Inspection on 28/11/07 for Mount Hall Nursing Home

This inspection was carried out on 28th November 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 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 05/10/06

Mount Hall Nursing Home 08/12/05

Mount Hall Nursing Home 02/06/05

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 Cheshire SK10 5AQ Lead Inspector Helena Dennett Unannounced Inspection 09:30 28 November 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 Mount Hall Nursing Home DS0000018773.V341996.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. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 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 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) www.bupa.co.uk BUPA Care Homes (GL) Ltd Jane Elizabeth Fielding Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 42 service users in the category of OP (old OP age not falling within any other category). 5 October 2006 Date of last inspection 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 Bollington, Cheshire, and has been completely refurbished. There are surrounding gardens for residents to use, with a summerhouse, pond and greenhouse. The home can provide care and accommodation for 42 people; residents’ rooms are 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. The scale of charges is from £450 - £850 per week. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit was just one part of the inspection. Staff at the home were not informed of the date the visit was to take place, but before the visit the manager was asked to complete a questionnaire to provide the inspector with some information about the service. The manager was also asked to distribute questionnaires to residents, relatives and health and social care professionals to help the inspector find out what they think of the home. Some of the comments from these questionnaires are included in the report. During the visit the inspector spoke with the manager, staff, residents and visitors. She also toured the premises and looked at various records held by the home. What the service does well: What has improved since the last inspection? The company that runs the home has introduced a new care planning system into the home. This is more focussed on the individual resident so should ensure that their needs are identified and met. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 6 There were enough staff working in the home to meet the needs of the residents. Call bells were answered quickly. The residents spoken with during the visit also confirmed this. Adult protection training has been provided for staff so that residents can be confident that any issues or allegations will be taken seriously and acted on promptly. 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. Mount Hall Nursing Home DS0000018773.V341996.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 Mount Hall Nursing Home DS0000018773.V341996.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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Where possible prospective residents have an assessment before coming into the home so they can be confident that staff at the home can meet their needs. EVIDENCE: Information is given about the home and the service it provides to residents so they know what to expect when they first come to live at Mount Hall Nursing Home. One resident spoken with said she came to the home straight from hospital on the recommendation of a friend. A member of staff did an assessment when she first came in and concluded that they would be able to meet her needs. The person was given information about the home and a contract was issued detailing the terms and conditions of her stay. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 9 Other records looked at there showed that staff visit prospective residents before they move into the home to find out what their needs are so they can be confident they have the skills, experience and facilities within the home to meet those needs. Intermediate care is not provided so Standard 6 does not apply. Mount Hall Nursing Home DS0000018773.V341996.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 adequate. This judgement has been made using available evidence including a visit to this service. Although residents receive health and personal care based on their individual needs, the management of the medicines needs to be improved to make sure that residents’ health is not put at risk. EVIDENCE: The records of three people were looked at in detail. These provided information on how the health and well being of the individual are promoted. A full assessment of need is carried out when someone first moves to the home. Care plans are then written and these provide residents and staff with the information on how these needs will be met. The care plans have improved since the last inspection and are more focussed on the individual. For example: one person suffered from poor eyesight and the care plan clearly outlined what staff should do to ensure that this person has the best quality of life. