Inspection on 19/02/07 for Mountbatten Lodge

This inspection was carried out on 19th February 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

Mountbatten Lodge 14/04/09

Mountbatten Lodge 17/04/08

Mountbatten Lodge 23/10/07

Mountbatten Lodge 20/01/06

Mountbatten Lodge 25/06/05

Mountbatten Lodge 14/01/05

Mountbatten Lodge 17/08/04

Mountbatten Lodge 26/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Mountbatten Lodge Old Crabtree Lane Hemel Hempstead Hertfordshire HP2 4EX Lead Inspector Mrs Jan Sheppard Unannounced Inspection 19th February 2007 10:00 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 Mountbatten Lodge DS0000019476.V332568.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. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mountbatten Lodge Address Old Crabtree Lane Hemel Hempstead Hertfordshire HP2 4EX 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) 01442 244188 01442 282546 www.quantumcare.co.uk Quantum Care Limited Mrs Roslyn Renimida Turton Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (60) Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th January 2006 Brief Description of the Service: Mountbatten Lodge is a purpose built home for up to sixty older people. The home is on two floors and divided into four individual units with single en-suite bedrooms, a lounge, dining room and assisted bath and shower rooms. Two units cater for people with dementia and these are on the ground floor with access to an enclosed garden area. Parking for cars is available. Mountbatten Lodge is situated in the Jarman Park Area of Hemel Hempstead, close to the town centre with its local shops and facilities and adjacent to a large supermarket and leisure park. Currently the fees range from £400 to £550 per week. Information about the home and the services it offers are contained in its Statement of Purpose and Service Users Guide. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over one day by one inspector during which the manager, deputy manager, staff on duty and residents were spoken with. A tour of the building was also undertaken and the care and administration records checked. This report reflects the observations made in the home on that day and also takes account of the information gathered from the pre-inspection questionnaire recently completed by the homes manager, details given in questionnaires completed by the residents and relatives and of other information periodically sent to the Commission from the home. This was a positive inspection The home which was found to be running smoothly had a calm relaxed atmosphere where the residents comfort and happiness was clearly the first priority for all the staff. Since the last inspection a new manager has come into post and has been successfully registered by the Commission. What the service does well: What has improved since the last inspection? Since the last inspection the planned programme of refurbishment works have continued throughout the home. A new boiler has been fitted, redecorations in some communal areas and in some bedrooms, areas where new carpeting has been fitted and kitchen cupboards have been replaced in two of the unit kitchens. A new medication storage and administration system has been successfully introduced. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 6 Following the appointment of a new Activities Organiser the homes activities programme has been enlarged. Improvements have been made to the Care Planning system. 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. Mountbatten Lodge DS0000019476.V332568.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 Mountbatten Lodge DS0000019476.V332568.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. The care needs of all prospective service users are fully assessed by the manager before visits to the home or decisions about admission are taken. EVIDENCE: The home follows the pre admission policy and procedures agreed by the company Quantum Care; these are fully compliant with the requirements of these standards. Residents recently admitted to the home confirmed that their arrival at the home had been handled sensitively and had been managed at a pace which suited them. All confirmed that they had spent at least one day visiting the home before their admission was agreed and that they had been made to feel very welcome by the staff and by the other residents on the unit where they spent that day. They said that they were invited to join in the activity programme and were given a choice of meals. One resident told the Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 9 inspector that “ the manager came to talk with me and showed me all over the building”. The manager confirmed that two staff always makes the initial needs assessment if possible in the prospective residents own home but often because of illness this has to be done in hospital. Relatives are involved in this assessment process and they are asked to add detail to the care plan if they wish (this always depending on the agreement of the prospective resident). The home provides an up to date Statement of Purpose and Service Users Guide for all prospective new residents along with an information pack provided by the company. Mountbatten Lodge DS0000019476.V332568.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All the residents care needs are set out in their individual care plan. Prompt access to health professionals is available when needed. The home was found to be following its medication procedures to ensure the safe storage and administration of medication. EVIDENCE: Personal care was seen to be being delivered in a kindly manner by staff who clearly knew their residents well, understood their care needs and were endeavouring to meet these in a manner that retained their dignity and respect. It was noted that the staff worked very well together as a team and that they promoted a calm and relaxed atmosphere in the home. The residents all looked very smartly dressed and staff were seen to be encouraging them to take an interest in their clothes and appearance. Several Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 11 ladies made visits to the hairdresser during this inspection. Others commented on the prompt return of their laundry, which they confirmed was always neatly pressed. The care plans examined were found to set out with good detail how each resident wished to be supported and to indicate what