Inspection on 02/06/05 for Mount Hall Nursing Home

This inspection was carried out on 2nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Mount Hall Nursing Home 28/11/07

Mount Hall Nursing Home 05/10/06

Mount Hall Nursing Home 08/12/05

Mount Hall Nursing Home 18/11/04

Mount Hall Nursing Home 11/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Mount Hall Nursing Home Flash Lane Bollington Cross Macclesfield SK10 5AQ Lead Inspector Helena Dennett Announced 02 June 2005 09:30 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. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mount Hall Nursing Home Address Flash Lane Bollington Cross Macclesfield Cheshire SK10 5AQ 01625 574177 01625 560251 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) Goldsborough Limited Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Within the maximum of 42, 3 OP beds are provided for persons requiring personal care only. 2 Service Users age 60 years and above. Date of last inspection 18/11/04 Brief Description of the Service: Mount Hall Nursing Home is a country house built in the 1830s. It stands in 6 acres of landscaped grounds in the rural village of Bollingon and has been completely refurbished. There are surrounding gardens for residents use with a summerhouse, pond and greenhouse. The home was first registered as a nursing home in 1984 providing care for 34 residents. An extension was added to the existing premises in 1990 increasing the number of beds to 50. The number of service users accommodated was reduced in October 1997. The accommodation is provided on two floors and there is a passenger lift and staircases to both levels. The bedroom accommodation consists of 29 single rooms with 25 having en-suite facilities. There are 3 double rooms available all with en-suite facilities. There is a choice of lounge/dining areas including a spacious reception area, hairdressing salon and a laundry on site. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 7 hours. Five residents and two relatives were spoken with and their views are included in the report. CSCI received completed CSCI cards from four residents, four relatives/visitors, one from a social care assessor, and one letter from a resident’s relative giving views on the way the home is run. What the service does well: What has improved since the last inspection? There is a structured programme of supervision for staff now in place to make sure that staff know what is expected form them and to enable them to discuss any concerns or issues that they may have. All staff found this to be very positive. Most of the staff are now enrolled on NVQ Programmes. Staffing levels have increased since the last inspection. The number of care staff have increased by 30 hours and also the domestic staff hours has also increased by 30 hours per week. The sensory garden provides a very pleasant area for residents sit in and enjoy outside in the milder weather. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 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. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 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 Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 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) 3 & 6 Assessments of people’s care needs are carried out before they move into the home so there is information to show that their needs can be met at the home EVIDENCE: Three residents’ files were looked at. These contained assessments of people’s care needs, done by a senior member of staff before they moved in to make sure that these needs could be met at the home. Intermediate care is not provided at this home. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 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) 7,8,9&10 Although there were care plans in place, these were not set out as individual plans of care and did not include enough information on all residents’ care needs and how these are to be met so residents could be at risk of not having all their needs met. Although residents appeared to be well cared for and stated they felt their needs were met by staff concerns were raised that residents’ teeth, hearing aids and spectacles are not always attended to properly by staff. Residents are educated on their health care needs and so can make positive choices about their lives. EVIDENCE: Three residents files were examined. Care plans were in place, however these did not fully address all of the residents’ needs. The care plans are standard for all residents and do not address individual needs. The care plans are evaluated monthly but were not updated when the resident’s needs changed. For example a member of staff when spoken to stated that one resident had difficulties in swallowing and because of this they offered her thickened fluids on a regular basis. However the plan of care did not give clear instructions that staff were to make sure that this resident had thickened fluids because of her swallowing difficulties. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 10 If this is not included in the plan of care there is a risk that a new member of staff may not realise that thickened fluids are needed and may place the resident at risk. See Requirement 1. There was evidence that the health and welfare needs of residents are being met by staff. Residents spoken to confirmed that they were very happy with the care and facilities on offer. There was evidence in the daily records that staff contact the doctor or other healthcare professionals as needed. Staff spoken to knew the residents well, what their needs were and the action to be taken to make sure they were well cared for. A relative raised concerns regarding the care of a resident’s teeth or hearing aid and felt staff should be more careful when attending to these aspects of care. A resident’s comment card expressing dissatisfaction with the care of teeth, hearing aid and spectacles was also received. The manager agreed to investigate why these aspects of care are not been met by the staff. One resident stated that she had attended a group meeting with a dietician the day before the inspection. The dietician gave out leaflets to the group and she felt she learnt a lot about maintaining a healthy lifestyle and eating. She found it ‘most helpful’. Residents were positive about the attitude of the staff. They felt treated with respect. One resident stated that she did not like the term ‘service user’ being used as she felt this ‘label’ was degrading and disrespectful. She stated that she wished to be referred to as a resident of the home. She confirmed that having discussed this with the manager, staff have all respected her views. Medicines are managed well. Staff at the home need to take care that residents’ medications times are reviewed if they are generally asleep at the times the medications are required. The manager audits the medicines regularly to make sure that they are given correctly and to prevent potential problems occurring. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.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 There are plenty of activities offered to meet the needs of all residents in the home and to keep them stimulated. Residents can choose how they spend their time at the home, which enables them to keep control over their lives. Visiting can take place at any reasonable time so that residents can keep in touch with their relatives and friends. EVIDENCE: Residents spoken to stated that they can choose what they want to do during the day. They stated that the activities provided a the home were good there was ‘plenty going on and we are informed’. Residents stated they enjoyed the cheese and wine celebration the previous night. Others stated that they enjoyed the garden party. All of the residents said they enjoyed the food at the home and that they are given a choice. Residents said that visitors can come at any reasonable hour. