Inspection on 20/10/05 for Mountford House

This inspection was carried out on 20th October 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 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

Mountford House 13/08/07

Mountford House 04/09/06

Mountford House 04/05/05

Mountford House 18/01/05

Mountford House 16/08/04

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 Mountford House Cyril Road Truro Cornwall TR1 3TB Lead Inspector Lynda Kirtland Unannounced Inspection 20th October 2005 1:55 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 Mountford House DS0000009158.V258481.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. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mountford House Address Cyril Road Truro Cornwall TR1 3TB 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) 01872 274097 01872 223990 mail@cornwallcare.org Cornwall Care Limited Mrs Beverley Wills Care Home 37 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (8), Old age, not falling within any other category (23), Physical disability (6) Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Total number of service users not to exceed a maximum of 37 Service users to include up to 12 adults aged over 65 years with dementia (DE[E]) Service users to include up to 8 adults aged over 65 with a mental illness (MD[E]) Service users to include up to 23 adults of old age (OP) Service users to include up to 6 adults aged 50 years and over with a physical disability (PD) 4th May 2005 Date of last inspection Brief Description of the Service: Mountford House is one of eighteen homes owned by Cornwall Care Ltd. It is registered to accommodate thirty-seven older people in need of personal care and who are over retirement age. Admissions are on a planned basis and emergency admissions are avoided whenever possible. Mountford House core services are: 1) Residential home: provides long term care to service users who are in need of personal care and are over retirement age. 2) One respite bed 3) 6 bedded Rehabilitation unit : referrals are received from health professionals for service users who due to a physical health need are needing a period of rehabilitation before they return to their own homes in the community. 4) Day care facility. 5) Domiciliary care services are inspected under differing national minimum standards and are therefore not inspected during this inspection process. Mountford house is near to local facilities and has good transport links to the local town. Mountford House is a large purpose built Care Home situated just outside the City of Truro. Accommodation is on the ground floor and consists of four wings. Each wing has a separate lounge, bedrooms and bathing facilities. One wing has a small sitting room for the few smokers living at the home. All rooms have call bells. Meals are prepared in a well-equipped kitchen on the lower ground floor and served in a central dining room on the ground floor. All parts of the home are accessible to all service users. Grounds are accessible for all who use the home. There is limited parking at the home. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited Mountford House Residential Home on the 20 October 2005 and spent three and a half hours at the home. This was an unannounced visit. The purpose of the inspection was to gain an update on the progress of compliance to the recommendations that were identified in the last inspection report dated 4 May 2005. In addition the inspector focused on the following key areas of care: health care, leisure, environment and complaints. On the day of inspection 33 service users were resident in the home. The methods used to undertake the inspection are to meet with a number of residents, staff and the interim manager to gain their views on the services that Mountford House offer. Some of Mountford House records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. There has been a temporary change of manager at the home. Therefore since the 1 October 2005 Di Hicks has been employed as the interim manager of Mountford House. For the purposes of this report the term ‘residents’ refer to those who are provided a care service from the residential care home, rehabilitation unit and day care service unless otherwise stated. What the service does well: Service users and their representatives from the residential home and rehabilitation unit stated that Mountford House provides good quality care and accommodation. Comments about staff that were made by residents included; they are ‘kind’, ‘caring’ and ‘patient with a good sense of humour’. Residents commented that they felt that they were consulted about their care needs which staff ‘ met at all times’. Residents and staff commented that there are sufficient staffing levels on duty. Residents commented that the welcome to the home was a positive experience and ‘relieved anxiety’ about moving into either the residential or rehabilitation unit of the care home. Residents commented that they have access to health care and felt that all their health needs were met to a ‘good’ standard. Residents confirmed that there was a varied and stimulating programme of activities that is provided by the home and local community. These were observed during the inspection. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 6 Residents felt their visitors were welcomed to the home. Residents, relatives and staff stated that if there were any issues they felt able to approach members of staff and felt that their ideas would be listened to and where appropriate acted on. Mountford House has a stable staff team that allows staff and residents to get to know each other well and provide consistent care to residents. Residents were complimentary about staff skill and attitude. Cornwall Care prioritises staff training and is keen to continue to develop staff skills. Staff were complimentary about the training they receive and support from the management team. What has improved since the last inspection? What they could do better: Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 7 From this inspection two requirements were identified: The medication process in the home is overall satisfactory. One area for improvement is for the registered manager to audit the administration and recording of loose medications in the rehabilitation unit and to ensure that it is stored securely. In addition the interim manager must ensure that all fire exits are not blocked at all times. From this inspection three recommendations were identified to expand the adult protection policy and procedure. Cornwall Care ltd has discussed the amendments needed and is in the process of complying with this. Secondly to ensure that a timed and phased programme of replacing windows plus updating the homes sluice facilities has been re notified. The interim manager stated both of these are in process as quotes have been reviewed. Residents and staff could not think of any improvements that Mountford House could make. This inspection highlighted that Mountford House provides a good standard of care to residents. The inspector would like to thank the residents, staff and management team for their assistance during this inspection process. 