Inspection on 17/08/06 for Montagu Court Rest Home

This inspection was carried out on 17th August 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

Montagu Court Rest Home 24/07/07

Montagu Court Rest Home 03/11/05

Montagu Court Rest Home 22/02/05

Montagu Court Rest Home 25/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Montagu Court Rest Home 49-51 Edgar Road Cliftonville Margate Kent CT9 2EQ Lead Inspector Tina Thomas Key Unannounced Inspection 17th August 2006 10:00 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 Montagu Court Rest Home DS0000047079.V305350.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. Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Montagu Court Rest Home Address 49-51 Edgar Road Cliftonville Margate Kent CT9 2EQ 01843 223648 01843 226740 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) Alan Morris Mrs Margaret Ann Woods Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To admit one (1) Service User, whose date of birth is 09.05.1953. To admit one (1) Service User with physical disabilities, whose date of birth is 26/01/1950. 25th August 2004 Date of last inspection Brief Description of the Service: Montagu court is a large privately owned property providing residential care and support for up to thirty service users who require varying degrees of assistance. The home is a family run business, with the proprietors having a great deal of input into the day-to-day running of the business. Staffing within the home comprises of the registered owners, registered manager, deputy manager, senior care staff, care and ancillary workers. A home manager is employed who is responsible for the general maintenance of the building. The home is located within a short walk of Cliftonville shopping centre and promenade. Fees range from£295-£365 Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection this year. This inspection was a key inspection that considers all key standards. It was conducted with the assistance of the registered provider Mr Morris, Mrs Morris, the manager Maggie Woods and senior staff. The previous inspection was a random inspection that concentrated on specific standards. There were 16 requirements made following the random inspection and an additional 4 immediate requirements. Areas for improvement were also identified. The home met all of the requirements that were made at the random inspection, except for one, within the agreed timescales. The Provider is unable to fulfil the one outstanding requirement, as to do this; he is dependant on information from other healthcare professionals, for which he is awaiting. There is evidence that since the random inspection in May 2006, the Provider, management and staff have worked exceedingly hard to improve systems of work, and better meet the standards. The Provider, management and staff are understandably proud of what they have achieved, and the quality they have produced in such a small amount of time. The Registered Manager has resigned, but took the decision to stay at the home until a new manager was appointed. A new manager commences at the home in September 2006. What the service does well: The home has developed a good quality assurance process. It has looked at its systems and the points raised at the last random inspection and has acted positively to improve outcomes for the people living at the home. It now has a much stronger staff team committed to improvement and quality for service users. The environment is clean and homely. Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The home has done a lot of work to improve its systems. As yet they are relatively untested, within the home, as working tools, as they have only been recently implemented. The staff must continue to show that these new systems are good working tools and use them appropriately paying particular attention to recording. Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 7 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. Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 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 the following standard(s): 3,4 6 Quality in this outcome area is adequate. The judgement has been made using available evidence including a service visit. Service users move into the home having had their needs assessed and be assured that these will be met. The home does not offer intermediate care EVIDENCE: People have their needs assessed prior to becoming a service user at the home. The home has at least one service user that is out of the homes category of registration. A requirement was made at the last inspection that the home must seek a variation to the registration of any service users outside of the homes registered category. The compliance date was the 16/06/6. The Provider has been unable to meet the compliance date as he has been waiting for supporting documentation from other health care professionals. The Provider has kept the Commission informed of the progress regarding this matter. A new compliance date has been agreed. Montagu Court Rest Home DS0000047079.V305350.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): 7,8,9,10,11 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. Each service user has a plan of care that fully describes their health and social care needs. Service users are protected by the homes policies and procedures for dealing with medication. Service users are treated with privacy and dignity. Service users are treated with dignity at the time of death. EVIDENCE: The home has, since the last random inspection, completely reviewed this outcome group. The home has implemented new tools for the recording of each service users plan of care. Staff have worked hard to transfer information from one system to the other. Two care plans were viewed and they were of very good quality. The new tool includes an in-depth view of each person’s health and social care needs. The information contained in risk assessments is more appropriate then previously and instruction for staff is more in-depth. Service users sign agreement of their care plans. Staff indicated that the new system was more orderly. Measurement of the quality of the reviewing of the Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 11 new care plans could not be conducted, as the system is so new. This will be performed at the next inspection People that live in the home were clean and well dressed. Service Users that spoke with the inspector indicated that they were contented and their needs were being met. The incidence of pressure sores, their treatment and outcome, is now better recorded than previously in the service user’s individual plan of care and reviewed on a continuing basis. The home has sought out a nutritionalist who will be working at the home. As previously mentioned in the report the home has overhauled its medication policy and practices. One senior person has the responsibility of the medication and has taken the lead in the changes. Nine carers are on a 16 week medication course, linked to the NHS Trust. Medication procedures were audited and found to be sound. People that live in the home expressed that they were treated with privacy and dignity. Senior staff have monitored dignity and choice for service users by working along side colleagues and reinforcing best practice within the home. The last random inspection came about following a complaint from a family unhappy with care delivered at the point of death of a family member. As a result requirements were made, the home became more aware of the need to more fully record events and to involve the district nurse team earlier. The home has worked very hard to ensure that an event like the one described does not reoccur and all requirements and recommendations that came about due to it have been actioned. A conversation regarding the most recent death in the home evidenced that the service user and the family were particularly well supported by staff and the Provider. The home also had a recent letter from a family thanking them for the care they gave to a deceased service user. Montagu Court Rest Home DS0000047079.V305350.