Inspection on 09/01/07 for Mount Pleasant Nursing Home

This inspection was carried out on 9th January 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 Pleasant Nursing Home 22/02/06

Mount Pleasant Nursing Home 06/07/05

Mount Pleasant Nursing Home 06/12/04

Mount Pleasant Nursing Home 10/08/04

Mount Pleasant Nursing Home 07/03/04

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 Pleasant Nursing Home London Road Allostock Knutsford Cheshire WA16 9NW Lead Inspector June Shimmin Unannounced Inspection 9th January 2007 09:15 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 Pleasant Nursing Home DS0000018822.V317292.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 Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mount Pleasant Nursing Home Address London Road Allostock Knutsford Cheshire WA16 9NW 01565 722918 01565 722014 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) Mount Pleasant Nursing Home Limited Miss Amanda Short Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42), Physical disability (1) of places Mount Pleasant Nursing Home DS0000018822.V317292.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 to include: * Up to 42 service users in the category of OP (old age not falling within any other category * 1 named service user in the category of PD (physical disability under 65 years of age) 2. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The registered provider must provide staff to meet the dependency needs of service users at all times and shall comply with any guidance which may be issued through the Commission for Social Care Inspection. 22nd February 2006 3. Date of last inspection Brief Description of the Service: Mount Pleasant Nursing Home is a two storey converted and extended property standing in its own grounds in the rural community of Allostock. The home is situated approximately 4 miles from the towns of Knutsford and Holmes Chapel. Accommodation is provided on two floors. Access to the first floor is by a passenger lift or one of the staircases. There is a separate dining room and two lounges on the ground floor with a quiet lounge and smoking lounge on the first floor. The home provides its own hairdressing salon. All bedroom accommodation is en suite. The gardens are wheelchair accessible. There is car parking to the front and side of the home. The weekly fees are £475 to £618. There are additional charges for hairdressing, toiletries, newspapers, chiropody and one to one sessions with “Cheshire Holistic Health.” Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 9th January, 2007 and lasted six and three quarter hours. A regulatory inspector carried out the inspection. CSCI are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social services. We are currently testing a method of working where `experts by experience` are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term `experts by experience` used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for older people. The visit was just one part of the inspection. Other information received was also looked at. Before the visit the home manager completed a questionnaire providing up to date information about Mount Pleasant. Questionnaires were also given to residents, families, health and social care professionals to find out their views. During the visit various records and the premises were looked at. A number of residents and relatives were also spoken with and they gave their views about Mount Pleasant. Feedback was given to the deputy manager at the end of the inspection. What the service does well: Mount Pleasant provides good standards of care for residents. A typical comment was made by a health care professional, “I have always found the staff at Mount Pleasant helpful and cooperative.” A resident said, “the staff are always friendly and helpful” and a relative, “the care is excellent and everything is managed properly. People at the top are good, Matron etc, therefore patients are cared for. Thank you.” Residents are fully assessed before admission so that the home is confident that it can meet their needs. Residents enjoy a good quality of life. Mount Pleasant provides a wide range of activities and entertainment, which residents can choose to take part in if they wish. The standard of catering is very good with the following comments made, “if food is not suitable it will be changed” and “the cook is very good.” There have been no complaints. Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 6 Mount Pleasant provides a comfortable and pleasant living environment. The home is well maintained. Staffing levels are good and staff are encouraged to undertake relevant training. Mount Pleasant is well managed and there are effective procedures in place to monitor the quality of care provided. 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. The summary of this inspection report can be made available in other formats on request. Mount Pleasant Nursing Home DS0000018822.V317292.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 Pleasant Nursing Home DS0000018822.V317292.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their needs assessed before admission to ensure that the home has the resources to meet their needs. Intermediate care is not provided. EVIDENCE: The assessments of two recently admitted residents were looked at and also the assessment of a resident who was to be admitted during the afternoon. The registered manager or another nurse had carried out the assessments. The content of the assessments included information about the cultural, social and spiritual care needs of the three residents. The assessments also included information about the residents` health care needs so that a full care plan could be drawn up. The assessments were reviewed on admission and thereafter on a regular basis to reflect any changing needs. Mount Pleasant Nursing Home DS0000018822.V317292.