Inspection on 05/10/06 for Mount Hall Nursing Home

This inspection was carried out on 5th October 2006.

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

Other inspections for this house

Mount Hall Nursing Home 28/11/07

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 5th October 2006 09:30 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.V307226.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.V307226.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.V307226.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). 8th December 2005 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 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. The scale of charges is from £675 - £945 per week. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over 7 hours. An ‘expert by experience’ assisted the inspector. She stayed for approx 3.5 hours. (An ‘expert by experience’ is a person who, because of their experience of using services, and/or ways of communicating, visits a home with an inspector to help them get a picture of what it is like to live in or use the service.) The manager was invited to provide evidence as part of this inspection process. The Inspector spoke to the manager, three staff members, four residents and one relative. The ‘expert by experience’ was shown around the building by a member of staff, spoke to several residents in the lounge and dining room and had lunch with residents. Three residents’ records were examined as part of the inspection process, in respect of the care they receive. Records of medication, care plans staffing rotas and training were also examined. Examination of the homes documentation, policies and procedures formed the basis of the visit. What the service does well: Mount hall provides a very pleasant and comfortable environment for people to live in. It is situated in the countryside in very pleasant surroundings, with well-tended gardens. There is a sensory garden at the front of the home that is appreciated by the residents. Assessments are carried out for all prospective residents before they move into the home so that they know their needs can be met. There are good links with healthcare professionals such as the dietician, doctors and chiropodists so residents can be confident that advice will be sought if needed. Medicines are managed well within the home so residents know they will get their medicines as prescribed. Residents and relatives were very complimentary about all of the staff. Comments such as ‘Staff are first class’. ‘Carers always report any problems to the nurse in charge’, were made. There is a good quality assurance system in place to ensure that the home is run in the best interests of the residents. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mount Hall Nursing Home DS0000018773.V307226.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.V307226.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of people’s care needs are carried out before they move into the home so they can be confident that their needs can be met at Mount Hall nursing home. EVIDENCE: The comment cards received back from residents said that they were given enough information about the home before they moved in so they could make an informed choice. The manager or a senior member of staff visits prospective residents before they move in so that they can assess the residents needs to make sure that they can meet these needs. Intermediate care is not provided at this home so standard 6 does not apply. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9 &10 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although residents are generally well cared for, their current healthcare needs are not always identified on the care plan and so there is a risk that these needs may not be met. EVIDENCE: An individual plan of care is in place for each resident. These set out the health and personal care needs of the resident and the action staff should take to make sure that these needs are met. A sample of resident’s care plans were looked at. Although these have improved since the last inspection, further improvements are needed to make sure that the information contained in them is kept up to date. The care plans are not always reviewed when the resident needs change and so there is a risk of these needs not being met. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 10 There were also occasions where the healthcare needs of residents did not appear to be monitored sufficiently or reported on regularly. For example, it was difficult to track the condition of one residents wound, as the size, depth and exudates were not recorded regularly in the records. There was evidence that other professionals such as the dietician, the optician and the chiropodist visit regularly. The ‘expert by experience’ spent some time in the lounge talking to residents and observing what was happening. She noted that although there were plenty of easy chairs for residents to sit in, some residents were sat in the lounge in wheelchairs for long periods of time. One resident appeared to be uncomfortable as there was no back or neck support to the wheelchair. Two gentlemen who were sat in wheelchairs and appeared not to be able to communicate had their heads on their chest for quite some considerable time. This could cause pressure on the residents’ necks causing pain and discomfort. Residents spoken with were very positive about the care they received at the home. One resident said ‘Carers report anything if they spot it and nurses will deal with it’. Medicines are managed well by staff at the home. Staff need to ensure that they respect the privacy of residents. On two separate occasions a member of staff walked into a resident’s bedroom without waiting to be invited in. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14 &15 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough activities at Mount Hall Nursing Home to ensure that the residents are kept active and stimulated. EVIDENCE: On two relatives survey forms a comment was made about the need for more activities to be provided in the home. However, residents who spoke with the inspector said that there was plenty going on at the home. One resident said ‘Activities are improving and I enjoy the counters games’. She said they sometimes have musical evenings. Another resident said that ‘ There are lots of activities at Mount Hall. A shopping trolley goes around the home, staff will go to the shop if they don’t stock it on the trolley. The home also has a pat a dog scheme. Very pleasant staff, nothing is too much trouble’. The resident said she was pleased to see the bookcase and had read some of the books. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 12 An activities organiser is employed to work at the home 30 hours per week. She organises activities such as flower arranging, bingo, poetry reading, snakes and ladders, exercise classes as well as trips out and visiting musicians. Relatives spoken with confirmed that they are welcomed into the home at any reasonable time. Residents are given a choice of what they want to eat for lunch. The ‘expert by experience’ took her lunch with the residents. Although the presentation was nice she noted that all of the vegetables were mashed. One elderly couple said that they enjoyed all their meals. Another lady made a positive comment and said the food was ‘liken to school dinners of yesteryear’. The temperature of the dining room was cold during lunch period, as staff had opened several windows. Residents’ views should be sought before opening windows etc to ensure that they are comfortable with the temperature of the room. