Inspection on 02/11/05 for Montague Street Care Home

This inspection was carried out on 2nd 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.

Other inspections for this house

Montague Street Care Home 14/08/07

Montague Street Care Home 25/10/06

Montague Street Care Home 19/07/05

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 MIXED CATEGORY MAJORITY OLDER PEOPLE Montague Street Care Home 28-30 Montague Street Mansfield Nottinghamshire NG18 2PN Lead Inspector Meryl Bailey Unannounced Inspection 2nd November 2005 11:00 X10029.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 Montague Street Care Home DS0000008720.V263059.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 and Care Homes for Adults 18 – 65*. 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. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Montague Street Care Home Address 28-30 Montague Street Mansfield Nottinghamshire NG18 2PN 01623 653 253 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) Royal Mencap (Housing & Support Services) Mrs Joanna Christine Turner Care Home 12 Category(ies) of Learning disability (12), Learning disability over registration, with number 65 years of age (12) of places Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users shall be within categories LD or LD(E) Date of last inspection 19th July 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 DS0000008720.V263059.R01.S.doc Version 5.0 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 day. Seven of the current eleven service users were at home and four staff were seen in addition to the 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 seen, but bedrooms were not inspected on this occasion. 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 DS0000008720.V263059.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed at this inspection. EVIDENCE: Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are 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 and 9. Some individual written plans describe care needs, but are not updated to take account of changes and not clearly in place for all service users. This could lead to needs not being met, but health needs are met. Current medication practices could lead to errors and all staff must be retrained in this area. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 9 EVIDENCE: The files of three service users over the age of 65years were examined. There were some standard forms on the files, but care planning varied considerably. Some information was out of date and misleading. One service user’s plan described the care given in most areas of need, but was last reviewed in July 2005. There were continual comments in daily notes regarding incidents relating to continence at night, but no plan of care to meet needs in this area. Some plans, referred to on a contents page, were missing. Another service user’s plan was limited to risk assessments and actions required to reduce risks. Other needs were not described and the last review of the risks had been in August 2005. A third service user was described as requiring Palliative care. A summary was provided that clarified needs and was followed by detailed plans and risk assessment. There were also some detailed daily notes and completed charts of care given, but overall reviewing of the plan was not clear. On two files there was a list of health professionals involved and records of contacts with them. There were daily contacts for the person looked after in bed and additional care staff have been commissioned to meet her needs. A community nurse was present at the commencement of this inspection. Medication was held securely and a mixture of bottles, packets and predispensed blister packs was used. Some medication was required dependent on need (prn). The policy for giving this was that two staff make the decision and sign their names, counting the remaining tablets each time, though these were not officially controlled drugs. A staff member was observed signing the record a few hours after tablets had been given and the other member of staff was no longer on duty. The tablets were then counted and the number did not match with the record. For other medication being prescribed staff were observed signing before the tablet was administered and three staff said this was their usual practice. Further training in administering medication is essential and this was later discussed with the manager who made immediate arrangements for such training. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 A range of freshly prepared food is available to service users and meals are enjoyed. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 11 EVIDENCE: Lunchtime meals were prepared during this inspection and large portions were served. Meals are prepared separately in the two kitchens. Three service users in each house were eating at the dining tables within the lounges. All service users present enjoyed meat, vegetables and potatoes. Freshly baked apple pie was also served, with custard or cream. Service users meet together with staff to decide on menus each week and the current week’s menu was displayed. Records of food eaten were written in a diary. One service user was fed a liquidised meal in bed. This meal had been pre-cooked, liquidised and frozen and contained beef and vegetables. On the day it was defrosted and the reheated to the correct temperature (over 75°C). A probe thermometer was used. One service user was drinking tea from a damaged feeder cup and an alternative was given during inspection. It is recommended that a stock of cups, acceptable to the service user, be stored ready for use. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed on this inspection EVIDENCE: Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) 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 A homely environment is provided. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 14 EVIDENCE: The premises comprised of two houses, linked with a corridor. Laundry facilities were shared but other facilities were separate for each house. The communal areas were found clean, homely and in a good state of decoration. The lounge/dining room in each house provided service users with a choice of seating. Bedrooms were not viewed, but it was noted that, since the last inspection, a tree previously restricting natural light to one room had been removed. An outstanding requirement regarding radiators remained unmet (see standard 38) Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the 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 and 30 Sufficient staff are normally available to meet the current needs of service users. Staff are supported to train and develop in order to effectively meet the needs of service users. The recruitment practices protect service users. EVIDENCE: The rota showed four staff on duty for the morning of this inspection, so that two staff were available for each house. However, one staff member was not aware of the change in rota and there were just three staff from 11am until 1pm. The manager should ensure all staff are made fully aware of when they are expected on duty. Additional staff, employed by another service, were working within the premises to meet the increased needs of one service user every morning and evening. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 16 Staffing files were sampled and records included the evidence of Criminal Records Bureau checks, but clear individual training profiles were not recorded. The deputy manager was able to confirm that she has commenced level 4 National Vocational Qualification in care and another staff member is currently doing level 3. Most staff have reportedly received Foundation Training with Mencap. This is comprehensive and accredited within the Learning Disability Award Framework. None currently hold National Vocational Qualification level 2, but some further staff are due to commence level 3 soon. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) 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, 35 and 38 The registered manager continues to develop her skills. Service users financial interests are protected by procedures in place. Health and safety in the home is generally promoted, but risks continue from unguarded radiators. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 18 EVIDENCE: The manager is registered with the Commission and has completed part of the level 4 National Vocational Qualification in management and care. She was not present during this inspection and staffing and management information was given by the deputy manager and an area service manager. Since the inspection the manager has made contact with the Commission to clarify some information. Service users’ finance was planned individually and they had their own bank accounts. Small amounts of service users’ money was held securely and records of transactions were kept. Some checked at random were found to be accurate. Radiator covers have still not been provided and the target for this, as set at previous inspections, was 1st August 2005. Further estimates were being gathered during this inspection with a view to replacing with replaced with low surface heat radiators. This work must now be carried out. Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 19 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 X 2 X 3 X 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 X 34 X 35 3 36 X 37 X 38 2 Montague Street Care Home DS0000008720.V263059.R01.S.doc Version 5.0 Page 20 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 2 3 Standard OP7 OP7 OP9 Regulation 15(1) 15(2) 13(2) Requirement Ensure there is a clear plan of care to meet the needs of each service user Ensure all plans of care are reviewed monthly and kept up to date Make arrangements for the safe recording, handling and administration of medicines (immediate) Provide radiator covers (or replace radiators). The initial target date for this from a previous inspection was set at 1st August 2005 and the work must now be carried out. Timescale for action 02/12/05 02/12/05 02/11/05 4 OP38 13(4) 31/12/05 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 Refer to Standard OP15 OP27 Good Practice Recommendations Keep an accessible stock of feeder cups, acceptable to the service user concerned. Ensure all staff are made fully aware of when they are expected on duty DS0000008720.V263059.R01.S.doc Version 5.0 Page 21 Montague Street Care Home Commission for Social Care Inspection Nottingham Area Office 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 DS0000008720.V263059.R01.S.doc Version 5.0 Page 22 - 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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