tasks they could safely do for themselves and the extent to which they required help with others. Care plans contained appropriate risk assessments and were seen to be subject to regular monthly reviews. Six monthly formal reviews are also undertaken with residents and their relatives being invited to agree and sign these new plans. Visits by the Doctor were recorded on the care notes and the District Nursing notes gave clear instruction as to the care processes to be continued on a daily basis between the nurses visits. The manager explained that over recent months she had established better links with the local CPN service and that she had a meeting set up for later that week to meet with the various local GPs to try to co ordinate the times of their visits to the home so as to enable the staff to be available to give more time to individual doctors. The new medicine storage and administration systems were described and shown to the inspector. The recently created new storage room was found to give good secure storage space with all the required equipment, (lockable medication fridge, wash basin, CD, controlled drugs cupboard and adequate working and storage shelving spaces) and facilities to maintain the room at the correct temperature. The administration records checked were generally accurate and well maintained. Two omissions that were noted by the inspector, these having occurred with the administration recording on the previous evening, had already been identified by the morning duty manager who was found to be taking appropriate action immediately. This proving that the homes own surveillance systems are working .The manager explained that she regularly monitors the accuracy of the MAR sheets and the records evidenced that medication training for the staff is ongoing. The records relating to the six Controlled Drugs that were being administered on the day of this inspection were checked by the inspector and found to be correct. The home was subject to an internal company Pharmacy inspection during January 2007 following which one improvement suggested had been carried out. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. The home provides a variety of activities which meet the needs of its residents. Relatives and visitors are always welcome in the home. Good quality and nutritious food is provided. EVIDENCE: Without exception all the residents spoken with were complimentary about the quality and variety of the food. The recently introduced food theme nights had proved very popular with some residents providing extra variety of dishes and giving a good topic for conversation and reminiscing. One resident complained to the inspector that the size of her dinner plate was too small and the manager who explained that new crockery was soon to be ordered for the home anyway, agreed to address this comment. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 13 The inspector observed the serving of lunch; the meal that was tested was found to be served at the correct temperature and to be tasty, appropriately seasoned and attractively presented. Staff were noted to be assisting residents who required help with feeding in a discrete manner having individually assessed their eating speed and to be retaining the residents dignity whilst encouraging them to do as much for themselves as they could comfortably manage. Food preference sheets are maintained for each resident and these were seen to be regularly updated. Residents were heard both to ask for more and to request a smaller sized portion. The chef explained that he makes an effort to speak with a different group of residents each day to get their feedback and suggestions. Bowls of fresh fruit were seen to be freely available throughout the home. It is suggested that to encourage some of the more reluctant fruit eaters among the residents some of this fruit could be served in the form of a “smoothie.” The records evidenced that during the time of this inspection the home was visited by more than twenty relatives and friends of the residents a goodly number which staff said was not unusual. One visitor who spoke to the inspector explained that she had come to take her relative home after his first short stay in the home and she said “ we are both entirely happy with this stay quite surprised at the care and attention given by the staff to help him to settle in and be comfortable.” Many residents told the inspector of the frequent visits they receive from family and friends many of whom live nearby. One 97 year old resident told the inspector of the recent weekend she had spent staying with her son in Hampshire and of the various activities they had enjoyed over that time, “ Life is for Living “, she said. The manager explained how for one daughter who lived a great distance away and could not visit as often as she wished weekly updates and photos of her mother were sent to her by the staff in an effort to involve her as fully as possible. Since the last inspection the allocation of hours for the Activities organiser has been increased and this has enabled a very good improvement to be made to the variety and range of activities that are now offered. Residents are regularly asked for their preferences and daily records of activities participated in are kept. Residents who spoke with the inspector were very complimentary about the new arrangements and spoke appreciatively of recent outings parties and the fete that is to be held again this year. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 14 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. The home has a robust complaints procedure and follows the adult protection procedures as set out in the Hertfordshire Joint Agency Guidelines. EVIDENCE: A copy of the homes complaints procedure was seen in the entrance hallway alongside the recent inspection report. Residents spoken with said that if they had a complaint they would talk to the manager or another of the staff. One said “I would tell my daughter. She often speaks with the manager.” There have been no formal complaints since the last inspection. The inspector was shown a number of Complimentary letters. There have been no incidents concerning Adult protection since the last inspection. The manager said that she had found a recent discussion of a query she had had with a member of the social service adult protection team most helpful. The homes training records evidenced that all staff attend adult protection and whistle blowing training. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 15 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 adequate. This judgement has been made using available evidence including a visit to this service. The home is spacious, well appointed, adequately maintained and meets the space and facility provision requirements of these standards. The home was found to be clean, pleasant and hygienic. EVIDENCE: On the day of this unannounced inspection the home was found to be clean and tidy with no offensive odours. The home is subject to a regular maintenance programme, the plan over the next few months was discussed with the inspector. A number of renovation and repair works were being carried out during this inspection day e.g. refitting of kitchen units and redecorations in a bedroom. However the manager expressed her concern that the speed of renovation works planned was not Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 16 keeping up with the general needs of the home caused by the day to day wear and tear on a building now some eight years old and she said that she is discussing this need with the company. Residents asked all said that they were happy with their bedrooms and that they provided them with all the facilities they required. Bedrooms viewed were seen to be comfortable and well personalised in a manner that reflected the tastes and style of the individual resident. The decorations in some bedrooms were in need of refreshing. It was noted that a number of bathrooms were in need of redecorating and that their furniture / storage provision needed adjustment to get away from a somewhat institutional appearance. In the kitchen the frequency of the cleaning of the extraction hood needs to be increased to meet need and not just following an annual pattern and a fridge showing signs of rust should be replaced. Recommendations are made. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 17 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. The home is adequately staffed with experienced and qualified carers who seemed very positive about their work and to work well together as a team. The home has robust policies and procedures for the recruitment of staff which ensures the proper protection for the service users. EVIDENCE: The recruitment policies and procedures in place ensure the suitability of staff to work with older people with checks being made before they commence duties in the home. The personnel records seen by the inspector for staff recently appointed to the home evidenced that these procedures were being carried out. References had been obtained and verified, evidence of residency and permission to work records checked, health assessments undertaken interview notes made and kept and employment contracts issued. New staff all undertake an induction training programme and new staff spoken with confirmed that they felt well supported by the home managers and by the peer staff group. The staffing rotas evidenced that sufficient staff are on duty to meet the needs of the residents. The manager explained that some staffing adjustments Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 18 including additional staff hours had recently been introduced this particularly to meet the greater needs of the dementia care units. The number of staff who have attained or are working towards the NVQ level 2 award has increased since the last inspection. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 19 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 good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the service users. The registered manager provides strong leadership within the home. The health and safety of the residents is promoted by the homes good maintenance of its financial procedures, safety checks and procedures. The frequency of staff supervision did not meet the required standard. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 20 EVIDENCE: The new manager has a positive and open approach to the management of the home which promotes a continuous improvement and the development of the service. It also creates an atmosphere of trust and co-operation amongst the staff that was commented on in a positive manner by some of the staff to the inspector. Mrs. Roslyn Turton the new manager has many years experience working in residential home management; she has trained as a nurse and more recently completed the NVQ level 4 Registered Managers Award. She was registered with the Commission as the Registered Manager for this home in October 2006. Without exception residents relatives and visiting professionals interviewed for this inspection confirmed that the manager and her team were always very approachable and make every effort to sort out any problems quickly. The records relating to Fire testing, the monitoring of water temperatures, risk assessment for the environment and safety checks for the homes equipment were seen to be well maintained this ensuring the safety of the residents at all times. The homes records did not evidence that staff supervision although routinely planned well ahead was offered at the required frequency to meet the standard of at least six meetings a year. A requirement is made. Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 21 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 3 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 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 2 x 3 Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 22 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 OP36 Regulation 18 (2) Requirement The registered manager must ensure that all staff receives formal supervision at least six times a year and that adequate records of these meetings are kept. The registered manager must ensure that the redecoration programme keeps pace with the need so that all areas of the home are maintained in good decorative order; and that the frequency of cleaning in the kitchen and the repairs and replacement of items as detailed in the text for this standard are carried out. Timescale for action 20/04/07 2. OP19 23 (2) (b) (c) 30/06/07 Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 23 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 Mountbatten Lodge DS0000019476.V332568.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Mountbatten Lodge DS0000019476.V332568.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!