Inspection on 06/03/07 for Mont Calm (Sandgate Road)

This inspection was carried out on 6th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 (Sandgate Road) 04/03/08

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

CARE HOMES FOR OLDER PEOPLE Mont Calm (Sandgate Road) 211 Sandgate Road Folkestone Kent CT20 2HU Lead Inspector Wendy Jones Key Unannounced Inspection 6 March 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Mont Calm (Sandgate Road) DS0000068207.V325707.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 (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mont Calm (Sandgate Road) Address 211 Sandgate Road Folkestone Kent CT20 2HU 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 251903 Mr Stephen Anthony Castellani Mrs Dawn Gregory Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Mont Calm (Sandgate Road) is a large, period, detached, corner property with high ceilings and character features. It is situated on the main road between Folkestone and Sandgate. Folkestone town centre and The Leas area are only a short distance away. There is a bus stop and railway station nearby. The home is registered to provide care for 20 older people who have dementia. Prospective residents or their relatives can request a statement of purpose that gives information about the service the home provides. Currently the scale of fees is between £367.82 and £500 per week. Hairdressing, chiropody and toiletries are at an additional charge. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over a period of time and ended with a site visit to the home between 9:30am and 1.45pm on 6 March 2007. A range of evidence has been used to inform this report and judgements have been made based on this evidence. Evidence used includes any concerns, complaints, allegations and other information received; reports of incidents and deaths that have occurred since the home was registered; a tour of the home; inspection of care plans and some other records, comments received from health professionals, residents and their relatives and discussion with the manager, some residents and staff on duty. What the service does well: What has improved since the last inspection? What they could do better: One double room is vacant at the moment. This should have screens fitted so that when residents move in they can have their privacy. There should be enough bathrooms in use for all residents to be able to have a bath when they want to. Ways should be looked into of reducing the risk the open, main staircase could pose to residents with dementia. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Mont Calm (Sandgate Road) DS0000068207.V325707.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 (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4 Quality in this outcome area 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 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 are attending training so that they have a clear understanding of the needs of residents who have dementia. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 9 Residents’ and their relatives were surveyed prior to the site visit. The people who replied had enough information to decide whether the home would be able to meet their (or their relative’s) needs. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 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: Residents’ care plans are clear and easy to follow. They are comprehensive and identify what each resident’s goals and needs are. They explain the action staff will take to meet these needs. Risks to residents’ safety are thoroughly assessed. They are specific and deal with risks that are specific to individual residents and their circumstances. Care plans are reviewed every month and amended as necessary. Details of when residents see their doctor, or district nurse and of optician, dentist etc appointments are kept in their personal files. Daily records also have details Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 11 of these appointments. Residents are weighed regularly and the results are recorded in their care plans. Records seen showed that residents’ weights are remaining reasonably constant. Medication is kept in a locked medication trolley and stored at the correct temperature. There is a locked medication fridge in the kitchen for medication that needs to be refrigerated. Records of the medication that residents take are up-to-date and accurate. Boots is now dealing with residents’ prescriptions. Medication is in blister packs and staff have been trained by Boots in their use and administration. Staff spoken with who have responsibility for medication are clear how to make sure that residents’ medication is administered correctly and safely. One double room is vacant at the moment. This should have screens fitted so that when residents move in they can have their privacy. Staff are polite and caring to residents. They clearly understand their needs and treat them with respect and courtesy. Residents and their relatives who returned survey forms feel the residents are given the support they need and “staff are always caring and help as much as they can”. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 Quality in this outcome area 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 can keep in contact with their family and friends. EVIDENCE: Two activities people come to the home on alternate Wednesdays to organise and carry out a range of activities for the residents. The manager said that residents can also join in other activities with staff on duty on a daily basis. Photographs of residents enjoying games, arts and crafts, parties and visiting entertainers are displayed in the entrance hall and other areas around the home. An Easter party is planned and this was advertised in the main hall. Residents who returned surveys said there are usually activities arranged that they can join in with if they want to. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 13 Relatives who returned survey forms said they felt welcomed any time and could visit in private. They felt the home helps their relatives keep in touch with them and live the lives they choose. Copies of menus received before the site visit showed that residents have a balanced, nutritious diet that gives them variety and choice. Most residents have their meals in the dining room. However, others prefer theirs in their room. The cook was very knowledgeable about the residents’ likes, dislikes and special diets. Residents like the meals and said “the meals are varied, always hot and well cooked”. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 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 have been received since the owners bought the home. There is a clear procedure for investigating thoroughly any complaints that are received. Staff have received training in adult protection. Those spoken with were clear about what to do if they suspect a resident is being abused in any way. Mont Calm (Sandgate Road) DS0000068207.V325707.