Inspection on 10/06/05 for Monument House Resource Centre

This inspection was carried out on 10th June 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 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

Monument House Resource Centre 28/11/06

Monument House Resource Centre 09/02/06

Monument House Resource Centre 01/09/04

Monument House Resource Centre 21/06/04

Monument House Resource Centre 19/02/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Monument House Resource Centre The Circle Chequerfield Pontefract WF8 2AY Lead Inspector Tony Brindle Unannounced 10 June 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. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Monument House Resource Centre Address The Circle Chequerfield Pontefract WF8 2AY 01977 722830 01977 722833 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) Wakefield MDC Ms Gina Milne Care Home 26 Category(ies) of Older People 26 registration, with number of places Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The care staffing hours are calculated by the provider using the Residential Forum staffing model and the number of full time equivalent staff appointed is in accordance with this calculation or otherwise as agreed in writing with the CSCI. Date of last inspection 1 September 2004 Brief Description of the Service: The overall aim of the Monument House Resource Centre is to provide a joined up service between health and social services, to promote faster recovery from illness, prevent unnecessary acute hospital admissions, support timely discharge and maximise independent living. Monument House offers a short stay in an environment, where the staff can work with residents to find out what care arrangements will suit them best. The manager, care staff and therapy staff encourage people to practice daily activities, to improve their confidence and ability to manage at home. These activities may include walking and exercise, domestic and daily living skills, personal care and hobbies and leisure activities. The servce aims to rebuild skills and confidence so that people can return home and continue to live independently. People usually stay for a period of no longer than six weeks. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced 4 hour inspection began at 10.30am and ended at 2.30pm. 10 service users and 5 members of staff were spoken with. During the inspection, the following documents were inspected: 6 service user assessments and care plans, the daily records, health and safety records, and various policy documents. There have been no additional or complaints visit to this home since the last inspection in September 2004. The inspector would like to take the opportunity to thank the service users, the manager and staff for their hospitality and patient cooperation throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The manager and staff team must ensure that there are satisfactory systems in place to make sure that the assessed needs of the service users are detailed within a written care plan. These care plans must give sufficient detail of the risks associated with those needs, and the actions that need to be taken by the staff to make sure that those risks are minimised and so far possible eliminated. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 6 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. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.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 Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.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) 3 and 6 Although there is a clear admission system in place which should make sure that new service users have their needs assessed prior to and upon admission to the centre, a lack of detailed information from other agencies prior to admission places additional pressures both on the new service users and the staff at the home. A further potential reduction in the therapy and rehabilitation input, places at risk the centre’s overall aim to promote fast recovery from illness, prevent unnecessary acute hospital admissions, support timely discharge and maximise independent living. EVIDENCE: The files show that new service users are admitted to the centre either from hospital or their own homes, after an assessment of their needs is carried out by a social worker. The manager said that sometimes, the information the centre receives is not as detailed as it should be, so the centre’s staff complete their own assessment of need, which is then used to make sure that a new service user gets the right type of care and support. The manager said that rehabilitation and therapy are the main focus of the services provided at the centre. One service user said that she had really Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 9 benefited from the work of the staff team. When she arrived at the home, she said she was totally dependent on other people. Now she can do everything for herself, but has some worries about using the stairs. She said that the staff are helping her to develop her confidence when using the stairs, and she is really looking forward to going home. The rotas show that alongside the care staff, qualified therapy staff (Senior Nurse, a Physiotherapist and 2 Therapy Instructors, employed by the local Primary Care Trust), work to make sure that service users are encouraged to recover and return to independence before returning home. The manager explained that the therapy input had already been halved in the last year, which had had a negative impact on the way services were provided. The manager and senior nurse said that meetings were being held to talk about the future of way therapy services were to be provided at the centre. They were both worried that a further reduction in the therapy input at the centre could take place. The manager said that a further reduction could mean that people’s rehabilitation could take longer, putting at risk the aim to help people return home quickly following an illness or trauma. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 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 standard(s) 7,8,9 and 10 The system for clear and consistent care planning and risk assessment must be improved so as to make sure that all staff have the information they need to satisfactorily meet the needs of service users. EVIDENCE: The service user files show that on the first day of admission to the centre, the service user assessment information is used to develop an in-house care plan. These care plans provide staff with basic information on how to support the service user in their daily living. Service users said that the staff treat them with respect, and staff were observed to show respect when talking with and working alongside the service users. The therapy staff have one set of individual care plan files, which are kept in the therapy rooms. The care staff use another set of individual care plan files, in which the therapy staff add notes, comments and care directions to be followed by the care staff. Some care plans were found to be in need of review due to the fact that the service user’s care needs had changed following admission. Only 1 out of the 7 care plans seen, had been signed by the service user. Risk assessments and fall prevention plans were found to be missing or not completed from 2 care plans. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 11 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) 12, 13, 14 & 15 Social activities and meals are managed well, providing service users with daily variety and a well balanced diet. EVIDENCE: Three service users said that they have been able to keep contact with family and friends. Two service users said that the food they receive is very good, and one said that it was really important to get good quality food at her time of life, as she believed it helped in maintaining her health and wellbeing. Service users and their relatives are informed of how to contact external agencies. (e.g. advocates), who will act in their interests, by way of a leaflet on the notice board. One service user said that the centre offers limited social and leisure activities, which she takes part in, such as bingo, quizzes and raffles. Another said that she just likes to watch the others take part, and joins in only now and again. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 12 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 & 18 The home has a satisfactory complaints system in place, with some limited evidence that service users feel that their views would be listened to and acted upon. There are satisfactory systems in place to protect service users from suspected or alleged abuse. EVIDENCE: The manager said that the complaints procedure is straight forward, providing service users and their families with clear information about how to raise issues, and how these would be dealt with. The procedure was seen to be understandable, two service users independently said that they had read it when they arrived at the home, and added that they would feel confident that any issues or complaints they raised would be dealt with properly by the manager and staff. Over the past 6 months, staff said they have attended abuse awareness training. One staff member who was spoken with was able to satisfactorily explain the procedure for responding to suspected or alleged abuse. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 13 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) 19 & 26 The standard of the décor within the home is good, providing service users with a homely and comfortable environment. EVIDENCE: Service users said that the home is always clean and tidy. Recent improvements to the bedroom décor and facilities have been made providing service users with more up to date wardrobes and sink vanity units. The laundry facilities were found to be sited appropriately, away from the dining area, with staff having a good understanding of infection control issues. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 14 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 & 30 Service users are supported by an experienced and well-trained team of staff. EVIDENCE: Two service users said that the staff are always very caring and kind, and even though they appear to be very busy from time to time, they respond quickly to queries, questions and call bells. The manager said that the numbers of staff on duty are dependent on the needs of the service users and the number of service users in the home. The rotas were seen to support this. Staff have attended training courses such as induction, movement and handling, POVA, infection control and NVQ in care. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 15 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) 35, 37 & 38 The systems operated within the home make sure that service users’ financial interested are protected, although the health and welfare of service users and staff are not always promoted and protected by the safety systems operated within the home. The lack of satisfactory risk assessments places the health and welfare of both the service users and the staff at risk. EVIDENCE: The manager said that service users are encouraged to look after their own monies, and there are systems in place for monies to be keep safely within the home for service users who either lack capacity in this area. One service user said that she likes to keep control of her own money, and uses a lockable drawer in her room for safekeeping. The fire testing records show that the fire safety system is tested routinely, with staff and service users taking part in training and fire drills on a routine basis. The service user care plans showed that individualised service user risk assessments are not always carried out. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 16 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 x x 1 x x 2 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 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 x 3 x x x x 3 x 1 1 Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 17 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 OP 7 Regulation 15 Requirement The registered person must prepare a written plan of care for each service user, detailing how their health and welfare needs are to be met. This must be reviewed as and when required The registered person must make sure that all the records relating to service users, required by regulation are kept and maintained within the home. The registered person must ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. Appropriate risk assessments must be undertaken, recorded and acted upon. The registered manager must ensure that the needs of new service users are appropriately assessed prior to admission. Timescale for action July 10th 2005 2. OP 37 17 July 10th 2005 3. OP 38 13 4(c) July 10th 2005 4. OP3 14 July 10th 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 18 No. 1. Refer to Standard OP 6 Good Practice Recommendations The deployment of staff, and specialist services from relevant professions including occupational and physiotherapists, should be provided or secured in sufficient numbers and with sufficient competence and skills, to meet the assessed needs of service users admitted for intermediate care / rehabilitation. Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 19 Commission for Social Care Inspection Park View House Woodvale Office Park Brighouse HD6 4AB 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 Monument House Resource Centre J51J01_s32906_monument house_v228114_100605.doc Version 1.30 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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