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Inspection on 27/04/05 for Montana Residential Home

Also see our care home review for Montana Residential Home for more information

This inspection was carried out on 27th April 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.

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 is run by a community of sisters and nuns who live on site and provide most of the staffing. They are available at most times during the day and night. Although the order is a Roman Catholic one, the home welcomes residents from all denominations. The atmosphere in the home is calm and peaceful, although the residents were having a lively conversation in the dining room. One resident called it "a very happy home." Care standards are good. "It`s why we live so long" one resident said. Training is given a high priority and the records showed that staff had many opportunities for improving their skills.

What has improved since the last inspection?

The service users` guide had been revised to include more comments from residents about the Home as part of the satisfaction survey. Written agreement on the use of bedrails for a resident had been obtained from the GP. It was important to have this clearly stated as bedrails are a restriction on a person`s freedom of movement, albeit they may be for a good care reason.

What the care home could do better:

The home met all the standards inspected on this visit. The remaining standards will be covered at the next one, when a complete assessment will be made.

CARE HOMES FOR OLDER PEOPLE Montana Residential Home East Barton Road Great Barton Bury St Edmunds, Suffolk IP31 2RF Lead Inspector John Goodship Unannounced 27 April 2005 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 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 I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Montana Residential Home Address East Barton Road, Great Barton, Bury St Edmunds, Suffolk IP31 2RF 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) 01284 787321 Grace & Compassion Benedictines Sister Vijaya Panthaleon Care Home 16 Category(ies) of OP Old age (16) registration, with number of places Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Montana is a residential home for older people situated in the village of Great Barton, approximately three miles from the town of Bury St Edmunds. The home is owned by the House of Hospitality Ltd., a registered charity and run by an order of Roman Catholic nuns named the Benedictine Sisters of Our Lady of Grace and Compassion.The home was opened in 1969 and comprised a single storey detached building, which had been extended and refurbished over the years. It is now registered to accommodate sixteen service users who require personal care at some level. The home is situated in a quiet residential street with a village shop and post office within walking distance. There was a regular bus service to Bury St. Edmunds. Each service user had their own single bedroom with en-suite facilities, but there were two larger rooms that could be used by couples if required. While most of the bedrooms had pleasant views over the home’s gardens, those at the rear of the house had a particularly nice outlook towards open farmland. There was an abundance of bird and wildlife to watch. Montana is set in its own landscaped gardens. Oakampton House, a sheltered housing complex that comprised eighteen flats, accommodating older people who were semi-independent, was sited adjacent to Montana. The homes enjoyed close links with one another and many of the occupants of Oakampton House joined service users in Montana for meals, social activities and worship. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which will be followed later in the year by a further inspection. The visit lasted 4.5 hours. Both the Sister-in-charge, and her deputy, were present. The inspector toured the home, spoke to several residents, and reviewed records for care and for environmental matters. The home met all of the standards which were inspected on this visit. What the service does well: What has improved since the last inspection? The service users’ guide had been revised to include more comments from residents about the Home as part of the satisfaction survey. Written agreement on the use of bedrails for a resident had been obtained from the GP. It was important to have this clearly stated as bedrails are a restriction on a person’s freedom of movement, albeit they may be for a good care reason. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 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 I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 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 standard(s) 1,3,5. The Home provides all the information and visiting opportunities needed to let prospective residents decide if they would feel comfortable in the Home. EVIDENCE: There had been no new permanent admissions since the last inspection. However, due to the deaths of 3 resident, the opportunity had been taken to admit 3 people for respite care. This only happens when there are vacancies. All 3 had been assessed by the Home prior to admission. The Home was advised that they should always complete the normal care plans, although this may seem onerous for very short 5 day stays. The Statement of Purpose and the Service User’s Guide were on display in the hall. They contained all the required information, and the satisfaction survey information had been amended following the last inspection. The home does not offer intermediate care so Standard 6 is not applicable. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 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 standard(s) 7,9,10. 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 was advised to use their normal care plan system even for short respite care stays. Care plans are regularly reviewed, with review dates recorded. The amount of professional information in the daily record has improved since the last inspection, and presents positive information rather than assuming that a lack of information meant all was well. Drugs were supplied in blister packs. 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. The care plan of a resident whose bed had been fitted with bed rails contained the written agreement of the GP to this restraint. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 10 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 standard(s) ALL 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. The Home had written a guidance sheet for relatives to help them recognise that the wishes of the residents were paramount. The lunch was tasty and nutritious, and of sufficient quantity. Some residents explained that staff knew which of them could only eat small portions. All meals were served in individual portion trays to allow self-selection. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 11 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 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. One resident had completed their postal vote that week. All staff had been trained in Protection of Vulnerable Adults (POVA) procedures. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 12 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 standard(s) All The environmental standards of room sizes, communal areas and facilities continue to be met. EVIDENCE: All bedrooms had en-suite facilities. Communal facilities were adequate. The sluice had been moved to a more suitable location, as required. 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. A contractor was in the home undertaking a water system check. There had been a visit from the environmental health officer in March, who had commented in the report that the standards were very good. Since then, the home has been given a St Edmundsbury Food Hygiene Award for its excellence. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,30 Residents benefit from the total staffing concept of 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. EVIDENCE: By the nature of the home being based on a religious order, the sisters are on duty throughout each day. Lay 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. Staff were trained to induction and foundation levels within the required timescales. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,36,38. 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. EVIDENCE: The Mother General visited the home every six months. The core care staff team consisted of caring nuns. It was agreed that because of the closeness of the circumstances in which they live and work, individual supervision was not required for them. Mother General made twice-yearly appraisals. 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. Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 x x 3 x 3 Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 16 NO 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. Standard Regulation NONE 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. 1. Refer to Standard NONE Good Practice Recommendations Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich 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. Extracts may not be used or reproduced without the express permission of CSCI Montana Residential Home I54-I04 S24451 Montana V224515 050427 Stage 4.doc Version 1.30 Page 18 - 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!