Inspection on 23/07/09 for Mount Pleasant

This inspection was carried out on 23rd July 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mount Pleasant 16/05/07

Mount Pleasant 28/07/06

Mount Pleasant 31/10/05

Mount Pleasant 14/04/05

Mount Pleasant 10/11/04

Mount Pleasant 11/05/04

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 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Mount Pleasant Finger Post Lane Norley Frodsham Cheshire WA6 8LE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Porter     Date: 2 9 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Mount Pleasant Finger Post Lane Norley Frodsham Cheshire WA6 8LE 01928787189 F/P01928787189 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Pribreak Limited care home 25 Number of places (if applicable): Under 65 Over 65 25 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category of service only: Care Home only - code PC, to people of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is 25. Date of last inspection Brief description of the care home Mount Pleasant is a converted, extended care home registered to provide care and accommodation for twenty-five older people. It is in the village of Norley on the road from Frodsham to Cuddington. The home is set in large grounds, has attractive views across farmland, and provides a tranquil setting with adequate car parking facilities. People are accommodated on two floors. Access between floors is via a stair lift or stairway. There are 21 single rooms and two shared bedrooms, all of which have wash hand basins. Communal space consists of two lounges, a large room and a small sitting area in the entrance hall. Mount Pleasant provides a well cared for, bright and welcoming environment. Throughout the building there are an adequate number of toilets and a variety of Care Homes for Older People Page 4 of 26 Brief description of the care home bathrooms available for people who live at the home. There are aids around the home to help people who live there. Aids include bath hoists; grab rails and an emergency call bell system. There is a large, attractive garden with a number of sitting areas and pathways available for people to enjoy. The fees at Mount Pleasant are £405 per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use this service experience good outcomes. This visit, part of the key inspection of the home, took place over 7 hours. It was carried out on 23 and 29 July by one inspector. The report will refer to we and us, as it is written on behalf of the Care Quality Commission. The visit to the home was just one part of the inspection. Before the visit the manager was asked to provide information as part of the inspection. The views of the residents and relative were sought; their views are incorporated into the report. Care Homes for Older People Page 6 of 26 During the visit we spoke with the manager, some staff members and a number of people living in the home. The records of two people living in the home were looked at to check the care they receive. Policies and procedures, records of medication, care plans and training records were also examined to see how the home is run, how care is provided for the people who live there and what training staff have received. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Older People Page 8 of 26 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they move into Mount Pleasant so that they can be confident their needs can be met there. Evidence: We inspected the documents the home has developed to help them when assessing anybody who wishes to move to the home. The manager told us that as well as people visiting the home to see if they like it, either she or the deputy manager would visit them to check their needs. The assessment covers the persons needs in respect of what support they need with personal care, their mobility, sensory needs, nutritional needs, foot care and oral hygiene. We saw evidence that a moving and handling assessment is completed and an assessment in relation to falls. We looked at a file of someone who had recently moved into the home which showed that the persons needs had been assessed before they moved in and that a care plan had been developed during the two weeks after they moved into the home. Care Homes for Older People Page 11 of 26 Evidence: The home does not offer intermediate care. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are monitored and other health professionals are involved so that people get the care and support they need. Evidence: We looked at the care plans of two people living at the home and saw that they had been developed from information obtained during the initial assessment. Plans showed that peoples needs are reviewed regularly, as a minimum monthly or when the persons needs change. One plan we looked at contained information written by the person about their life before they came to live in the home. Staff we spoke with said that they enjoyed reading about peoples lives so they could understand what peoples lives were like before they moved into the home. This helped them to provide person centred care. Peoples daily living skills, for example making a snack or a drink or putting on makeup, had been assessed and the records were written positively to show that Care Homes for Older People Page 13 of 26 Evidence: people can do. People living at Mount Pleasant are registered with the doctor and either visit the optician or can use the services of the visiting optician. We saw records that visits by the doctor and the district nurse are recorded; one person was having regular visits from the doctor and visits by the district nurse every other day to make sure their health was being maintained as well as possible. We spoke with three relatives and all spoke positively about the care and support given to their relatives living in the home. The home was described as home from home, always clean and tidy and one person living in Mount Pleasant told us it was a five star hotel. We saw that, where necessary people had pressure mattresses and cushions to help make sure they did not develop pressure sores and a device had been fitted to one bed, as the person occupying that room had fallen from bed. We inspected medication records and saw that records were being maintained appropriately. The training records we saw showed that senior staff responsible for administering medicines had received training to make sure they knew how to do this safely. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with opportunities to remain active and involved with social activities so that they lead fulfilled lives. Evidence: There are various activities on offer in the home and records are kept of which people had taken part and what enjoyment they got from those activities. The records we saw showed that activities are usually well attended and included bingo, reminiscence, exercise, quizzes, poetry group, sing songs and dominoes. People living in the home also have the opportunity to go to a local over 60s club and a number of people are actively involved with the church. One person living in the home told us that she did not take part in all the activities and often just enjoyed spending time in her room reading. On the day of our visit we spoke with a church visitor who told us he regularly visits people in the home. He spoke highly of the support people have and said that he was always made to feel very welcome during his visits. He told us that arrangements could be made to collect people to go to church should they wish. We saw that people knew him by name and gave the impression his visits were very important to them. We saw that people had brought some of their own possessions with them and Care Homes for Older People Page 15 of 26 Evidence: bedrooms were nicely personalised with small items and photographs. People are encouraged to look after their own money themselves or their families help them with this. We observed part of the breakfast and lunch times on the day of our visit. We saw that people had choice about what they wanted to eat and lunch was a pleasant social experience for them. There are two sittings at lunch; the earlier time is for people needing help with eating. Relatives we spoke with told us this arrangement was working well. We looked at the menu plans and talked with the cook who told us that peoples likes and dislikes are known and any suggestions they might make for different meals are included on the menus. One person living in the home confirmed that she could always choose what she wanted to eat and if the planned meal was something she didnt fancy they would make something else for her. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has policies, procedures and staff training for complaints and safeguarding so that people living at Mount Pleasant know their concerns will be listened to and they are protected from harm and abuse. Evidence: There is a complaint procedure for the home and this is displayed on the notice board by the front door. Two relatives we spoke with said that they knew how to complain but they had never found it necessary to make a formal complaint as staff always responded to any concerns they may have had. The manager reported that the home had not received any complaints. People living in the home told us that they felt they could always speak to staff about any problems, but they did not have any. Staff training records showed us that all staff working in the home had either had full training on safeguarding adults or had attended basic awareness training so that they knew the action they must take should they suspect abuse. No referrals have been made by the home under the local safeguarding adults procedures. We looked at the money kept in the home on behalf of two people living there and records were detailed and accurate. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained so that people live in well decorated, comfortable surroundings but leaving fire doors wedged open means their welfare could be compromised in the event of a fire. Evidence: We walked round the home and saw all the communal rooms and some bedrooms, when invited to look at them by the people living in them. The home was well decorated, fresh and clean throughout. Bedrooms contained some personal items, small pieces of furniture and photographs so they were homely and personal for the people living in them. There are two shared bedrooms in the home and the rest are single rooms. We spoke with one person who shares a bedroom who told us that she wanted a single room; she told us that she had spoken with the manager about it. We discussed this with the manager who said a move would be possible when a ground floor room became available. When we walked around the home we saw a number of doors propped open with door wedges. One person living in the home told us she did not like the door closed even a night. However, having fire doors open means that people would not be properly protected if there was a fire. We discussed this with the manager and representative of the owner who told us that they would seek professional advice and resolve the Care Homes for Older People Page 18 of 26 Evidence: situation. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by a well established and trained staff team which means that people receive support from staff who know them well. Evidence: The home has a low turn over in staff; nobody has been recruited since 2006 and no new information was available to inspect. During our visit we spoke with staff working in the home who said that they enjoyed coming to work, they felt supported and received enough training to do the job. During our visit we saw that there was sufficient staff on duty to meet the needs of the people in the home on that day. Training records showed us that more than 50 of staff have achieved a national vocational Qualification (NVQ) in care at level 2 or above. These are nationally recognised qualifications for people working in care and achievement of them shows that staff are competent to provide good quality care. In addition, the training records showed that staff have received training in the following; moving and handling, fire, food hygiene and medication administration for those staff who give out medicines to people living at the home. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is aware of her responsibilities so the home is run in the best interests of people living there. Evidence: The manager has been in post for a number of years and is registered with the Commission. The manager told us that the views of people living in the home and their relatives are obtained using annual surveys. We saw that the findings of the last survey had been published and showed that people were satisfied with the services of the home. We discussed with the manager and representative of the owners the role of the owners in checking that the home is running well. We acknowledged that the owner and his wife are often at the home but they do not carry out the recorded visits that are required under the Care Homes Regulations 2001. Such visits and the records made of them will show that the owners are aware of how the home is running, what Care Homes for Older People Page 21 of 26 Evidence: the people living there think about the services provided and that there are no problems with the premises. These recorded visits should happen monthly. We inspected the records regarding the money held for two people living in the home and found them to be detailed and accurate. We inspected a selection of health and safety records in the home and found that accident records were satisfactory, stair lifts, bath hoist and mobile hoist are serviced in accordance with the manufacturers recommendations. The fire alarms and fire equipment had been serviced in April 2009 and the fire alarms were being tested weekly. We saw that the manager has a monitoring tool so that she can be sure all servicing and checks are carried out on time. As recorded in the section for the environment an alternative to wedging fire doors open needs to be found so that people living in the home, staff and visitors are protected in the event of a fire. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 Advice as to suitable hold open devices for doors must be sought so that doors can be left open without being wedged. This will make sure that any doors that are left open will close automatically if the fire alarm goes off so that people in the home are kept safe in the event of a fire. 26/10/2009 2 33 26 Monthly visits should be made to the care home in accordance with Regulation 26 of the Care Homes Regulations 2001. These recorded visits will help to show that regular checks are made about the premises and the quality of the service being provided at the home. 26/09/2009 Recommendations These recommendations are taken from the best practice described in the National Care Homes for Older People Page 24 of 26 Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 16 23 A record should be maintained of all concerns/complaints raised including the action taken and the outcome. People should be given the opportunity to move from shared rooms when single accommodation becomes available. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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