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.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. Information about the complaints process for the home is readily available so residents and their relatives know how to make complaints and who to make them to. EVIDENCE: One resident stated that he had made a complaint to the manager and that this was dealt with quickly. Other residents stated that the manager is approachable and they would feel comfortable bringing any concerns to their attention. Statements such as ‘Irene gets things done’ were made by residents. Staff know the adult protection policy and discussed the action they would take if they witnessed an incident that caused them concern. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.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) 19,20 &26 The home is well maintained to provide a comfortable, attractive environment for the residents. It is kept clean and tidy. Residents’ rooms contained many of their own possessions making them more homely. EVIDENCE: The home is well maintained to provide a comfortable, attractive environment for the residents. There is a sensory garden at the front of the building which has been recently finished. This provides a very pleasant outdoor area that residents and their relatives will be able to use on mild pleasant days. Several bedrooms have been re-decorated and re-carpeted since the last inspection. The staff area has also been decorated. One resident stated that the ‘décor is up to scratch, no expense spared. Work has been done on the grounds more recently’. The manager stated that there are plans to replace the specialised bath, which is not used very often, with a walk in shower for residents. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 14 Residents stated the environment they live in is pleasant. All confirmed it is kept clean and tidy. All were very complimentary about the laundry and said their clothes are looked after very well. Residents’ bedrooms are personalised, containing residents’ own possessions. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 15 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 Although some residents felt the home may be short-staffed at times, their needs are been met by the number of staff on duty. Care staff were positive about the senior staff and had the time to care for the residents. Training and supervision programmes are in place at the home so staff feel supported and are able to meet the needs of the residents. EVIDENCE: There was a relaxed and calm atmosphere on the day of the inspection. There were 27 residents in the home on the day of the inspection. There were two Registered General nurses and four carers on in the morning, one Registered General Nurse and three carers on in the afternoon and one Registered General Nurse and three carers rostered for night shift. However the manager did confirm that at times there is one Registered General Nurse and two carers on at night, dependent on the number of residents within the home and their dependency. Residents were very positive about the staff working at the home. One resident stated that with the new management, staff working practices have improved. The resident felt that the nursing staff from India were ‘exceptionally good, pay attention to the residents’. One resident stated the home is short staffed on occasion particularly in the evening or nights. Other residents said that ‘staffing levels are fine now’, night staff answer call bells quickly and that there are more permanent staff, not as much agency being used. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 16 One relative felt that care needs are not met because there are not enough staff on duty. A relative’s comment card received stated that levels of staffing are only just ok if all staff are present and that the high standard of care is not always maintained. See Recommendation 1 The manager stated she has reviewed staffing hours since the last inspection and has increased by 30 hours per week to make sure that they have additional staff to cover sickness etc. She said that the home has recently recruited several staff. Members of staff who spoke with the inspector stated that they felt supported by the senior staff working at the home. They confirmed there is plenty of training available and that staff are encouraged to enrol on NVQ Level 2 in care course. They felt the staffing levels were good at the moment and that residents’ needs are being met by staff. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 17 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) 31,32,33, &38 There is evidence that the manager of the home has made significant improvements in all aspects of the running of the home. The quality assurance system makes sure that the home is run in the best interests of the residents. Safety checks are carried out on the equipment in the home, so that residents are not placed at risk. EVIDENCE: Residents stated that the management of the home has improved since the manager has come into post. Two residents stated that the manager ‘gets things done’. Members of staff felt that things had improved a lot since the manager and deputy manager have come into the home. They felt the home is more organised, professional, training is good, staff are given time to attend training and that staffing levels are now good. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 18 The manager is a first level Registered General Nurse. An application for her to becme registered with the Commission for Social Care Inspection must now be submitted so that her suitability to be a registered manager of care home can be checked. See Requirement 2. Residents are asked to complete satisfaction questionnaires to assist the management to develop systems within the home to make sure that all residents are happy with the care and facilities available to them. There are three-monthly head of department meetings, and staff meetings. Residents meetings are held, and a newsletter is available so that residents are made aware of events in the home. The manager is also attending multidisciplinary meetings held at the local surgery, so that communication links are developed to enhance the service given to residents at the home. The health and safety of residents is maintained. Fire checks are carried out regularly. There was evidence that maintenance checks are carried out on the lift and hoists regularly making sure that the equipment used by the home is safe to be used by staff and residents. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 19 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 3 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 3 x x x x 3 Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 20 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 7 Regulation 15 Requirement A care plan must be put in place as soon as practicable after a resident had moved into the home, which identifies the individual needs of the resident and how these needs are to be met. This must be revised after consultation with the resident and/or relative if the residents needs change. An application to become registered manager must be submitted to the CSCI. Timescale for action 15/7/05 2. 31 9 2/7/05 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 27 Good Practice Recommendations The manager should review the staffing levels currently provided in line with the dependency needs of the residents to make sure that numbers of staff on duty are adequate to meet the needs of the residents. Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire CW9 7LT 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 Mount Hall Nursing Home F51 F01 S18773 Mount Hall V224497 020605 Stage 4.doc Version 1.30 Page 22 - 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!