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive health and personal care based on their individual needs. Staff respect the privacy and dignity of residents. EVIDENCE: Three care plans were looked at in detail. These included the care plans of residents who had recently been admitted to Mount Pleasant. The care plans had been written within five working days of the residents` admission to the home so that staff were aware of their care needs on admission. Two care plans were well written and included all the care needs of the residents. The third care plan did not address all the care needs identified in the resident`s assessment. This could mean that those care needs were not being monitored and reviewed. Further, the care plan indicated that the resident had been losing weight since admission but had not been weighed since October 2006. Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 10 All care plans included appropriate risk assessments and these had been reviewed on a monthly basis. The deputy matron reported that no residents had pressure sores, which is indicative of good care. Although a form was seen to demonstrate that residents and/or their families had been involved in the care planning and review process this had not been completed and there was no other evidence that this was taking place. Residents said that staff respected their privacy and staff knocked on bedroom doors before entering. The expert by experience commented that staff had a very good attitude to residents. Care plans demonstrated that prompt referrals had been made to a number of health care professionals such as GP, optician, dentist and specialist nurses. The GP from the Nursing Home scheme commented, “Very good care – especially palliative care. Staff very caring both to patients and relatives. Good relationships with patients and relatives.” Medication administration records and the storage of medication were inspected. Both were managed well. Mount Pleasant Nursing Home DS0000018822.V317292.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents enjoy a good quality of life with their choices respected. The standard of catering is very good. EVIDENCE: The expert by experience spent time with the activity coordinator at Mount Pleasant. The activity organizer works three to four days a week and provides one to one and group activities. There is a separate sitting room on the first floor where some activities take place and visitors are welcome to join in. The activity coordinator keeps a record book of all activities and visiting entertainers. Information provided by the registered manager before the inspection included the following activities: library books, jigsaws, puzzles, DVD and video selections, bingo, board games and external group talks and lecturers. The activity coordinator said that she does “what they want” and is therefore flexible and responsive to the needs of individual residents. The home holds fundraising events and raffles to pay for entertainers and specialist activities. A therapist visits once a week to provide one to one and group exercise. This is funded by Mount Pleasant. Residents can choose to join in activities or stay in their own room if they prefer. Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 12 The subject of activities for younger residents was discussed with the activity coordinator. She is aware of their differing needs and tries to find ways to meet their individual social care needs. The spiritual needs of residents are also taken into account and met. Ministers from local churches visit parishioners and will also visit residents who may not have attended a local church. Holy Communion is held once a month. The standard of catering at Mount Pleasant is very good. The home has a dining room or residents can take their meals in their own room if they prefer. Menus are reviewed on a seasonal basis and a healthy option is available. The expert by experience found that all of the residents spoken to were very satisfied with the standard of food. The following comments were made “food is excellent-especially for diabetics,” “a proper good dinner with two courses” and “food suits me very well.” The expert by experience noted that residents requiring assistance to eat were given help in a discreet and sensitive manner. The menu is displayed on a whiteboard in letters, which can be read from a distance. Residents are asked for their choices in the morning. The main meal is served at lunch and a lighter meal in the evening. Mount Pleasant Nursing Home DS0000018822.V317292.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are well managed and residents are protected from possible abuse. EVIDENCE: Mount Pleasant has a complaints procedure, which is displayed in the reception area. Residents and relatives were aware of the complaints procedure and who to speak to if they had a concern. No complaints were recorded and the deputy matron said that none had been received. Mount Pleasant has policies and procedures relating to the protection of vulnerable adults. Staff spoken to were aware of what to do if they suspected possible abuse. However, the deputy matron confirmed that there had been no recent training in this subject and was not planned for the near future. Further training or refresher courses should be held so that all staff are aware of the actions to take. Mount Pleasant Nursing Home DS0000018822.V317292.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, safe, clean and well maintained environment. EVIDENCE: The expert by experience and the inspector carried out a partial tour of the building. Mount Pleasant offers a pleasant, comfortable and safe living environment. The home was found to be clean and tidy and measures had been taken to prevent the spread of infection at the home. The standard of fixtures and fittings is good. Externally a new patio has been laid so that residents will be able to enjoy sitting outdoors when the weather is warmer. A bedroom is currently being converted into an office for the registered manager. Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 15 The expert by experience commented that one bedroom had birdfeeders attached to the window which was a great source of joy to the resident. Steps were taken to ensure that clothing was marked and did not become lost. The expert by experience noted that many of the bedrooms were furnished with the residents` own furniture and were further personalized with photos and other memorabilia. A couple of the residents were able to help with the upkeep of their room, thereby encouraging their independence. Mount Pleasant provides a range of aids and adaptations suitable to the needs of residents with a disability. Mount Pleasant Nursing Home DS0000018822.V317292.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mount Pleasant employs sufficient numbers of well-trained staff. Recruitment practices are thorough. EVIDENCE: There were two registered nurses on duty on the morning of the inspection. The rotas indicated that there are two nurses on duty in the morning four days a week. The deputy manager said that efforts would be made to ensure that there are two registered nurses on duty every day of the week. There were also six carers on duty. Staff said that they considered staffing levels to be adequate. Several residents commented about having to wait when they rang the nurse call bell but said that this was usually at busy times of the day. There are also a sufficient number of ancillary staff. Information provided by the registered manager before the inspection indicated that 41 of care staff have achieved NVQ level 2 or above. Eight more staff are working towards NVQ level 2 in care and two staff have also attained NVQ level 3. The registered manager has organised a number of training sessions later in the month on health and safety, moving and handling followed by first aid, food hygiene and infection control in February, 2007. Staff said they were given training opportunities and encouraged to undertake training courses. Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 17 The recruitment records of three new staff members were looked at. These were complete and demonstrated that the home had been thorough in its approach to taking on new staff. Appropriate checks had been carried out through the Criminal Records Bureau. Staff worked under supervision until an enhanced disclosure had been received from the CRB to verify that the individual was not included on the protection of vulnerable adults list. Copies of training were kept on file. However, the home did not have a training matrix so that records could be seen at a glance of staff training. A new staff member said that although she had been supernumerary for a month and received training there were no records kept of the induction. Mount Pleasant Nursing Home DS0000018822.V317292.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Mount Pleasant has effective quality assurance mechanisms, financial procedures and maintenance systems thereby demonstrating that the home is well managed. EVIDENCE: The registered manager has been matron for nearly nine years and is a first level registered nurse. A deputy matron and administrator support her in this role. The administrator has now been appointed as general manager of the home and will provide the registered manager with more support for nonclinical issues. The registered manager is about to commence the NVQ level 4 course in management and has been given additional supernumerary time for this. Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 19 The new general manager is very keen to ensure that standards of care are maintained and improved. The management team were described as being friendly and approachable. Mount Pleasant does not handle money on behalf of residents. The home invoices families directly for small outgoings such as chiropody and hairdressing. There are effective quality assurance procedures in place. The registered person visits the home on a monthly basis and provides a detailed report about the home, which is given to the registered manager. Any issues identified during the visit are dealt with promptly. Two staff members conducted a survey within the home in August 2006 and the two issues raised through the survey were looked into. Information provided by the registered manager before the inspection indicated that equipment and installations are serviced and well maintained. The fire officer and environmental health officer have recently visited the home. The EHO commented, “excellent standard of hygiene and procedural control” in relation to the kitchen area. The home was awarded a highly commendable rating for standards of hygiene and a Platinum Foodsafe award by Vale Royal Council. Accident and fire records were inspected. Accident records had been completed and where necessary the CSCI had been informed of any serious incidents. The registered manager also informs the CSCI of any other matters that have to be notified by law. Fire records demonstrated that equipment is tested on a regular basis and that staff receive appropriate training. The deputy manager said that refresher training in fire safety was to take place later in the month. Mount Pleasant Nursing Home DS0000018822.V317292.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 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 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 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations Care plans should be provided for all identified needs. Residents and/or their families should be consulted during the care planning and review process. The weight of residents who are at risk of weight loss should be monitored on a regular basis. The registered person should ensure that all staff receive up to date training in the protection of vulnerable adults and that a record of this is kept. The registered person should provide a training matrix so that records of staff training are clear and can be seen at a glance. The registered person should ensure that records are kept of staff induction. 2. 3. OP7 OP18 4. 5. OP30 OP30 Mount Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 22 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 Pleasant Nursing Home DS0000018822.V317292.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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