Inspection on 14/09/05 for Montana Residential Home

This inspection was carried out on 14th September 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Montana Residential Home 11/11/08

Montana Residential Home 19/01/07

Montana Residential Home 27/04/05

Montana Residential Home 26/10/04

Montana Residential Home 03/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Montana Residential Home East Barton Road Great Barton Bury St Edmunds Suffolk IP31 2RF Lead Inspector John Goodship Announced Inspection 14th September 2005 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 Montana Residential Home DS0000024451.V250787.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. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Montana Residential Home Address East Barton Road Great Barton Bury St Edmunds Suffolk IP31 2RF 01284 787321 01284 788012 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) Grace & Compassion Benedictines Sister Vijaya Panthaleon Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th April 2005 Brief Description of the Service: Montana is a residential home for 16 older people situated in the village of Great Barton. The house is owned by the House of Hospitality Ltd, a registered charity and is run by an order of Roman Catholic nuns, the Benedictine Sisters of our lady of Grace and Compassion. The home was opened in1969 as a single storey detached building, which has been extended and refurbished over the years. Oakampton House, a sheltered housing complex of 18 flats, accommodating older people who are semi-independent, is sited next to Montana. The homes enjoy close links with each other and the occupants of Oakampton House may join residents in Montana for meals, social activities and worship in the chapel. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and followed an unannounced inspection in April 2005. All the national minimum standards were covered over the 2 inspections. The visit lasted 6 hours. The sister-in-charge and her deputy were present throughout. The inspector was able to talk to several residents. Fourteen had completed comment cards which showed their satisfaction with the care they received. Fifteen comment cards were received from relatives. Again all were complimentary. Comments from both groups have been included in the report. The home now meets all the national minimum standards. What the service does well: What has improved since the last inspection? There were no requirement or recommendations from the last inspection. However, all aspects of the quality of care had been maintained. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 6 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. Montana Residential Home DS0000024451.V250787.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 Montana Residential Home DS0000024451.V250787.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): 1,2,3,4,5,6 The home provides all the information and visiting opportunities needed to let prospective residents decide if they would feel comfortable in the home. The home also gathers information to ensure it can meet people’s needs. EVIDENCE: The Statement of Purpose and the Service User’s Guide were on display in the hall. They contained all the required information, including the results of the most recent satisfaction surveys. All residents had a contract and terms and conditions of their stay. These contained information about the trial period for new admissions. There were pre-admission assessments for all prospective residents, and opportunities for them to visit the home before deciding if it was to their liking. If there were vacant rooms, respite care stays were possible. Sometimes this led to permanent residence. Although Montana is a Christian community, staffed mainly by Roman Catholic nuns with a resident priest, people of all denominations were welcome, and enabled to see ministers of their own religion. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 9 The home does not offer intermediate care so Standard 6 is not applicable. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 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. Care plans were comprehensive and regularly reviewed to ensure they reflected the changing needs of residents. This assists staff to meet residents’ needs. Drug administration practices were accurate and up-to-date, keeping residents safe and medicated according to prescription. Staff showed respect for the privacy and dignity of residents. EVIDENCE: The system used for the care plans brings together all information in an easy to use record and reference file. The home also used their normal care plan system for short respite care stays. Care plans were regularly reviewed, with review dates recorded. The content in the daily record provided positive information rather than assuming that a lack of information meant all was well. Drugs were supplied in blister packs. Medication administration records (MAR charts) were up-to-date and complete. The supplier conducts monthly stock checks. There was a book for recording drugs returned to the supplier. There was a record of medication taken out with a resident when their relative took them out for the day. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 11 One resident had had several falls recorded recently. They had been referred to the falls clinic and assessed by the community physiotherapist. Rails had been fitted to the bed as protection rather than restraint. Information in the care plan was comprehensive with input from the health professionals. The home also sought advice as necessary from the continence adviser. The wishes of residents concerning arrangements when they died were recorded in the care plan. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 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. The home supports people to enjoy a range of activities inside and outside the home. The home promotes contacts with families and the community to encourage socialising. Residents expressed their satisfaction with the kindness and helpfulness of the staff and with the facilities offered to them. EVIDENCE: Those residents who were able went out for walks in the garden or further afield. These residents were given a key to let themselves back in the Home, without compromising the general security. Others chose whether to stay in their rooms or join others in the 3 communal areas. It was good practice to see staff sitting with residents helping them to read the paper or do puzzles. There was a range of activities available, with weekly exercise sessions, singing, board games, and outings. The home no longer had its own minibus but hired suitable vehicles locally, either Dial-a-Ride or another wheelchairaccessible vehicle. The home joined up with the sheltered housing unit next door on some outings. Relatives were frequent visitors. Some helped with the activities. A musical duo were playing in one of the communal areas during the inspection. The home had written a guidance sheet for relatives to help them recognise that the wishes of the residents were paramount. One visitor said that they were “impressed with the care and spiritual support given to residents”. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 13 The lunch was tasty and nutritious, and of sufficient quantity. Some residents explained that staff knew which of them could only eat small portions. One resident said that “the food was very good and plentiful”. All meals were served in individual portion trays to allow self-selection. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 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): 16,17,18. The home has an up-to-date complaints policy. Legal rights are protected and exercised. Policy and training protects residents from abuse. EVIDENCE: The home had a complaints procedure displayed in the hallway where it was easily available to service users, their relatives and friends. It had been amended to provide an easier format. It contained the required information, including contact details for the Commission for Social Care Inspection. Service users in the main had either close family or a solicitor to advocate for them. Residents were able to vote. All staff had been trained in Protection of Vulnerable Adults (POVA) procedures. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 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): 19,20,21,22,23,24,25,26. The environmental standards of room sizes, communal areas and facilities continue to be met. EVIDENCE: All bedrooms had en-suite facilities. There were 3 separate communal facilities. There were policies and procedures for dealing with soiled linen. Staff had been trained in the use of the hoist. There was an emergency call system in every room. Water temperatures were being maintained at a temperature at or around 43o degrees Celsius. The home was centrally heated with warmth being delivered through floors and ceilings. Every service user had a bedside light. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 16 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. Residents benefit from the way the home is staffed during the day by the sisters and the novice nuns, with personal attention from the staff, who have the time to talk to residents as well as undertake personal care tasks. Residents are protected by frequent updating and refresher training of the staff and by the recruitment process. EVIDENCE: A resident told the inspector that “the staff treat me very well”. A relative commented that “staff care with kindness, efficiency and devotion”. Another said that their relative felt “very enfolded in Montana”. By the nature of the home being based on a religious order, the sisters are on duty throughout each day. Lay care staff are on duty at night, with radio access to the sister on sleeping duty. Training records were comprehensive, showing attendance at a full range of, mostly, in-house training sessions on topics such as protection of vulnerable adults, caring for confusion, infection control, activities for reminiscence as well as fire safety, moving and handling, food hygiene and first aid. Training and attendance certificates were in staff files. The deputy manager had completed the course to be an accredited trainer for moving and handling. She had also Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 17 introduced the traffic light system of risk assessment in this area for residents’ care plans. Staff were trained to induction and foundation levels within the required timescales. Five staff had been qualified to National Vocational Qualification (NVQ) Level 2 or above, and another person was due to start their course in September. This constitutes more than the minimum 50 required. The recruitment process for the most recently appointed staff member showed that safe procedures were followed. Prior to the latest appointment, some use was made of agency staff at night. The home had devised an excellent checklist for new agency staff to ensure that they were safe to care. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 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): 31,32,33,34,35,36,37,38. Quality assurance visits and questionnaires bring residents’ views to the attention of the staff. These enable residents to be involved in the way the home is run. Sisters and lay staff are supervised to ensure best practice is followed. Clear maintenance records ensure that residents health and safety are protected. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 19 EVIDENCE: A senior person from the religious foundation visited the home monthly and prepared a report to the provider and to the CSCI on the service. The core care staff team consisted of caring nuns. It had been agreed at a previous inspection that because of the closeness of the circumstances in which they live and work, individual supervision was not required for them. They were appraised every 6 months by the Mother Superior. Lay staff did receive individual supervision at the required intervals. Evidence was seen of this having taken place. There was a full record of fire matters, including training and fire drills. The fire risk assessment had been approved by the Fire Officer. The inspector was shown the Business and Financial Plan for 2005 which demonstrated the viability of the home. The petty cash records for 2 residents were checked against cash held and receipts and were reconciled. Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 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 3 3 3 3 3 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Montana Residential Home DS0000024451.V250787.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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. 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