Inspection on 04/05/05 for Mountbatten Nursing Home

This inspection was carried out on 4th May 2005.

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

Other inspections for this house

Mountbatten Nursing Home 21/06/07

Mountbatten Nursing Home 17/10/06

Mountbatten Nursing Home 09/11/05

Mountbatten Nursing Home 30/11/04

Mountbatten Nursing Home 14/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Mountbatten Nursing Home 82-84 Trull Road Taunton Somerset TA1 4QL Lead Inspector Shelagh Laver Unannounced 4th May 2005 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 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 Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mountbatten Nursing Home Address 82-84 Trull Road Taunton Somerset TA1 4QW 01823 333019 01823 334793 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Richard Derek Brice Mrs Sarah Katrina Collard Care Home with Nursing 27 Category(ies) of Old Age (27) registration, with number of places Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, not less than 60 years, who require general nursing care. 2. Up to three places for personal care. Date of last inspection 30th November 2004 Brief Description of the Service: The Mountbatten Nursing Home was first registered in 1984. The home is registered for 27 persons over the age of 60 needing nursing care. The current provider has been registered since 2000 and continues to make improvements to the fabric of the home. Mountbatten is a specially adapted Victorian building providing accommodation on four floors with a large sitting dining room on the ground floor. This room opens into a large conservatory that leads onto a decked patio and the well-tended gardens. There is a call bell system and adequate numbers of assisted bathrooms. Nursing care is provided at all times and the home liaises with other health services for service users with complex nursing needs. The home is developing the provision of activities and outings for service users over the past months. There is an experienced Registered Manager Mrs Sarah Collard and the proprietors Mr and Mrs Brice are involved in the management of the home on a day-to-day basis. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day and was conducted by one inspector. A tour of the premises took place where most of the bedrooms and all of the communal areas were seen. Twelve service users and six staff were spoken with. The registered manager was available through out the inspection and as she was the registered nurse on duty brought in another nurse in order to contribute fully to the inspection. Records relating to care, staff and health and safety were examined. What the service does well: Service users spoken to during the inspection stated that staff were kind. The manager demonstrates a clear sense of leadership and service users benefit from her clinical knowledge and pro-active approach to accessing specialist treatments and services. The manager is pro-active in arranging a range of training for nursing and care staff. The manager takes appropriate action to ensure that admissions take place following a comprehensive assessment of the service users needs. Service users benefit from a safe, clean and pleasant environment. Service users spoken to liked living in the home and felt well cared for. Service users stated that the food was enjoyable. One service user said that staff tried hard to make sure that all service users enjoyed their meals and had individual choices when necessary. The home takes appropriate steps to ensure the health and safety of the service users, staff and visitors. The staff group at the home is stable and few agency staff are used. The home owners have invested considerably in the fabric nad equipment of the home and are committed to continuous improvement. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4, 5, Standard 6 does not apply as Intermediate care is not provided. The manager ensures that the home can fully meet the assessed needs of the prospective service users prior to making a decision about admission. The assessment and admission process is comprehensive and well managed. EVIDENCE: The home has produced a Statement of Purpose and service User guide which is made available to service users and prospective service users. The homes current fee range is between £449-500. Contracts and terms and conditions were observed for three recently admitted service users. The contracts showed clearly the break down of responsibilities of parties for the fees. The contribution of the nursing care element to the overall fee was clearly shown. Extra charges are made for personal toiletries hairdressing, chiropody and newspapers when applicable. The manager ensures that prospective service users are fully assessed and when possible are invited to visit the home. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 9 Files contained assessment documentation from nurse assessors and other professionals that had contributed to the assessment. Thre manager stated that whenever possible a service user visits the home prior to admission. In some instances the service user may be admitted from hospital and may be too ill to visit. Relatives are welcome to visit for the service user. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10, The home takes appropriate action to ensure that the health care needs of the service users are met. The home’s procedure for the management and administration of medication is safe and effective. Staff must consider the impact of care procedures on a service users privacy and dignity at all times. EVIDENCE: Individual care plans are maintained for all service users. Three were examined and found to be detailed. Care plans use SHARP documentation and are compiled from appropriate assessments which include pre-admission assessments, prevention of pressure sores, moving and handling needs, nutrition and dependency. Additional training was required in the use of the MUST nutritional assessment by some trained staff. Attention must be paid to the completion of bedrail assessment forms including consent by service user when appropriate. Social therapies and psychological needs and care recording should be developed particularly where service users have some degree of dementia alongside their physical nursing needs. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 11 All service users have access to appropriate health care professionals and the manager ensures that the health care needs of service users are met. The home liases with other health care professionals to meet individual needs and evidence of correspondence was seen in care plans. The homes procedure for the management of medication was observed. All records examined were appropriately completed. Medicines were seen to be appropriately stored. The homes last Health Authority Community Pharmacy visit was carried out by Boots the Chemist on 16th March 2005 and stated “no problems in this home.” Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. The home provides a wholesome and varied menu which takes into account the needs and preferences of service users. Arrangements for service users to maintain contact with family and friends is good. Continued development of the social and recreational programme in the home is required. EVIDENCE: All service users spoken to during the inspection were happy at the home and felt it met their individual needs. One service user said that while he did not want to be in a nursing home “this one is as good as it gets”. Service users were able to describe a range of different routines in the home that allowed them some control over their lives. A family member was visiting and had been provided with accommadation. One visitor confirmed they were welcome to visit at any time. The manager felt the activities programme had suffered a set back due to staff changes. Records in care files relating to social activities were brief or missing. A quiz had been held and a new member of staff has been allocated the role of activities co-ordinator. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 13 On the day of the inspection the lunch was “service users choice “ day. Service users were able to tell the inspector that they were satisfied with the food. Meals are served both in service users rooms and in the conservatory. The tables in the conservatory were pleasantly set and there was a congenial atmosphere. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18 The complaints procedure in the home is good with evidence that the views of service users are listened to and acted upon. The recruitment procedures of the home are designed to protect the service user and comply with minimum standards. EVIDENCE: The home has a complaints procedure which is clearly displayed in the home. Copies are found in the Statement Of Purpose and Service User guide. There have been no formal complaints. Informal concerns are recorded and addressed by the manager. Service users had been offered the opportunity to vote including postal votes. The home has a Whistle Blowing Policy. There had been no new staff recruited since the last inspection. At the last inspection procedures were seen to be generally sound but a requirement was made to obtain two written references prior to the commencement of employment. POVA checks and CRB checks have been completed on all staff. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, and 26 Service users live in a comfortable and clean environment and are able to personalise their bedrooms. The home’s environment is able to meet the assessed needs of the service users. The home provides specialist equipment to ensure the needs of service users are met. EVIDENCE: The home has been the subject of considerable investment from the present owner. Most recently a large conservatory has been added to the sitting room and is used as a dining room. The home has pleasant gardens that can be accessed by service users. All communal areas and a selection of bedrooms were seen at this inspection. Bedrooms were pleasant and comfortable. Service users commented on the enjoyment gained from a nice view or a comfortable environment. Some prefer to spend a considerable amount of time in their room. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 16 The inspector spoke with members of the housekeeping staff who demonstrated a commitment to maintaining high standards of cleanliness in the home. Specialist beds and pressure relieving equipment were seen in place when needed. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29. 30 The home had sufficient staff on duty on the day of inspection. The combination of trained staff, carers and support staff enabled the home the service users and home to be well cared for. A programme of training contributes to staff competence. EVIDENCE: The staff on duty on the day of inspection were those recorded on the duty rota. The duty rota showed consistent numbers of regular staff. Service users confirmed that staff were kind and attentive to their needs. The manager was able to confirm that training had been arranged in Dementia Care. An up-date on the care planning system had been booked. Staff were accessing an open learning programme on Infection Control. The NVQ programme is continuing and is progressing well. There was evidence of Fire Training and manual handling up-dates. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 and 38 The home is effectively managed by the registered manager who promotes a clear and inclusive style of management. The homes systems for ensuring health, safety and welfare of service users and staff. Financial systems are in place to ensure the protection of service users and the efficient running of the business. EVIDENCE: The registered manager is Sarah Collard who is an experienced nurse and manager. She is very much a “hands on” manager who has a clear understanding of the needs of service users living at the home. She is active in communicating with staff, service users and their families. A system of appraisals and supervision has been developed. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 19 Systems are in place to maintain health and safety including servicing labels and maintenance checks for hoists and the lift undertaken in accordance with LOLER regulations. In house weekly fire alarm tests are carried out, the record for these checks were seen. . The emergency lighting and smoke detectors are checked on a monthly basis. The handyman carries out Bath hot water temperature checks on a weekly basis. The hot water outlets are thermostatically controlled. All radiators are of the low surface temperature type. Financial records inspected were organised and clear. Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 21 yes 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. 1. 2. Standard OP10 OP 12 Regulation 12 4 (a) 12 (3) 16 (2) m Requirement Catheter bags must not be emptied in the sitting room. The ways in which the social needs of service users are met must be reviewed and the development of the activities programme must continue. Razors must be disposed of safely in the Sharps bin. Bed rail assessments must be completed in all situations where they are used. Timescale for action 25/5/05 1/7/05 3. 4. OP38 OP7 !3 (4) b 13(4) b 25/5/05 25/5/05 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 OP 7 Good Practice Recommendations Additional training in care planning documentation should be provided to those trained staff who need it.i Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mountbatten Nursing Home D53 - D02 S3272 Mountbatten V224585 040505 Stage 4.doc Version 1.30 Page 23 - 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. 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