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): 12,13,14,15 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. Service users social, cultural, and religious needs are being met. Service users maintain contact with whom they wish. Service users are helped to exercise choice and control over their lives. Service users receive wholesome meals in pleasing surroundings. EVIDENCE: Service users through surveys and in conversation indicated that they were satisfied that their social, cultural, religious and recreational needs were being met. Some described continuing with hobbies and interests they had before they entered the home. Care planning around this area has been strengthened. The homes visitors book indicated that visitors come and go at a selection of times. Visitors were in the home at the time of inspection. Service users have recorded meetings so that they can have input into the home. Service users can bring items of their own into the home to personalise their own rooms. People that live in the home indicated that the meals were wholesome and filling. Mealtimes are social occasions with most people choosing to eat in the Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 13 dinning room. Meals were plentiful and attractive, new tablecloths have been purchased. Montagu Court Rest Home DS0000047079.V305350.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, 18 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. The home has a suitable complaints procedures. Procedures adequate to potentially protect service users from abuse. EVIDENCE: The complaints book was viewed. Complaints are investigated and suitably actioned. Staff have had training regarding adult protection. Staff spoken with showed an understanding of abuse. Montagu Court Rest Home DS0000047079.V305350.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): 19,21, 25,26 Quality in this outcome area is good. The judgement has been made using available evidence including a service visit. The home is a safe and well-maintained environment. The home is generally clean, pleasant and hygienic EVIDENCE: The home continues to undergo a programme of continual improvement. The outside of the home is cosmetically attractive with floral baskets. As previously mentioned in the report the home has provided thermostatic valves on all hot taps, preventing the risk from burns. All doors have been fitted with automatic closures, ensuring safety in the case of fire, whilst also enabling service users to have their bedroom doors open if they choose. The programme to cover radiators has been completed, preventing the risk from burns. Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 16 Equipment in the home is now suitably stored. The hairdressing room was clean and tidy. Some areas of the home identified at the last inspection have been redecorated or suitably cleaned. New toilet facilities are being installed on the ground floor. A new boiler and air conditioning has been installed. The air conditioning enabled service users to stay cool during this year’s extremely hot weather. The home is generally clean and free from offensive odours. Montagu Court Rest Home DS0000047079.V305350.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): 27,28,29,30 Quality in this outcome area is good. The home has appropriate staff numbers for the needs of the current service users. Service users are in safe hands. The homes recruitment practices protect the service users. Staff are trained and competent to do their jobs. EVIDENCE: The staff rota was viewed and arrangements for night staffing examined. The home has employed some new, experienced, members of staff to boost staffing numbers and to support the manager. Conversation with staff indicated that they believed there was sufficient staff to meet the current needs of service users. Observation showed that staff worked in an unhurried manner with the people that live at the home. All new members of staff undertake an induction, which is line with skills for care. It examines carer’s levels of understanding and competency. Staff files were viewed and held all the information that they should. The home seeks references and Criminal records checks prior to staff commencing employment. Less then 50 of staff are trained to NVQ Level 2. The standards express that this should have been completed by 2005. However, this is because some trained staff have left and one is on maternity leave, as opposed to lack of training within the home. Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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 adequate. The judgement has been made using available evidence including a service visit. Management of the home will be changing. The home is run in the best interests of the service users. Service users financial interests are safeguarded. The health, safety and welfare of service users and staff are generally well promoted and protected. EVIDENCE: The registered manager Maggie Woods has resigned. She will be replaced in September 06. Maggie expressed that it had been easier for her to conduct her role, and that she had felt more supported, since another senior member of staff had joined the staff team. Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 19 The home has realised the importance of good quality assurance practices. It has overhauled many areas since the last inspection to ensure the safe guarding of people that live in the home. There is continual self-monitoring by the Providers who are at the home on a regular, almost daily basis. The home has an open culture and input is welcomed by the Providers from staff, service users, health care professionals and visitors. The home now has investors in people award. The processes for ensuring secure facilities are provided for the safekeeping of money and valuables on behalf of the service user were examined and audited and found to be sound. The manager ensures as far as reasonably practicable the health and safety of staff service users and visitors. The manager ensures safe working practices and risk assessments have been reviewed and updated. One carer was found to be performing manual handling tasks without appropriate training. A requirement has been made regarding this matter. Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 2 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 Standard No Score 16 3 17 x 18 3 3 x 3 x x x 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 21 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 OP4 OP3 Regulation 12,14 Requirement No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users must be within the category of registration or a variation sought . Previous compliance date 16/06/06 All staff performing manual handling must have appropriate manual handling training Timescale for action 30/09/06 2 OP38 18 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 22 Montagu Court Rest Home DS0000047079.V305350.R01.S.doc Version 5.2 Page 23 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 Montagu Court Rest Home DS0000047079.V305350.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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