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Inspection on 03/11/05 for Montagu Court Rest Home

Also see our care home review for Montagu Court Rest Home for more information

This inspection was carried out on 3rd November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home offers service users a great deal of choice in all aspects of day-today living. The home statement of purpose and service user guide accurately reflects the working practices observed in the home. The management and staff of the home are dedicated in providing quality care to all residents.

What has improved since the last inspection?

Since the last inspection all members of the acre team have undertaken safe handling of medication training. Improvements to the ground floor smoking lounge have been provided service users with a more welcoming and homely environment. Service users care plans now demonstrate service user involvement.

CARE HOMES FOR OLDER PEOPLE Montagu Court Rest Home 49-51 Edgar Road Cliftonville Margate Kent CT9 2EQ Lead Inspector Elizabeth Hendry Unannounced Inspection 3rd November 2005 09:15 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.V260509.R01.S.doc Version 5.0 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.V260509.R01.S.doc Version 5.0 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.V260509.R01.S.doc Version 5.0 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. 12th July 2005 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. Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second annual inspection which was undertaken unannounced. A tour of the ground floor was undertaken, service users and staff spoken with and records viewed. What the service does well: What has improved since the last inspection? What they could do better: Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 6 The home must review all medication policies and procedures to ensure the safe storage, accurate recording and safe administration of service user medication. Lines of accountability within the home for the management of medication need to be clarified. 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.V260509.R01.S.doc Version 5.0 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 Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion EVIDENCE: Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 9 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 and 9 The care planning system provides staff with the information they need to ensure all of the service users needs are fully met. The systems for medication administration, storage and recording are poor, potentially placing service users at risk. EVIDENCE: Individual care plans viewed identified service user involvement in the writing of and consent to the contents of the plan. Clear guidelines for staff to follow are held within each care plan, to ensure that all needs are fully met. The Registered manager and senior care confirmed that all members of staff had recently undertaken training in the safe handling of medication. A number of concerns were raised with regards to the management of insulin. The storage facilities for insulin were reviewed and found to be unsuitable. The registered owner confirmed that a new lockable medication fridge had been ordered and was due to arrive shortly. It was identified and confirmed by members of staff that insulin was being administered by staff who had not undertaken training. Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 10 Medication that requires temperature regulation was found to be stored in an un-controlled environment. Medication was found unlabelled, with no instructions as to the dosage or service user it had been prescribed for. Medication administration records were examined and discrepancies between the records and the drugs stored were found. Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 11 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): These standards were not inspected on this occasion EVIDENCE: Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 The home’s complaints policy ensures service users views are listened to and acted on. Arrangements for the protection of service users are satisfactory protecting them from possible risks of abuse. EVIDENCE: A copy of the homes complaints policy and procedure was viewed and found to contain detailed information in a format suitable for the service user group. Copies of this policy are displayed within the entrance hall and within the statement of purpose and service user guide. The registered manager confirmed that there had been no complaints made to the home since the last inspection. The registered owner spoke of four members of staff having undertaken training in adult protection since the announced inspection, with a further four booked to attend in the coming weeks. Staff spoken to were aware of the correct procedure to follow when reporting possible incidents of abuse. A copy of the Kent and Medway adult protection procedures is held within the manager’s office. Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26 Recent improvement has significantly improved the appearance of the home creating a comfortable and safe environment for those living and visiting the home. Infection control measures are in place, which promotes the well-being and health of service users and staff. EVIDENCE: A tour of the ground floor of the home was undertaken, a good standard of decoration and furnishing was found throughout. The smoking lounge has recently been redecorated and now provides an attractive and welcoming environment for those residents who choose to use this room. Staff files viewed at the last inspection confirmed that all staff have attended infection control training. Liquid hand soap was present in areas where hand washing takes place. The home was found to clean and no offensive odours were present. Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 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 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): These standards were not inspected on this occasion EVIDENCE: Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 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 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): These standards were not inspected on this occasion EVIDENCE: Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 17 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 OP9 Regulation 13(2) Timescale for action The registered person shall make 04/11/05 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. (The registered manager must ensure that all service users who are prescribed insulin, receive this medication from appropriately trained staff). The registered person shall make 03/11/05 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. (The registered manager must ensure that all medication is stored in accordance with the manufactures guidelines). The registered person shall make 03/11/05 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. (All eye drops are to be clearly labelled with the date of opening and service users name and dosage). The registered person shall make 14/11/05 DS0000047079.V260509.R01.S.doc Version 5.0 Page 18 Requirement 2 OP9 13(2) 3 OP9 13(2) 4 OP9 13(2) Montagu Court Rest Home 5 OP9 13(2) 6 OP9 13(2) arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. (A lockable medication fridge is to be purchased). The registered person shall make 04/11/05 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. (All medication that has been stopped or changed by a GP is to be recorded on the reverse of the medication administration records with clear reasons). The registered person shall make 03/11/05 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. (The registered manager must ensure that all prescribed medication is given at the correct time and the correct dosage is administered). 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 OP26 Good Practice Recommendations Paper hand towels are to be provided in all hand wash areas. Montagu Court Rest Home DS0000047079.V260509.R01.S.doc Version 5.0 Page 19 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.V260509.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!