Inspection on 06/09/05 for Mont Calm (Sturry)

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 (Sturry) 17/09/08

Mont Calm (Sturry) 09/08/07

Mont Calm (Sturry) 11/08/06

Mont Calm (Sturry) 23/05/05

Mont Calm (Sturry) 19/10/04

Mont Calm (Sturry) 13/05/04

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

CARE HOMES FOR OLDER PEOPLE Mont Calm (Sturry) Star Lodge, Park View Sturry Canterbury Kent CT2 0NW Lead Inspector Christine Lawrence Announced 6 and 7 September 2005 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 (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Mont Calm (Sturry) Address Star Lodge, Park View, Sturry, Canterbury, Kent, CT2 0NW 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) 01227 710897 as above stephenmontcalm@aol.com Stephen Anthony Castellani Sue Hancox is Acting Manager but has not yet applied for registration Care Home 16 Category(ies) of Older People with Dementia registration, with number of places Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 23/05/05 Brief Description of the Service: Mont Calm (Sturry) is a large detached house which has one shared room and fourteen single rooms. The home provides care for up to 16 people over 65 years old who have dementia. There are local facilities within Sturry and access to public transport, both buses and trains. There are parking places at the front of the building. There is a garden for residents use at the rear. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection undertaken over a period of two days. The inspector observed interactions between staff and residents, including a mealtime. Staff spoke to the inspector about their work within the home and the inspector also had discussions with the manager. Various records were examined. Three relatives and one social services care manager completed comment cards as part of this inspection. The report from the inspection of 23 May 2005 contains further information about this home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 6 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 (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 7 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) 1 and 3 Prospective residents (and/or their representatives) may not have the up to date information they need to make a decision about whether Mont Calm (Sturry) is the right place for them. Residents moving into the home have their needs assessed to ensure they can be met. EVIDENCE: The service user guide should be revised and the Commission for Social Care Inspection notified when the revision is complete. There is a mistake on page 2 relating to the age of residents (ie 60 instead of 65) and there is reference to residents’ meetings, which do not take place. Two records were seen during this inspection. An ‘Application for Residence’ form is used to gather initial information then an Assessment Form, comprising 12 pages is used to detail information about a range of topics relating to the health and welfare of an individual. There was evidence of assessments from placing authorities also. The homes assessment covers all aspects identified in Standard 3.3. These assessments are used to compile a care plan. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 8 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) 7,8,9,10 and 11 Residents’ care needs are set out in an individual plan. They are monitored to ensure that needs are being fully met. Residents are protected by the home’s policies and procedures for medication. Residents are treated with respect and their privacy is considered important. Residents can be sure that at the time of their death they will be treated with care and respect. EVIDENCE: Care plans seen show that improvements have been made since the previous inspection with regard to ensuring that plans are monitored and kept up to date. Care plan reviews also now contain a section entitled Resident and/or Representative Comments/Concerns/Wishes. The assessment tool for identifying if a resident is at risk of developing a pressure area has now been changed by the manager Sue Hancox. The new tool is more informative and detailed than previously. There is also a more detailed nutritional screening tool available. Sue Hancox has also improved the recording related to appropriate physical activities but agreed that this still needs to be monitored. Other aspects of the care planning system are as before (see report of the previous inspection for 23 May 2005)). Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 9 No resident is able to self medicate. Policies and procedures are in place regarding medication. The storage of medication was appropriate and the medication administration records were properly completed. The shared room allows for privacy. Wherever possible medical examination and treatment are provided in residents’ own rooms but if necessary a mobile screen can be used in the lounge area. This is an important option as sometimes a resident may not wish to move when attended by a community nurse or chiropodist for example, but the staff will still try to ensure privacy. Staff spoken to confirmed that privacy and dignity were part of induction training. Residents’ preferred term of address is noted in care plans. The residents were all individual in their appearance and style of dress. A portable phone is available for residents to use if required. Staff emphasised the importance of maintaining privacy and dignity at the time of death or when a resident is gravely ill. Examples were also noted of staff visiting residents at this time, if they were in hospital. The manager confirmed that there are contacts with local churches and wherever possible wishes about terminal care and arrangements after death will be recorded. Relatives and friends will be supported to visit as often as they wish or to stay with the resident. There are policies and procedures relating to caring for people who are dying or to managing things after death. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 10 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 and 15 Residents’ wishes regarding social contacts and activities are identified as far as possible and responded to. Residents are supported to maintain contact with family/friends and are given opportunities to exercise choice giving them a degree of control over their lives. Residents are offered a wholesome, appealing and balanced diet. EVIDENCE: During the inspection it was noted that the home tries very hard to ascertain previous interests. An activities person is employed for three sessions per week, and dependent on the weather residents are also enabled to go out. Staff confirmed that they try to give residents opportunities to make choices about aspects of their daily lives but this is only within the limitations of any individual dementia. Visiting is not restricted and all of the four people who completed comment cards said that they are welcomed in the home at any time and can meet with who they are visiting in private if they wish. The home is registered with services which can offer support and advocacy if required. The menu changes seasonally and appears to offer a balanced and nutritious diet. Snacks and drinks are available at any time. Special occasions such as birthdays will be catered for if wished by the resident. The manager said that Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 11 two of the catering staff are due to attend a course relating to nutrition and the elderly in order to update their knowledge. There is a dining room which provides a pleasant environment and residents are encouraged to eat there although the home will respond if an individual prefers not to. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 12 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) 18 The issues outstanding from the previous inspection have only partially been responded to therefore residents are still potentially vulnerable. EVIDENCE: The in-house information pack relating to adult protection still needs to be personalised for the home and given out to all staff. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 13 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) 26 Residents live in a home which is clean and hygienic. EVIDENCE: There were no offensive odours at the time of the inspection and all areas seen during this inspection were clean. The laundry is sited away from food storage and preparation. Sue Hancox informed the inspector that all staff have undertaken a course on infection control. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 Residents’ needs are met by the numbers and mix of staff and they are protected by the home’s recruitment practices and training policies. EVIDENCE: The rota seen indicated that there are sufficient staff on duty, both day and night. Mrs Hancox is aware of the Residential Forum guidance about staffing levels and she confirmed that she reviews staffing levels according to the needs of residents. Three staff records were seen during this inspection contained application forms, references and terms and conditions of employment. Copies of the General Social Care Council’s codes are given to all members of staff. There are job descriptions for care staff and an interview form is also used to ensure all relevant questions are asked. Criminal Record Bureau checks are undertaken. Induction training is provided within the home, as is ongoing training. The staff files seen each contained an individual record of training undertaken and Mrs Hancox confirmed that staff would be offered at least three training days a year. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 15 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) 33,35 and 38 Further work needs to be done to ensure that the home is run in the best interests of the residents. Residents are safeguarded by the financial procedures for personal allowances. The health and safety of residents and staff are promoted and protected. EVIDENCE: The owner, Mr Castellani has undertaken an audit which includes checklists relating to policies and procedures and questions relating to residents, staff and the environment. This has been copied to the Commission for Social Inspection, including an action and improvement plan with timescales for achievement. Sue Hancox said that quality assurance forms have been sent out to family and friends but this is just the beginning of the process of seeking their views. There are no details yet about the system to be established and maintained for reviewing and improving the quality of care at the home based on seeking the views of residents’ representatives and Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 16 measured against the aims and objectives within the statement of purpose. Sue Hancox said this was still being looked at. Residents are not able to manage their own money because of their individual limitations. The home is only involved in managing personal allowances and these are managed through a system of recording money in and money out with individual ‘purses’ to keep cash safe and separate. Receipts are also kept for any expenditure on behalf of a resident. There are secure facilities for the safekeeping of money and valuables. A spot check on maintenance and service records showed that these are up to date and relevant. There are policies and procedures in place for various aspects relating to health and safety. Some training has taken place and more is planned. The fire safety records were properly maintained. Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 17 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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x 2 x 3 x x 3 Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 18 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. 2. Standard 1 18 Regulation 6 (a)(b) 13(6) Requirement Revise the service user guide and notify the Commission of the revision within 28 days The planned information packs for staff regarding adult protection must be provided (this was identified at the previous inspection 23/05/05) Timescale for action 31/03/06 Originally 15/08/05 now 31/03/06 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 33 Good Practice Recommendations Further work should be undertaken to ensure that quality monitoring systems include consultation with residents/representatives Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mont Calm (Sturry) H56-H05 S35711 Mont Calm Sturry V238374 060905 Stage 4.doc Version 1.40 Page 20 - 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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