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19- 21, 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: Work has begun on refurbishing the home. Some rooms have been redecorated and new carpets fitted. Carpets in some hallways are threadbare and a health and safety hazard. The manager explained that all carpets are being replaced throughout the home. Carpets in communal areas on the top floor have already been replaced. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 16 There is a lift for residents to reach all floors of the home. An impressive staircase in the main hallway also reaches all floors. This may be a safety hazard for residents with dementia who have mobility difficulties and wander. The manager has assessed the risk as low for the residents who are living in the home at present. She is very aware of the potential risk this could be for future residents and confirmed that thorough risk assessments would continue to be carried out for all current and future residents. She will also continue to research ways of making the stairs safe should they pose a risk for a resident. There are two lounges with music systems and comfortable seating. The dining room is next to the main lounge and the kitchen leads from this. There is a small conservatory on the side of the house. The manager said that more comfortable, appropriate seating and a heater will be provided so that residents can enjoy this area of the home too. There are attractive gardens. At present these are not secure and could pose a risk for residents with dementia who could wander into the road. The manager is well aware of this. She is confident that the gardens will be secured in time for the residents to be able to use them safely when the weather improves. 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 16 single rooms and two double rooms. One single and one double room have an en suite toilet and wash-basin. There are three communal bathrooms, and six communal toilets. Only one of these bathrooms is being used regularly at the moment. This affects when the 16 residents in the home are able to have a bath. The manager explained that one of the other bathrooms could be used but the residents did not feel comfortable using the bath hoist. There should be enough bathrooms in use for residents to be able to have a bath when they want to. There are two washing machines and one dryer in the laundry. Care staff cover the laundry duties. A carer 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 (Sandgate Road) DS0000068207.V325707.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. 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 there are enough staff to be able to meet the needs of the residents at all times. This was confirmed during the site visit. The manager and three care staff on duty at the time of the site visit was enough to meet the needs of the 16 residents in the home. At least 50 of the care staff have completed an NVQ level 2 or above in care and staff files contained copies of their certificates. Recruitment procedures are robust and protect residents. Records are kept of the checks that are carried out for all new staff before they are employed. These include POVA first and Criminal Records Bureau checks. Staff files Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 18 confirmed that new staff receive induction training. The subjects covered provide them with the basic skills and knowledge to provide the care and support the residents need. The manager keeps a matrix of the training that staff have attended and what is planned. From this she identifies when staff need training or updates in core and specialist subjects. Training certificates are displayed around the home. These show that staff have attended training in various subjects including, control of substances hazardous to health, fire and evacuation, dementia, medication, first aid and infection control. Staff spoken with talked about attending these courses. They feel they have enough training and support to be able to do their jobs well. Mont Calm (Sandgate Road) DS0000068207.V325707.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 – 33 and 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 has completed the Registered Managers Award. The manager and deputy manager have their own specific roles to play in the management of the home and there are clear lines of accountability. Relatives surveyed feel the home Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 20 meets the different needs of the people who live there. They think “they are very caring and always have time for residents”. Staff said that they enjoyed working at the home and felt the manager was very open and well liked by the residents. They feel well supported by the manager and deputy manager and feel they have the skills and resources they need to do their jobs well. No quality assurance surveys have been carried out yet as the home has only recently been bought by the owner. However, the manager intends to hold meetings for residents and their families and to send out surveys to gather their views. She also feels that she finds out how residents and their families feel about the care they receive because she has regular contact with them. All records are kept confidential and secure. Service users monies are recorded properly and kept securely for each resident. The manager said that staff are currently being supervised informally on a daily basis and feels she has good communication with them. Formal, recorded supervision is not being carried out on a regular basis yet. This is to be introduced and will take place at least six times a year. Staff feel well supported by the management. They said they are approachable at any time if they need help or guidance. Staff said that they have been on fire awareness training recently and are clear and confident about what to do if the fire alarm sounds. Training records showed that staff have attended this training. Training records also show that all staff have attended manual handling training and receive regular updates. Information received prior to the site visit shows that all relevant maintenance and checks are done and kept up-to-date. Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 21 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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 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 2 3 2 x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP10.1 Good Practice Recommendations Screens should be fitted in double rooms so that residents can have their privacy. Ways should be looked into of reducing the risk the open, main staircase could pose to residents with dementia. There should be enough bathrooms in use for all residents to be able to have a bath when they want to. 2. 3 OP19 OP21 Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mont Calm (Sandgate Road) DS0000068207.V325707.R01.S.doc Version 5.2 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. 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