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 11 Care plans were reviewed regularly and generally updated when the person’s needs changed. There was one instance where the resident’s needs had changed in that a different hoist was to be used; however the moving and handling assessment had not been updated with this information. There was evidence that staff were using the right hoist for this person. Daily records are written so that staff new on duty have information on how the person is feeling and whether there are any changes to their care. In some instances these daily records needed to be more detailed to make sure there is adequate information on the person’s health and well being. The records showed that doctors, chiropodists and other professionals visit as necessary. There was also evidence that residents are helped to keep outside hospital appointments as necessary. Many of the residents are provided with specialised beds and mattresses to promote their health, safety and comfort. Residents were positive about the care they receive at the home. The following comments were made on the day of the visit: ‘The staff are very good, they answer the call bells quickly’ ‘Good carers, nothing is too much trouble’ ‘Staff look after us well, answer the call bells when we ring, they have a lot of patience’. BUPA has a policy on the management of medicines that staff should follow. Some problems were found with the medicines. The door to the treatment room on the first floor was open. This means that an unauthorised person could get into this room thus compromising the security of the medicines. Pain relieving patches are stored in the controlled drugs cupboard. These should be counted every time one is used. When checked it was found that there was one patch missing on the morning of the visit even though a check had been carried out earlier in the week. The manager agreed to investigate this issue. There were also three other instances where medicines had been signed as given to a resident but the tablets were still in the blister pack. This means that residents have not had their medicines as prescribed. The medicine for the night of the inspection had been dispensed from one person’s blister pack with no explanation why or what had happened to that tablet. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 12 The privacy and dignity of residents was maintained at all times. Staff appeared to have good relationships with residents, were polite, knocked on residents doors and made sure that bathroom and bedroom doors were closed before assisting residents with personal care. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. There is a range of recreational activities to make sure that people living in the home have stimulation and interest. Residents have choices about what they eat and there is a system in place to make sure they receive a nutritious diet. EVIDENCE: Staff at the home have worked hard to improve the number of activities available for residents. An activity co-ordinator is employed and she organises most of the events that happen in the home. Residents spoken with said there were enough activities going on in the home to keep them stimulated and meet their needs. One resident explained about the painting club and although she didn’t take part thought it was a good idea. She said several people go to the ‘crossword club’ and that she had enjoyed one of the classic videos that was shown one afternoon. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 14 Another resident said they enjoyed going around the gardens, particularly the sensory garden, and looked forward to the work at the back of the home being completed so they could walk around the home in better weather. On the day of the visit the activity co-ordinator had invited a local supplier to display their chocolate collection. This included handmade chocolates that were gift-wrapped and novelty items. The residents were then invited to visit and buy any items they wished in preparation for Christmas. The local vicar also visited the home on the day of the visit and a service was held in the lounge area. Residents were invited to take part in the service. Visitors are made welcome at any reasonable hour. Coffee making facilities are available for visitors and residents in the lounge area. One resident said she enjoyed her visitors and usually walked around the gardens or went out with them, weather permitting. Residents confirmed they could to choose how to spend their time in the home. They choose what time to get up and go to bed, and whether they wish to take part in any activities held at the home. A new chef has recently been appointed. The manager said that BUPA have introduced a menu master that helps to ensure that the menu meets the nutritional needs of the residents. Residents spoken with were very positive about the meals provided. One resident said ‘there is a good choice of food, plenty of meat or fish’. Another said they chose to have their breakfast upstairs but liked to go to the dining room for lunch. One CSCI survey form received back before the visit indicated that the resident was not happy with the quality of the food. However this was completed before the new chef was appointed. The dining room was homely and provided a pleasant place for residents to eat. The new chef has also introduced a ‘nite bite’ system to ensure that food is available twenty-four hours a day. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 15 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. There are good procedures in the home to make sure that residents’ complaints are listened to and that they are protected from possible abuse. EVIDENCE: There is a satisfactory complaints procedure for the home, which is included in the information given to each resident when they first come into the home. Residents said they would know who to complain to if they had any concerns. The complaints record contained details of eight complaints that had been made in the last twelve months. These had been responded to satisfactorily. There is a policy and procedure for the home on adult protection. The manager confirmed that all staff have attended training on adult protection and more updated training was scheduled in for the week following the inspection visit. All staff had to supply references and a Criminal Records Bureau disclosure was obtained before they started working in the home to make sure that they are suitable to work there. Mount Hall Nursing Home DS0000018773.V341996.