This inspection was carried out on 20th January 2006.
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.
CARE HOMES FOR OLDER PEOPLE
Mountbatten Lodge Old Crabtree Lane Hemel Hempstead Hertfordshire HP2 4EX Lead Inspector
Mrs Sheila Knopp Unannounced Inspection 20 January 2006 11:05 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.V269232.R01.S.doc Version 5.0 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.V269232.R01.S.doc Version 5.0 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 Quantum Care Limited Ms Lin Kirby 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.V269232.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection Saturday 25th June 2005 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. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second planned unannounced inspection for the year April 2005 – March 2006. The majority of standards related to the personal and social care of residents were inspected on 25.6.05 and were assessed as meeting the needs of the residents. This visit confirmed the findings of the previous visit that residents are receiving a good standard of care and support in a stimulating environment. No requirements have been made as a result of the last two inspections. The information in this report is based on individual interviews with 5 residents, 2 visitors, 3 staff and the manager who was on duty. Time was also spent with groups of residents. The focus of this inspection was on the freedom of residents to make choices about their lives and to review the accommodation and staff training. The records of CSCI contact with the home and notifications received between inspections were reviewed. The Commission sent comment cards to general practitioners and social workers involved with the home. Positive responses were received from 4 general practitioners and 2 social workers in December. No complaints have been received by the Commission about Mountbatten Lodge between inspections Approximately 5 hours of inspector time has been allocated to this inspection. What the service does well:
The staff and management team are very in tune with the needs of service users with dementia. This is reflected in the interaction and alertness residents have with each other, staff and their surroundings. There was a calm relaxed atmosphere The residents and visitors describe staff as being ‘ very good’ and ‘kind’. The staff approach to residents was observed to be gentle and encouraging. All the residents had received a high standard of personal care and were wearing smartly laundered clothing. The residents were very positive about the standard of meals served to them. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 6 Mountbatten Lodge provides residents with accommodation, which has a high standard of housekeeping and is well maintained and decorated. 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. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 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.V269232.R01.S.doc Version 5.0 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): Not inspected EVIDENCE: See report for inspectin completed 25 06 05 for comments. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 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): Not inspected. EVIDENCE: See report for inspection completed 25 06 05 for comments. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 10 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 & 14 Discussions with residents, visitors and staff confirmed that residents are supported to make decision and choices in their every day lives. Information from residents confirmed an individual approach was being taken enabling residents to continue to manage their affairs and to have their own personal belongings around them. EVIDENCE: A resident when asked what it was like at Mountbatten Lodge said ‘ I don’t have to do anything, it’s all done for me’. ‘Another person said they could do what they wanted and could ask anyone if they wanted to do things’. Both residents and staff gave accounts of how individual interests and choices were supported. This included arrangements for managing finances. Residents and their families have been able to personalise rooms with familiar furniture, soft furnishings pictures and photographs. Couples living at Mountbatten Lodge are able to have a room as a bedroom and another as a private sitting room. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 11 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): Not inspected EVIDENCE: See report for inspection complted 25 06 05 for comments. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 12 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 Mountbatten Lodge provides residents with an excellent environment which based on the opinion of the inspector exceeds the standards because of the attention to detail in providing a stimulating place to live which promotes a sense of well being in the residents. EVIDENCE: There is a planned programme in place to maintain the decoration, furnishings and fabric of the building to high standards. Nice touches such as furniture in a style familiar to the residents and quiet seating areas to break up long corridors continue to develop as staff consider the environment residents are living in. As discussed in the summary a lot of work has gone into providing features to stimulate residents and make then feel at home. This attention to detail is continuing with plans to develop an allotment and sensory area in the garden. Staff are able to access equipment such as height adjustable beds if required. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 13 The manager reported that there are plans to upgrade the kitchens on each unit. The safety of residents is supported by providing low surface temperature radiators and window on the upper floors are restricted. There are contracts in place for the regular maintenance and servicing of equipment ensuring it remains safe for use. There are suitable systems and equipment in place for reducing the risk of infections in relation to the personal care of residents and in the laundry. All areas of the home were found to be fresh and clean. The manager agreed to move a sharps disposal bin from an unlocked sluice room to a more secure area. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 14 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): 28 & 30 Overall there are very good systems in place for staff to receive training as they take up their posts and continue in their jobs. However standard 28 is based on services achieving a ratio of 50 of care staff with a qualification in care at NVQ level 2 by the end of 2005 and this has not been met. The information provided indicates 29 of staff have achieved this award. The induction programme now being completed by new staff provides a foundation for continuing to NVQ and should improve this position. EVIDENCE: The information on NVQ training provided by the manager indicates that 14 out of 48 care staff have a qualification in care at NVQ level 2. A further 8 people are studying for the award which will take the ration from 29 to 46 . An overall training matrix and individual training files are maintained enabling the manager to plan and identify any shortfalls in training. Training needs for 2006 have been identified and places booked on courses. The induction programme enables staff to complete a Btec before proceeding onto NVQ training. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 15 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, 35 & 38 Lin Kirby has many years of experience in her role and is also a Quantum Care dementia care trainer. She has achieved the Registered Managers Award (RMA) qualification (28.4.04) required of care home managers. Residents are supported to continue managing their financial affairs. There is a secure system in place to enable residents to have access to money held on their behalf. The health & safety of residents and staff is supported by the maintencne contracts, policies and staff training in place. EVIDENCE: The systems for holding money on behalf of residents is reconciled weekly and also audited by the company. There is an individual transaction record for each resident, which is supported by receipts.
Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 16 Financial issues are followed up by the management team to ensure residents have access to their personal allowances. Quantum Care have service contracts in place to maintain the premises to the required health & safety standards. The hot water supply to 2 baths was checked and found to be within the required safety range. The fire records provided details of the regular tests and fire drills carried out. The fire risk assessment had been reviewed. Staff receive induction training followed by annual updates in health & safety, fire, first aid, moving and handling and food hygiene. Accident records are maintained and are reported to the Commission as required. An audit of accidents is maintained. The manager has reviewed this to include the time and place of the accident so that any trends can be identified. Discussion with the manager confirmed the work being carried out to reduce the risk of falls by looking at the environment, condition of footwear and zimmer frame ferrals (non slip feet) and involving general practitioners in reviewing medication. Staff are also able to refer residents to the local falls prevention service. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 17 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 4 x x x x x x 3 STAFFING Standard No Score 27 x 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 3 Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? 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 OP19 Good Practice Recommendations The manager agreed to remove a sharps disposal bin from an unlocked sluice room on Pearl unit to a more secure area. Mountbatten Lodge DS0000019476.V269232.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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