Inspection on 19/07/07 for Mostyn Lodge

This inspection was carried out on 19th July 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Mostyn Lodge 20/06/06

Mostyn Lodge 05/10/05

Mostyn Lodge 01/12/04

Mostyn Lodge 29/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Mostyn Lodge 2 Kelston Road Keynsham Bath & N E Somerset BS31 2JF Lead Inspector John Clarke Unannounced Inspection 09:00 2nd July 2007 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 Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 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. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mostyn Lodge Address 2 Kelston Road Keynsham Bath & N E Somerset BS31 2JF 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) 0117 9864297 0117 9869473 Mr Arthur Gent Mrs Jill Clarke Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 16 persons aged 65 years and over requiring personal care only. 20th June 2006 Date of last inspection Brief Description of the Service: Mostyn Lodge has been a registered care home since 1985 providing care and accommodation for up to 16 older people. It is an adapted property over two floors with stair lift to 1st floor. All rooms are for single occupancy and are of a good size some being over the minimum standard of 10 sq metres. None of the rooms offer en-suite facilities however all room are close to bathrooms and toilets. There are two lounge areas one being a quiet lounge overlooking the rear garden and patio area. There is a separate dining area. The home is situated close to the centre of Keysham but not within walking distance. Mostyn Lodge offers a small, homely environment described by one resident as lovely, couldnt find a happier place and another couldnt find a better home. We at Mostyn Lodge wish to enhance our residents quality of life by making sure that they keep their independence. Privacy and dignity are of the uppermost importance. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home as part of an inspection. The manager was not present during this visit and I was unable to examine all the necessary records and therefore parts of this inspection have not been completed. Areas not looked at on this visit will form part of the next inspection. I was able to look at records relating to care plans, medication arrangements in the home, staff recruitment and training. I also had the opportunity to talk with individuals who live in the home and staff. We received a small number of Have Your Say questionnaires and a completed Annual Quality Assurance Assessment these have been used to inform this inspection and make a judgement about the quality of service provided at Mostyn Lodge. I visited the home on the 28th August to discuss and clarify with the manager some of the areas I was unable to look at on my initial visit ie Criminal Record Bureau checks, training and requirements from the previous inspection. What the service does well: What has improved since the last inspection? A number of requirements were made at the previous inspection some of which have been addressed: care plans have improved with evidence of reviews taking place seen on this inspection, medication arrangements are now in place which protect individuals in the home and recording of medication administered has improved. The home has a Quality Assurance system in place which includes questionnaires for individuals who live in the home and relatives to comment on the quality of the service they receive. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 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 Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s Statement Of Purpose fails to provide the required information so that individuals have all the necessary and relevant information about the home and the service they aim to provide. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs of the individual. EVIDENCE: I looked at the home’s Statement of Purpose it provides information about the manager but not about other members of staff and their qualification ie number who have NVQ 2 or 3. Information about staff is out of date. Details about facilities do not reflect the changes made or number and sizes of rooms. The home’s complaint procedure is not set out in detail or how individuals are consulted about the quality of care provided in the home. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 9 Included is information about the care needs the home aims to meet and importantly how they would not be able care for individuals who are wheelchair dependant or have nursing needs (this could add that the home has the support of community nursing service). Pre-admission assessments were seen which gave information about the social and health care needs of the individual including any medical conditions. Where the local authority has assessed an individual a copy of their assessment has been obtained. Involvement from mental health professionals was included where there were needs and concerns around mental health needs. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care are generally good providing staff with the necessary information so that the health and social care needs of residents is met. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans were looked at and showed care needs and associated tasks to meet identified needs. Moving and handling assessments had been completed. Reviews had taken place (12/07/07 last). In one instance a pressure sore assessment had been completed however it failed to evidence that it reflected the individual’s current needs in this area being dated 07/07/06. Mental health assessment had been completed where there were concerns about individual’s mental well being. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 11 There are good arrangements for individuals who live in the home to receive community based health services such as chiropody, dental and optician. Any individual who has nursing type needs such as skin care, ulcers receives support from community nursing service. The home also has good links with mental health services and one individual receives support from Community Psyiatric nurse. Medication storage was looked at and was satisfactory as well administering records which accurately recorded medication given to individuals. Record is kept of medication returned to pharmacist and signed as being received. There were no individuals who self-administer their medication. Individuals spoke positively about the approach of staff “always friendly” “treat me well”. I observed staff talking with individuals and also assisting them and this was always with respect and done in a sensitive and supportive way. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting the social and recreational needs of residents would benefit from being looked at to see if activities in the home could be improved however there are good opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: As on the previous inspection there was mixed comments from individuals about the social activities provided in the home. Comments varied from “yes there’s enough for me” “they try to do their best” to “could be more”. Staff said they try to provide what they can but had difficulty because not all wanted to participate however this could be addressed by using one of the lounges or conservatory for those that did want to take part. Activities organised included quizzes, games and bingo there are also outside entertainers invited into the home however there is no record of the activities held in the home which Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 13 would establish the frequency of activities. Monthly religious services are held in the home. A strength of the home is the effort made to involve relatives and social events are organised the previous week a strawberry and cream tea had been arranged. This was enjoyed by the individuals I spoke to who said of the staff how “they always welcome my family” “always friendly here”. Comments from relative’s questionnaire the home had arranged: “all the care workers are helpful, friendly and always welcoming”, “staff easy to approach and talk to”. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has complaints procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. However this would be improved by making sure all staff undertake Safeguarding Adults training. EVIDENCE: In talking with individuals who live in the home there was a real sense that they all felt able to say if they were unhappy about anything and that the manager and staff were approachable. This was confirmed by comments made to me: “I would always tell someone if I didn’t like something or was unhappy” “I can always tell the staff about anything that upsets me” “get on well with staff can always talk to them about anything”. When asked a number of individuals I spoke with said they knew that they could make a complaint if they wanted to and how to do this though this was more about telling the manager or owner rather then knowing that there was a way to formally make a complaint. Comments received from relatives about making a complaint: “I have never had to complain but I would know who to approach if the need arose in the Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 15 future” and “ If my relative has problems I can usually speak to any staff member at the time and they are very good at their job”. The home has a Protecting Adults policy and Whistleblowing policy. Some but not all staff have undertaken Adult Protection training. I have previously spoke to a number of staff about their knowledge and understanding of Safeguarding Adults and they illustrated a good understanding of this area in particular the various forms of abuse which can occur in a care home setting. The home has acted appropriately where there were issues around protecting the financial affairs of individuals in the home. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. People who live and work in the home benefit from a warm, welcoming and well-maintained environment. EVIDENCE: Individuals I spoke with all said how the home was “always” clean one relative said that they always found “no unpleasant odours, fresh and clean at all times”. At the time of this visit the home was clean and free from any offensive odours. The home is well maintained and the owner makes every effort to continually look at ways the environment can be improved this has led to improving the dining area which makes for more space, new flooring being fitted to a number Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 17 of rooms. An area which could be improved is that of the toileting facilities in that on the ground floor there is only two toilets where access is limited for those that use mobility equipment such as frames. This was commented on by one individual I spoke to on this visit and on other occasions I have visited the home. There is no access for individuals who use a wheelchair however this is stated in the home Statement of Purpose namely that the home is not suitable for wheelchair dependant. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are generally satisfactory so that the needs of residents can be met in an efficient way. The training of staff needs to be more robust so that all staff have the necessary knowledge to undertake the tasks required of them in a competent and efficient way. Recruitment of staff needs to make sure that all prospective employees are only appointed where two complete references have been obtained so that there is adequate evidence of satisfactory previous employment. EVIDENCE: Staffing arrangements are good and rotas showed that there are normally two members of care staff on duty with waking night staff, the owner is also available in the event of an emergency. There are 5 members of care staff who have completed NVQ 2 or 3 and 2 working towards this qualification. I looked at recruitment records for two members of staff who had been recruited since the last inspection. Application forms had been