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, 20, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, tidy and well maintained so residents to live in safe and comfortable surroundings that suit their needs and enable them to remain as independent as possible. EVIDENCE: Mount Hall Nursing Home is situated in its own grounds. There is a sensory garden at the front of the building which is accessible for people who use aids to help them move around. This has won the BUPA prize for being the best garden in the north of England. The manager confirmed that plans were in place to develop the gardens at the rear of the home so that residents could also use that area. There is a large pond at the front of the building. The manager confirmed that a fence has been placed around it to minimise any risk to residents or visitors. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 17 The inside of the home is pleasant in appearance. There are plans to refurbish it next year. The standard of décor and furnishings are good. There are two communal lounge areas; they are open plan and so do not provide residents with total privacy, in particular if a religious service is being held there. This was evident on the day of the site visit when the vicar was holding a service, surrounded by the noise from the corridor of people coming and going around the home. Residents’ bedrooms are personalised, containing many personal possessions, ornaments and photographs. The home was found to be clean and tidy on the day of the site visit. There are sufficient laundry facilities to meet the needs of the residents. Residents were complimentary about the laundry service. Mount Hall Nursing Home DS0000018773.V341996.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. Although there appears to be enough staff working in the home to meet the needs of the residents, some of them have not received essential training so residents could be put at risk. EVIDENCE: There appeared to be enough staff working in the home to meet the needs of the residents on the day of the visit. Residents said that staff answer the call bells promptly and attend to their needs. The manager of the home has employed a hostess to give out drinks and help with meals so giving care staff time to spend with the residents to help them to eat and drink as necessary. Staff records showed that all staff undergo rigorous checks before being employed to ensure they are suitable for the job. 60 of care staff have a National Vocational Qualification (NVQ) Level 2 or above in care. This means that staff working at the home have the knowledge and skills to do their job. There was evidence to suggest that some staff have not had the required fire safety training or moving and handling training and so could put residents at risk. The manager said that arrangements had been made to address these Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 19 issues. Two members of staff have recently completed moving and handling trainers course so that they can now provide this training to staff at the home. The residents were generally content and full of praise for the staff. Staff were observed attending to residents’ needs and appeared to do their best to make residents comfortable. Mount Hall Nursing Home DS0000018773.V341996.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, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well managed so it is run in the best interests of the residents. EVIDENCE: The manager of the home has changed since the last inspection. The new manager is a registered general nurse with previous management experience. An application for her to become registered with CSCI needs to be made. All residents and staff spoken with said that they saw the manager around the home and that they could approach her if they had any concerns. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 21 There is a quality assurance system in place in the home. Questionnaires are sent out to residents and their relatives. These are returned to head office and the results are collated. The manager is then informed of the results of the questionnaires. An annual report is published which outlines the main findings. The manager carries out monthly audits to ensure that the quality of the service provided is maintained. Relatives’ meetings are also held and minutes are kept identifying the areas discussed and any actions agreed. The manager said she had arranged a cheese and wine evening for residents so that they could give their views on the running of the home and any other issues. Residents’ monies are kept in one bank account. The administrator can access information on each person’s account via the computer. Receipts are obtained and kept for all transactions so residents know their money is cared for properly. Staff received training in safe working practices on induction. The manager has a training chart displayed so she can identify the training each member of staff has completed. Pre-inspection information submitted to the Commission indicated that all equipment was serviced at the required intervals. The fire logbook showed that fire systems were tested regularly. As stated previously some staff have not had fire safety training; this needs to be addressed. Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 22 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP9 Regulation 13 (2) Timescale for action Staff must make sure that 28/12/07 residents are given their medicines as prescribed and if not given the reasons must be recorded clearly so that the health of residents can be monitored. The registered manager must 15/01/08 ensure that all staff have the required fire safety training and moving and handling training so residents are not placed at risk. Requirement 2 OP30 18 (1) (c) (1) 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 Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Mount Hall Nursing Home DS0000018773.V341996.R01.S.doc Version 5.2 Page 25 - 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. 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