Inspection on 19/07/05 for Montague Street Care Home

This inspection was carried out on 19th July 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

Montague Street Care Home 14/08/07

Montague Street Care Home 25/10/06

Montague Street Care Home 02/11/05

Montague Street Care Home 15/02/05

Montague Street Care Home 10/01/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Montague Street Care Home 28-30 Montague Street Mansfield Nottinghamshire NG18 2PN Lead Inspector Meryl Bailey Unannounced 19 July 2005, 09:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Montague Street Care Home Address 28-30 Montague Street Mansfield Nottinghamshire NG18 2PN 01623 653 253 01623 653 253 None Ms Janine Tregelles, Royal Mencap Society 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) Mrs Joanna Christine Turner Care home 12 Category(ies) of LD Learning Disability, x 12 registration, with number of places Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18 February 2005 Brief Description of the Service: 28/30 Montague Street is a care home providing personal care and accommodation for 12 adults with learning disabilities in two linked houses. Ages of current residents range from 48 to 86 years. The home is located in a residential area, close to shops, pubs, the post office and other amenities. The entrances provide level access. All bedrooms are single and located on two floors. A stair lift is provided in each house. There is a small patio providing an outdoor seating area, which is accessible by wheelchair users and there is a small car parking area. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one morning. Nine of the current eleven service users were at home and four staff were seen in addition to the manager and deputy manager. There was one current vacancy. Some service users and staff gave their views about the care provided, but no visitors were present on the day of this inspection. The communal areas of the home were inspected and a sample of bedrooms was also seen. 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. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 Needs are fully assessed prior to admission and introductory visits help prospective service uses to experience life at the home prior to deciding to live there. EVIDENCE: There were full assessments on the files of the most recently admitted service users. There is currently one vacancy and staff reported that a prospective service use has visited and stayed overnight recently. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Individual written plans describe care needs, but are not all updated to take account of changes. This could lead to needs not being fully met. Risks are assessed to enable individuals to take part in various activities. EVIDENCE: Four care plans were examined and found to contain comprehensive plans, covering all areas of care and marked as reviewed on a monthly basis. Key workers have written them in the first person and some signatures of service users have been obtained where they are able to comprehend the content of the plans. There were also written risk assessments linked to the care plans. However, not all areas described the current situation or plan for individual service users. Advice from medical appointments was not transferred to care planning and daily events were not all recorded in the daily logs. It is not necessary to record something every day about every service user unless significant, but, where observations are part of care planning, daily observations must be recorded so that changes can be monitored. There are risk assessments for a wide range of activities appropriate to individuals. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Involvement in appropriate activities is encouraged and contacts are maintained in the local community aswell as with family and friends. EVIDENCE: Two service users were attending a Day Centre during inspection and others spoke of attending a local Gateway club one evening per week. Service users were observed watching television or resting. Due to the increasing age of service users most prefer to stay at home. One service user spoke of holiday plans and staff said that holidays with staff support have been arranged for those who wish to go. Care plans show that family links and friendships are promoted and there are records of visitors to the home. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users are enabled to get the personal support in the way they want. Health needs are met and medication is dealt with appropriately, giving some control to individuals. EVIDENCE: All service users have a designated key worker, who has completed their support plan. Support preferred and required is recorded on individual care plans. The service users spoken with were satisfied with the support they are given. Medical appointments and advice received were recorded on files, but not always easily identified, as staff were not consistent in where this information was recorded. Links with care planning is dealt with under standard 6. Medication was stored separately for each house and found to be held securely. It is recommended that further divisions be installed between medications for each service user to ensure they are kept separately. Staff reported having had training in the administering of medication. Medication records were well maintained. Two service users were partially responsible for taking their own medication. Tablets were looked after and stored securely, but all handed over to these individuals to select what they need to take. This was well monitored and detailed in the individual care plans regarding medication. One of these service users was at home and said that the system worked very well. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 11 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The right to complain is respected and service users are protected from abuse, but procedures require amendments. EVIDENCE: The complaints procedure was available in written and picture format. No recent complaints have been recorded. The training programme for staff includes awareness of adult protection and whistle blowing policies with “Protect me from Abuse”. There was a copy of the Nottingham area Protection of Vulnerable Adults Policy and Procedure, but the manager was unaware of the recent amendments to this. It is recommended that they be obtained and anyone left in charge at the home receive training in these amended procedures. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 and 30 A homely environment is provided, with personalised bedrooms and all areas are clean and hygienic. EVIDENCE: The communal areas were found well decorated, clean and homely. Each house has a spacious lounge/dining room with a choice of seating to meet individual needs and preferences. Five individual bedrooms were viewed and found suitable to meet individual needs and lifestyles. All were very clean and had a high standard of furnishings. Some service uses have chosen and purchased their own bedroom furniture. A tree restricted natural light to one room and this needs attention. All areas were free from offensive odours. There is a sluice room adjacent to the laundry and effective washing machines and infection control procedures in place. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 13 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Sufficient staff are available and staffing is arranged well to meet the current needs of service users. EVIDENCE: The staffing rota was clear, up to date and accurately showed the staff on duty. Staffing is arranged so that more are available at particular times and both male and female staff are on duty. The rota is prepared three months in advance. Two staff were on duty for each house during the morning of this inspection. The deputy and manager were additional, which allowed for one member of staff to accompany a service use to the shops. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 14 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Health and safety within the environment are generally safeguarded, though radiators could continue to pose a risk. EVIDENCE: All staff have foundation training in all safe working practices including First Aid, fire safety, infection control, food hygiene and health and safety. Fire extinguishers were checked in March 2005 and the fire log is up to date. Electrical wiring is due to be checked and the manager is currently making arrangements for this. Substances hazardous to health are kept securely in the laundry room. Radiator covers have still not been provided and the target for this, as set at the last inspection, is 1st August 2005. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Montague Street Care Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 16 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 YA 6 YA 42 Regulation 15(2) 13(4) Requirement Timescale for action 1at August 2005 Ensure all plans of care are kept up to date following health appointments. Provide radiator covers. The 1st target date for this from a September previous inspection was set at 2005 1st August 2005, but is now extended to allow for the work to be carried out. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA 19 YA 20 YA 23 Good Practice Recommendations Record the outcomes from medical appointments in a consistent way in service users files and adjust action plans accordingly. Install divisions between medications for each service user to ensure they are kept separately. Obtain the amendments to Nottinghamshire’s Protection of Vulnerable Adults procedures and arrange for the manager and deputy to receive training in these amended procedures. Information is available on the internet at www.nottsadultprotection.org.uk Arrange for work to be carried out on the tree at the front of the property so that light is not restricted to any C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 17 4. YA 26 Montague Street Care Home bedroom. Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Montague Street Care Home C53 C03 S8720 Montague Street V239629 190705 Stage 4.doc Version 1.40 Page 19 - 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. 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