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. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 8 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 Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 9 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): EVIDENCE: These standards were inspected in detail at the previous inspection and were viewed to meet all the above outcomes. In discussion with residents it was evident that a pre admission assessment, period of trial visits and information prior to moving into the home, or on admission for rehabilitation residents remains in progress. Therefore it was not inspected on this occasion. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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 the following standard(s): 9, 10 Health care needs are met to a satisfactory standard but some areas could be improved on. Medication is administered by trained staff and stored securely The staff at the home builds positive relationships with residents that are based upon the residents dignity and privacy. EVIDENCE: The previous inspection focused on the care planning processes for all residents at Mountford House and was viewed as meeting individual care needs to a good standard. Therefore this was not inspected on this occasion. Residents commented that health needs are met by the staff at the home and by external professionals to a good standard. Cornwall Care Ltd has produced a detailed corporate policy in the ordering, administration, storage and disposal of medication. Designated staff attends annual training in this area of care. In addition the home has a contract with the local pharmacist to ensure that medications are ordered, administered, stored, disposed of correctly, and will provide a audit of their practice. In the rehabilitation unit, on inspection of their medications some issues were raised to improve the storage and recording of medication. The inspector Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 11 requires that the medication is stored in a safer manner, when discussed with the interim manager she immediately gave authority to purchase a medication trolley. In addition the tablet count did not tally on any medications. There was also an insulin pen, in use lying on the desk and so accessible to anyone who entered the office. An urgent review of medication in the rehabilitation unit must be undertaken and a requirement to this effect has been made. In the residential unit it was noted that from a tablet count all medication in the MAR system and loose tablets tallied. Medication sheets were completed correctly. The inspector was informed that medication kept in the fridge is monitored daily. Permission from residents is sought in the administration and storage of their medication. All residents spoken with stated that staffs display a high standard of respect in their daily interactions. Residents stated that staffs ensure that their privacy and dignity is maintained and could not see how this area of care could be improved. The inspector noted that the atmosphere of the home and residents appeared to be relaxed. Residents commented staff ’ were ‘kind’. Residents confirmed that they have a choice as to when to rise/ retire to bed, receive their mail unopened, have access to a private phone and can receive visitors in private. In addition the inspector observed staff interacting with residents in a professional manner at all times, alongside a sense of humour when appropriate. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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 the following standard(s): 12,13,15 Mountford House provide a programme of activities to promote and encourage the pursuit of residents social, educational and leisure needs. Flexible visiting arrangements are in place and visitors are welcomed at the home. A varied and nutritious diet is provided to all residents in a relaxing atmosphere. EVIDENCE: From discussions with residents they commented that there is ‘enough to do’ during the day. The inspector noted on the day of inspection a variety of activities taking place; socialising in lounges, music and receiving visitors. Activities are advertised around the home so that residents can choose whether to participate. Some residents commented that they prefer to spend time in their own company and this is respected. Residents were able to recall a list of activities that occur such as exercises, monthly communion, games and outings to name a few. There is a flexible visiting policy and residents determine where they meet with their guests. Residents felt their visitors were welcomed to the home positively and could not think of improvements in this area. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 13 Residents made positive comments to the inspector in the variety and quality of food provided. They can also choose where to have their meals, either in their room or in the dining area. The dining area was observed to be a relaxed and social occasion. Cornwall Care Ltd has implemented the ‘Appetite for life project’, which ensures that a varied and appealing diet is provided to residents in a relaxed atmosphere. In discussion with the catering staff they felt the food project had gone well. The cook confirmed that residents are aware the day before of the choices of menu so that they can choose what main meal they wish to have. The menu was also displayed on the notice board in the dining area. The cook stated that menu cards would be introduced in the near future. Meals are presented in serving dishes so that residents can help themselves to food, unless they request that it is plated and this is responded too. Training to catering staff has been provided. The cook did state that as the food project requires more preparation work that she is discussing with the management team reviewing staffing levels in the kitchen area, which the interim manager confirmed. All equipment in the kitchen area works satisfactorily. The windowsill area next to the sink due to condensation becomes damp and affects the wooden sill and needs cleaning frequently. The cook suggested tiling this area would prevent the build up of condensation on the sill and this was recommended to the interim manager who will address this. