Inspection on 03/02/06 for Montfort Fields 12

This inspection was carried out on 3rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Montfort Fields 12 22/05/09

Montfort Fields 12 13/04/07

Montfort Fields 12 06/10/05

Montfort Fields 12 02/03/05

Montfort Fields 12 21/09/04

Montfort Fields 12 25/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Montfort Fields 12 Kington Herefordshire HR5 3AT Lead Inspector Christina Lavelle Unannounced Inspection 3rd February 2006 03:45 Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 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 Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 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 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. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Montfort Fields 12 Address Kington Herefordshire HR5 3AT 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) 01544 231030 01544 231030 www.macintyrecharity.org MacIntyre Care Mrs Lindsay Joy Ross Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 residents with physical disabilities in addition to their learning disability may also be accommodated. 6th October 2005 Date of last inspection Brief Description of the Service: The provider (McIntyre Care) is also a registered charity and runs many day and residential care services for children and adults with learning disabilities. Montfort Fields provides accommodation with personal care for five adults (men and women) who must be aged less than sixty-five. Service users must require care due to learning disabilities and two service users may also have a physical disability in addition to their learning disability. The service users all have a high level of need, which is reflected in the staffing levels at the home. Macintyre Care makes six promises to service users in its mission statement: • • • • • • To To To To To To listen to and treat service users with respect. help keep service users safe, healthy and fulfilled. enable service users to make decisions about their lives. encourage and challenge service users to achieve their ambitions. enable service users to take their place in the community. speak up for service users when they want them to. The home comprises of a detached house, which is situated in a cul-de-sac in the market town of Kington. It is in walking distance of the town’s shops and facilities and the home also has two vehicles to provide transport further afield. Each service user has a single bedroom, three of which are large. None have en-suite facilities. The two ground floor bedrooms are adapted for people with physical disabilities and may need a wheelchair. There is a bathroom and shower on both floors and a separate toilet on the ground floor. The downstairs bathroom is assisted and so is suitable for people with physical disabilities. There is a lounge, dining room and a substantial conservatory for everyone to use. The home also has a large and enclosed garden with a summerhouse, which provides a very pleasant, private and secure place for the service users. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection was carried out in two hours in the late afternoon on a Friday in winter. The main aims were to obtain an impression of the home today and to check it continues to offer a good quality service and meet its stated purpose. For more detailed information about the service and facilities provided at Montfort Fields you are advised to read this report along with the report of the last, fuller inspection undertaken on October 6th 2005. Three service users were at home (the other two were with their families). Time was spent in their company in the sitting room, whilst also talking with staff. The manager discussed service users and their care as well as the current staffing and management situation with the inspector in the office. They were all were very welcoming and helpful with the inspection process. Some parts of the house were seen and various care, staff and safety records checked. All written correspondence and any other contact between the home and the Commission since the last inspection was also taken into consideration This included information about events in the home that affected service users and reports made by the provider following their monthly visits to check how the home is running and to obtain the views of service users, staff and visitors. What the service does well: Montfort Fields offers service users the opportunity to live in an ordinary house and so be part of the local community. The home is in a good place for getting to Kington town and its shops and other amenities. The house is very homely; was clean and safe and is very nicely decorated, well furnished and equipped. There was a warm and friendly atmosphere and staff were seen to be caring and supportive towards the service users. Whilst service users are not able to openly express their views of staff and if they like living at the home, it was clear they feel really at home and were relaxed with the manager and staff. Staff help service users to go out and mix in the wider community as much as they can and want to. Service users still take part in a wide range of activities to make their lives more interesting; to develop skills and take exercise. Staff also make sure all their personal, health and emotional needs are met properly The home and service users benefit from a stable, well motivated and suitably trained staff team, who have the skills and knowledge needed to do their jobs better. The home is well run, with a clear and positive management approach. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 6 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. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 1&5 Suitable information is provided to help prospective service users decide if they might like to live at Montford Fields and if the home could meet all their needs. EVIDENCE: These Standards were not assessed, as there has not been any new service users admitted to the home for several years. However it was previously confirmed that appropriate information documents are available for prospective service users, their families and supporters. These include a statement of purpose, a service users’ guide and a service agreement (contract). The guide is also produced in a format that people with learning disabilities are more likely to understand. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 6 Thorough “person centred” care planning makes sure staff know all service users’ needs, goals and wishes and how to meet them. EVIDENCE: It was previously confirmed all the service users have a care plan containing details of their needs and goals and how staff and the service can meet them. One person’s care records were checked. Their plan covered all relevant areas of need including their communication and behaviour. Although there is a limit to how much service users can be actively involved in drawing up their own plan the focus was on their preferences and meeting their individual needs. To achieve this “person centred” planning meetings were held regularly by the home with senior staff and link workers allocated to each service user from the staff team. The plan seen had appropriately been reviewed and updated and so reflected the service user’s current and changing needs. Formal care reviews were also arranged at least annually with service users’ day services, their families and funding authorities providing input. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 14, 15 & 17 Service users were being supported to maintain links with their families. Also to participate in appropriate leisure activities, so making their lives more active and interesting and helping them to integrate within the wider community. Staff made sure the food provided by the home promotes service user’s good health and that mealtimes are part of the social life of the home. EVIDENCE: Some of these Standards were not fully assessed. However it is apparent from discussion with staff and observation that service users continued to take part in a wide range of activities within the community. They included day services and social outings, based on what they like to do. Staff time was allocated flexibly to support them, which is accepted as an essential part of their role. Two service users had been out for a walk today and one person usually goes out horse riding, which had been cancelled due to the very cold weather. Since the last inspection the home had a new television and DVD player for the service users’ entertainment. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 11 The manager described how service users and the home retain close contact and involvement with families. One service user was at home with their parents for a few days at this time, and staff were taking another to meet their mother to go home when the inspector arrived. Staff supported service users to help choose their meals and menus, using pictures from recipe books. A weekly menu was then drawn up and those seen indicated a wholesome diet is provided, including a variety of fish and meat dishes, fresh vegetables and most meals being home made. There was plenty of fresh fruit, yoghurts and salad stuff seen and the manager said that staff ensured that service users had the recommended daily portions. The manager and staff team were clearly very aware of the importance of a balanced diet for good health. One service user required a special diet and a Dietician had appropriately been consulted. Staff had to ensure this person had strict portion control and they kept a record of their weight and the exercise they had taken, as part of the monitoring process. Although service users are not able to take an active part in meal preparation, cooking and related tasks staff tried to involve them in these processes. So for instance although the kitchen has to be kept locked for safety reasons staff take service users who wish to into the kitchen on a one to one basis so they can observe them cooking. Some also go out with staff to buy the home’s food. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 19 & 20 Suitable arrangements were in place to meet the health care needs of service users and to manage medicines safely in the home. EVIDENCE: Service users’ health is closely monitored and staff promote their good health. This includes them arranging annual heath related check ups and by obtaining appropriate input from health care specialists and specialist medical units. There were comprehensive guidelines for staff regarding the management of one service user’s particular health problem. The manager and staff clearly monitor their condition very closely and follow advice given (with records kept) The last inspection included a detailed inspection of the handling of medicines in the home by a specialist Commission Pharmacist inspector. Although this had found the system was sound, it was positive that two requirements and three recommendations made had been addressed. They included the review and update of the home’s medicines policy & procedures and individual plans being drawn up for service users for use of “as required” medicines. More staff had since attended safe handling of medicines training and the manager and senior were soon to attend a comprehensive three day course. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 13 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 the following standard(s): EVIDENCE: These Standards were not fully assessed; however no complaints or vulnerable adults concerns have been raised with the home or the Commission since the last inspection. It was previously confirmed that the home provides an appropriate complaints procedure and policies and procedures for the protection of vulnerable adults, including whistle blowing. The manager is required by McIntyre to instruct staff in relation to all these procedures annually. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 24 The home is suitable for its stated purpose and meets service users’ needs. Montfort Fields provides service users with a safe and very comfortable home. There are also appropriate arrangements in place to ensure that the accommodation is kept clean, well maintained and is continually improved. EVIDENCE: These Standards were not fully assessed. However Montfort Fields is in a convenient location close to Kington town and being in keeping with nearby housing gives service users an opportunity to integrate in the local community. The impression obtained of the premises is as very homely and comfortable and those areas visited were warm, clean and tidy. The house is furnished, equipped and decorated to a high standard. It was apparent that work to improve and maintain the premises is ongoing. One bedroom had been completely redecorated and furnished since the last inspection and looked very nice. Staff had made sure it was to the service user’s taste and that the layout best meets their care needs. Routine servicing and maintenance to the home’s services and equipment and health & safety checks were also carried out. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 15 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34 & 35 Suitable staffing levels were maintained to meet service users’ needs and service users also benefit from a stable and appropriately trained staff team. Thorough recruitment procedures help to protect service users from unsuitable people working with them. EVIDENCE: The manager and three support staff were on duty today for the three service users at home. It was also confirmed that staffing levels and deployment at the home had not changed since the last inspection and were more than just sufficient to meet the individual and group needs of service users. A full time vacant staff post had recently been appointed and the home once again had a complete staff team. It was good however that the vacant hours had been covered by the home’s own part time and relief staff and that overall the staff team was stable, which helps to promote consistency of care. The recruitment process followed for the new staff member was discussed with the manager and their records checked. Two satisfactory written and one verbal reference had been obtained from previous employers and a CRB/POVA check taken up. They had already started an accredited induction programme. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 16 The whole staff team had undertaken all the mandatory health & safety training topics and refreshers were arranged at appropriate intervals. Staff had also attended training sessions relevant to service users’ special needs, such as autism and epilepsy, and most have an NVQ qualification. There had been a senior staff meeting held earlier today and staff meetings are generally held weekly. A team away day was planned which would include a session from the Adult Protection co-ordinator. The manager confirmed that all staff had an annual appraisal and individual supervision session 4-6 weekly. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 17 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were not fully assessed; however management arrangements for the home had not changed. The manager is suitably experienced and qualified. She undertakes periodic training to update and enhance her skills and knowledge e.g. recently a training session on disciplinary procedures and investigations. This inspection supports the previous evidence and view that the home is very well run, with an open and positive management approach. The home’s quality assurance and monitoring system was discussed with the manager. This will play an increasingly important role in ensuring the quality of care services and that they show continual improvements, based on what service users and relevant other people want. The manager said their system is based on “Investors in Care” and questionnaires will also be sent to service users, their families and other stakeholders to obtain their views of the home. No health and safety hazards were noted in the environment. Records of any accidents or incidents were seen and were maintained appropriately and a fire drill had been arranged earlier today. Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 18 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 Standard No 1 2 3 4 5 Score CONCERNS AND COMPLAINTS Standard No 22 23 Score 3 X X X 3 X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 X X X X ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 4 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score LIFESTYLES Standard No Score 11 X 12 X 13 X 14 4 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 4 3 X X X X X X X X Version 5.1 Page 19 Montfort Fields 12 DS0000024682.V282035.R01.S.doc 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 Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 Montfort Fields 12 DS0000024682.V282035.R01.S.doc Version 5.1 Page 21 - 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!