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 16 & 18 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Adult protection procedures are not always implemented so residents could be at risk of harm or abuse. EVIDENCE: A complaints procedure is in place and this is accessible to residents. All of the residents spoken with said they felt they could make a complaint if they needed to. Complaint records were looked at. One complaint that was investigated by the manager of the home should have been reported under adult protection procedures. One incident was reported to the inspector during the site visit. This was reported on to the manager and the manager instigated the appropriate procedures. One member of staff who spoke with the inspector said she had not attended any training in adult protection. Subsequent to the site visit the manager confirmed that she had booked a place on a two day adult protection course. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 19 & 26 The 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 and well maintained so residents are safe and comfortable. EVIDENCE: The ‘expert by experience’ toured part of the building. The standard of décor and furnishings was good providing people living at the home with safe and comfortable surroundings. There is a sensory garden at the front of the building. This provides a very pleasant outdoor area that residents and their relatives will be able to use on mild pleasant days. One resident felt that this was a positive aspect of the home as people in wheelchairs could get close to the plants without the wheels getting stuck in the grass thus meeting the diverse needs of the residents living at the home. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 15 The home was clean and tidy with no unpleasant smells. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are not being met by the number of staff and so could be at risk. EVIDENCE: All of the residents spoken with praised the staff. One resident said they were ‘first class’ and nothing was too much trouble’. Several of the residents spoken with during the inspection thought that there was not enough staff on duty to meet their needs. They felt that call bells were not answered quickly enough but said that was due to staff looking after other residents. One resident said ‘There is a shortage of staff. If the bell is rung it can be a long time before they come because they are dealing with other people. It is not the staff ‘s fault. There are highly dependent people here.’ However, residents confirmed that staff react immediately if the emergency call is activated. Residents also said that they would avoid ringing the bell at mealtimes, as they knew staff are very busy at that time. Whilst talking with a resident in their room the inspector rang the call bell. It took in excess of 5 minutes for the member of staff to answer it. Another call Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 17 bell was noted to ring in excess of 10 minutes. Residents should not have to wait that long for attention. Three members of staff spoke with the inspector during the visit. Each was knowledgeable about the residents and their needs. All had attended mandatory training. One member of staff was looking forward to gaining her National Vocational Qualification (NVQ) award in care. A sample of staff personnel’s files was looked at. Most of them were satisfactory. There was only one written reference on the file for one member of staff already working at the home. A reference from the person’s last employer was not received. These need to be taken up to make sure that the person is suitable for employment. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and so the health and safety of residents is promoted and protected. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection. She had previously worked in a senior capacity in one of BUPA’s other homes. Residents and relatives were very positive about the management approach. They felt they could approach the manager if they had any concerns or complaints. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 19 One resident discussed the service user guide and their expectations of the service. He said that residents meetings are held and he had received a copy of the minutes. The resident felt that this was very positive as it gives them a ‘voice’ to influence what goes on at the home. There is a good quality assurance system in place. The responsible individual visits monthly and writes a report on the conduct of the home. A copy is provided to the manager. Audits are done regularly so that the manager can identify any problems and address them as necessary. Residents’ monies appear to be managed well. Requirements made by the fire safety officer have been addressed by the home. A sample of maintenance records was looked at. These appeared to be satisfactory with all essential equipment being serviced regularly. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15 (2) (a) (b) (c) (d) Requirement The registered person must ensure that residents’ healthcare needs are documented accurately and monitored closely and that the care plan is revised when these needs changed. Previous timescale 28/02/06 not met. The registered person must ensure that residents are not left sitting in wheelchairs for long periods of time without suitable back and neck support. The registered person must ensure that the care home is conducted in a manner that respects the privacy and dignity of the residents taking into account residents’ views. All members of staff must be provided with training on adult protection. The registered person must review staffing levels provided at the home to ensure that call bells are answered promptly. The registered person must ensure that two written references, including where DS0000018773.V307226.R01.S.doc Timescale for action 05/12/06 2 OP8 12 (1) 05/11/06 3 OP10 12 (4) (a) 05/11/06 4 5 OP18 OP27 13 (6) 18 (1) (a) 05/01/07 05/11/06 6 OP29 19 (1) 05/11/06 Mount Hall Nursing Home Version 5.2 Page 22 applicable, a reference relating to the persons last period of employment, which involved work with children or vulnerable adults, of not less than three months duration, is obtained. 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 OP14 Good Practice Recommendations Staff should ensure that residents’ wishes are taken into account when dealing with environmental issues such as the opening of windows in communal or bedroom areas. Mount Hall Nursing Home DS0000018773.V307226.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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 DS0000018773.V307226.R01.S.doc Version 5.2 Page 24 - 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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