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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 the following standard(s): 16 Mountford House has an appropriate complaints and whistle blowing policy. Residents, their representatives and staff are confident to raise any concerns. EVIDENCE: Cornwall Care Ltd has completed corporate policies in respect of the complaints procedures. Mountford House and CSCI have not received any complaints about the home. From the inspectors discussions with residents all stated that they had no concerns about the care or facilities that were provided by the home. Staff likewise commented they had no current concerns. All felt able to approach the management team if they had any concerns. CSCI have met with Cornwall Care Ltd management team to discuss reviewing the adult protection policy and procedure, which they are in the process of doing. Therefore a recommendation to this effect has been made and this was not inspected further. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,22,24,25,26 Mountford House provide a good standard of décor and furnishings creating a comfortable and safe environment for those living there and visiting. Mountford House have invested in the homes furnishing and décor to continually improve the facilities in the home. The home is clean. EVIDENCE: The home is well maintained. The home caters for residents with mobility difficulties and visual impairments, all parts within the home are accessible to residents. The communal areas are comfortably furnished and decorated to a good standard. Residents stated that they enjoyed these areas and that they could choose which lounge to spend time in, this was the same for the dining areas. A garden area is accessible for residents to enjoy. All the bathroom facilities were inspected and some had a variety of aids and adaptations e.g. hoists, grab rails. Referrals are made to an occupational therapist when a resident care need has changed and an assessment of ability is needed. The bathroom facilities were decorated to a good standard and all were clean. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 16 Resident’s accommodation was inspected. The rooms are for single occupancy and four have an en suite facility. All rooms were decorated to a good standard, were personalised and residents stated they were ‘happy’ with their accommodation and facilities. Residents commented on how ‘clean’ the staff keeps the home. The laundry facilities were inspected and staff were satisfied with the workings of this area. Residents commented that washing is completed promptly. COSHH information was on display and staff had a good knowledge of health and safety issues. One toilet had a rusty frame and the assistant manager stated this would be replaced with a new frame to prevent infection risks. In discussion with the interim manager she informed the inspector that previous recommendations to upgrade the windows and sluice facilities are in process and quotes for work have been gained. Therefore these recommendations remain identified. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Mountford House ensure that suitable trained staffs are employed in sufficient numbers at all times. EVIDENCE: These standards were inspected at the previous inspection visit on 4 May 2005 and were viewed as met; therefore they were not assessed on this occasion. Residents continued to make positive comments about staff attitude and skills. During the inspection it was observed that there was sufficient, trained and experienced staff on duty. Staff displayed good communication skills and interacted with residents in a professional yet friendly manner at all times. Cornwall Care Ltd has robust recruitment processes and this was not inspected on this occasion. The interim manager confirmed that all but one staff member has POVA/CRB clearance. The member of staff without this clearance is being supervised at all times and evidence of her application for these clearances was seen. Staff also commented that they felt the staffing levels were adequate and complimented their access to training and support from the management team. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36,38 Satisfactory arrangements are in place to provide a safe environment for all who live, visit or work at the home EVIDENCE: The majority of these standards were inspected at the previous inspection visit on 4 May 2005 and were viewed as met; therefore they were not assessed on this occasion. The standards that were inspected on this occasion were in respect of health and safety issues for residents, visitors, staff and management of the home. The records show that policies and procedures have been established to promote safe working practices and provide a healthy and hygienic environment. The services and equipment at the home are regularly maintained and serviced and suitable arrangements are in place about fire precautions and action to take in the event of a fire. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 19 However the inspector did observe a resident sitting in the doorway of a fire exit, staff said they were also aware of this but the resident could not see the TV if seated elsewhere in the lounge. This was discussed with the interim manager who agreed to address this due to health and safety risks. Documentation also evidenced that the home undertakes appropriate individual and generic risk assessments, to promote minimising future risks to all who live, visit or work at the home. From discussion with the management team and staff they confirmed that the level of staff supervision is a minimum of six supervision sessions a year. The quality assurance process is currently being reviewed and so was not inspected on this occasion. Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X 2 Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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. 1 Standard OP9 Regulation 13,17 Requirement The interim manager must audit the administration and recording of medications and ensure that it is stored securely. The interim manager must ensure that fire exits are not blocked at any time. Timescale for action 30/11/05 2 OP38 23 30/10/05 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 2. 3. Refer to Standard OP18 OP25 OP26 Good Practice Recommendations The adult protection policy should be expanded to include a timetable of initiating an adult protection referral and explain what procedure should be followed A planned and timed programme of replacing windows should be implemented. The sluice facilities should be considered to be updated Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Mountford House DS0000009158.V258481.R01.S.doc Version 5.0 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. 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!