completed as required however in one instance only one reference rather then two as required had been obtained and this reference had not been fully completed in relation to employment history or performance. I was unable to examine or Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 19 confirm that Criminal Records Checks (CRB) had been completed on these individuals because they were not available. I visited the home again on the 28th August to discuss this with the manager and confirmed that CRBs had been obtained and was able to sign off these for all staff. Training records were looked at for 11 members of staff for 1 member of staff there was no training record available for inspection. Four staff had no record of moving and handling training and 7 had not undertaken Safeguarding Adults training. On my subsequent visit the manager advised that the Safeguarding Adults training was being arranged. From records seen two members of staff had completed Caring For People with Dementia and Equality and Diversity training. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home makes a good effort to run the home in the best interests of individuals who live there and encourages an environment that is supportive and caring. The record keeping practices of the home make sure that the best interests of individuals who live in the home are fully safeguarded. The health and safety practices of the home protect the welfare of individuals who live and work in the home. The home has a Quality Assurance system in place to review the home’s practice and obtain the views of individuals who live in the home and others about the quality of the service they receive. EVIDENCE: Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 21 The manager Mrs.J.Clarke (no relation to inspector) has extensive experience of working with older people and has been the manager of Mostyn Lodge for a number of years. From observing Mrs Clarke on previous inspections and talking to individuals and staff she is well thought of as someone who is “approachable” (staff) “we can always go to her with any worries we have” (resident) one individuals described her as “always there for us if we want her”. She is seen as a manager who works hard for individuals who live in the home. She has a warm and friendly approach to individuals who live in the home. Mrs Clarke has Care In Community Care Practice certificate, NVQ 4 Registered Managers Award and has undertaken mandatory training including Adult Protection “Investigators” course. Since the previous inspection two residents meeting (Feb 07, Mar 07) had been held these were previously not held. On my visit of 28th August I discussed with the manager increasing the frequency of such meeting and this is something she agreed would be useful. I also discussed how the minutes should provide more detail about comments made and any action taken. Minutes showed that individuals had commented on the food “very satisfied with food” available in the home and were also informed about changes in the home. One individual had raised the possibility of trips and the home was looking into this though they discussed with individuals the difficulties around transport and potential cost. Individual had also discussed having film evenings and this was being again explored. On my initial visit I was unable to look at Quality Assurance questionnaires that I understood had been completed or confirm that consultation had taken place about activities arranged in the home. On my subsequent visit the manager was able to show me results of questionnaires which had been completed by 16 individuals who live in the home and number of relatives. Some of the comments: “very nice and homely” “you wouldn’t find a home better” “I feel very lucky to be well looked after in the home” In looking through the questionnaires there were generally good and excellent responses to questions asked about the approach of staff, the facilities and cleanliness of the home and the care individuals received. The home AQUA (questionnaire about the service provided in the home) stated that fire equipment had been serviced 09/06,electrical equipment 02/07, emergency call equipment 04/06. Records confirmed that regular checks of fire system takes place. There are procedures in place about maintaining infection control and Control Of Hazardous Substances risk assessments. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 22 Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 23 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 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X 2 3 Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19 (4) Requirement Ensure two full and completes written references are obtained relating to any prospective employee. Ensure all staff undertake mandatory training e.g. moving & handling, Safeguarding Adults. Timescale for action 19/07/07 2. OP30 18 (1a,c) 30/12/07 3. OP12 4 OP37 5 OP1 Consult residents about activities 30/10/07 arranged in the home. (Requirement from previous inspection previous timescale not met) 19/07/07 17 (3) (a) The manager to ensure that records are kept up to date and (b) are available for inspection at all times. (This refers to staff records, CRBs and care plan information.) 6 (a) (b) The manager to ensure that the 01/12/07 home’s Statement of Purpose is kept under review and revised as necessary. (This refers to updating to show current staffing arrangements and training undertaken by staff) 16 (2)(n) Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 25 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 OP12 Good Practice Recommendations Identify a member of staff who has responsibility for the organising of activities in the home. Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Regional Office 4th Floor Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Mostyn Lodge DS0000008156.V337527.R01.S.doc Version 5.2 Page 27 - 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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