9. 27.1 31/10/05 10. 28.1 31/12/05 11. 30.3 38.2 & 38.9 31/12/05 12. 33.1 30/09/05 Mont Calm Folkestone Version 1.40 Page 27 13. 36.2 & 36.4 18 (2) the visit to the home and to CSCI Care staff shall receive formal supervision at least 6 times a year and all other staff shall be supervised as part of normal man agement process on a continuing basis 30/10/05 14. 15. 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 19.3 19.1 & 19.2 22.1 33.7 19.1 Good Practice Recommendations The grounds are kept, tidy, safe, attractive, and accessible to service users at all times. When communal areas are redecorated or refurbished additional assistance be purchased or arranged to ensure that the work is completed as quickly as possible and with minimum disruption to the service users. The home should arrange for an assessment of the premises and facilities by a qualified occupational therapist. The views of visiting professionals on how the home is achieving goals for service users should be sought on an annual basis Consideration should be given to installing a means by which disabled persons can obtain access to the home without the necessity for someone more mobile to climb the steps to the front door and alert the staff of their need. 3. 4. 5. Mont Calm Folkestone H56-H05 S63034 Mont Calm Folkestone V239615 060905 stage 4.doc Version 1.40 Page 28 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. 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