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Inspection on 16/05/06 for Mountview Community Support Centre

Also see our care home review for Mountview Community Support Centre for more information

This inspection was carried out on 16th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Mountview Community Support Centre offers both short stay and day care. It provides flexible service, including regular respite care to service users in the area and is the base and contact point for the domiciliary care teams supporting service users in the wider community. Appropriate staff training is provided and care staff members are knowledgeable about the service users they care for and provide attentive, friendly care and support to meet service users` needs. Mountview receives support from a Specialist Practitioner Nurse from Eastern Cheshire Primary Care Trust on a weekly basis, usually every Tuesday. The input has proved beneficial to both service users and staff and has aided the assessment process and liaison with General Practitioners. Domestic staff members take a pride in the environment and the premises are clean comfortable and welcoming. The centre is fully adapted to provide care for older service users and the majority of service users spoken with were happy with the standard of care provided.

What has improved since the last inspection?

The responsibilities of the team managers are being divided to provide clarity of roles. The key worker system is becoming more sophisticated and general assistants are to linked to particular areas of the building. Staff members have been nominated to attend basic awareness training in relation to the protection of vulnerable adults and a new training DVD has been obtained to promote aid this staff training.

What the care home could do better:

An updated statement of purpose is awaited to provide service users with accurate description of the services provided. Care file information should be fully completed and information should not be contradictory. Greater care must be taken when recording medication and the administration and recording of medication must be very closely monitored to bring about sustained improvement and accuracy. Mountview would benefit from the appointment of an activities co-ordinator to arrange regular and suitable activities for service users to take part in. Community involvement in the home should be encouraged for the benefit of service users and to foster community spirit within the area. Full and complete complaints records need to be kept showing the action taken to find a resolution and outcome. Rooms containing fuse boxes with doors marked `fire door` need to be kept locked. Some uncovered wiring in toilet and bathroom areas needs to be covered and made safe. Bathrooms must be checked frequently to ensure they are clean, ready for use and contain only appropriate items. Regular wheelchair checks need to be undertaken and footrests must remain on wheelchairs at all times. Cleaning solutions must be safely stored. The recruitment checks and processes could be improved. The management hours should ensure some management support is available to the centre on most days each week. The management processes and recording of service users money could be improved to protect the financial interests of service users.

CARE HOMES FOR OLDER PEOPLE Mountview Community Support Centre Melton Drive Congleton Cheshire CW12 4YF Lead Inspector Sue Dolley Key Unannounced Inspection 16th May 2006 09:00 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 Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 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. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Mountview Community Support Centre Address Melton Drive Congleton Cheshire CW12 4YF 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) 01260 272925 01260 297386 http/www.cheshire.gov.uk Cheshire County Council Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability (6) of places Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This care home is registered for a maximum of 36 service users to include: Up to 36 service users in the category OP (Old age not falling within any other category) * Within the total of 36, up to 5 service users may be in the category PD (Physical disability aged between 55 and 65 years) * Within the total of 36, up to 1 service user may be in the category PD (Physical disability aged between 50 and 65 years) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The registered provider must provide staff to meet the dependency needs of service users at all times and shall comply with any guidance, which may be issued through the Commission for Social Care Inspection. 27th January and 21st February 2006. * 2. 3. Date of last inspection Brief Description of the Service: Mountview is a community support centre providing personal care and accommodation, on a short stay/respite basis, for 36 older service users and including up to 5 people with disability aged between, 55 and 64 years and 1 person with a physical disability aged 52 to 53 years. It is owned and managed by Cheshire County Council, which operates a number of similar facilities in Cheshire. The fees at Mountview are based on a financial assessment of the individual. Mountview is in Congleton, close to a small shopping arcade with a variety of shops including two supermarkets, a post office, newsagent, chemist, a bakery and a public house. It opened in August 1988 and consists of a two-storey building. Part of the ground floor has been adapted to provide office accommodation for the home and for the community based services that operate from the building. All the bedrooms are single rooms and have washbasins. Access between the ground and the first floors is via a passenger lift. The garden is accessible to service users. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 16th May 2006 over almost 7 hours to assess if service users’ needs were being met. A tour of the building included several bedrooms, shared areas such as lounges and dining areas, bathrooms, toilets and the kitchen and laundry areas. Several members of the management and care staff contributed to the inspection process. A staff handover meeting was observed and four service users were spoken to. Several members of the senior management and care staff contributed to the inspection process. Feedback to the site visit was provided on 1st June 2006 to enable the two part time managers and the locality manager for the service to attend. What the service does well: Mountview Community Support Centre offers both short stay and day care. It provides flexible service, including regular respite care to service users in the area and is the base and contact point for the domiciliary care teams supporting service users in the wider community. Appropriate staff training is provided and care staff members are knowledgeable about the service users they care for and provide attentive, friendly care and support to meet service users’ needs. Mountview receives support from a Specialist Practitioner Nurse from Eastern Cheshire Primary Care Trust on a weekly basis, usually every Tuesday. The input has proved beneficial to both service users and staff and has aided the assessment process and liaison with General Practitioners. Domestic staff members take a pride in the environment and the premises are clean comfortable and welcoming. The centre is fully adapted to provide care for older service users and the majority of service users spoken with were happy with the standard of care provided. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: An updated statement of purpose is awaited to provide service users with accurate description of the services provided. Care file information should be fully completed and information should not be contradictory. Greater care must be taken when recording medication and the administration and recording of medication must be very closely monitored to bring about sustained improvement and accuracy. Mountview would benefit from the appointment of an activities co-ordinator to arrange regular and suitable activities for service users to take part in. Community involvement in the home should be encouraged for the benefit of service users and to foster community spirit within the area. Full and complete complaints records need to be kept showing the action taken to find a resolution and outcome. Rooms containing fuse boxes with doors marked ‘fire door’ need to be kept locked. Some uncovered wiring in toilet and bathroom areas needs to be covered and made safe. Bathrooms must be checked frequently to ensure they are clean, ready for use and contain only appropriate items. Regular wheelchair checks need to be undertaken and footrests must remain on wheelchairs at all times. Cleaning solutions must be safely stored. The recruitment checks and processes could be improved. The management hours should ensure some management support is available to the centre on most days each week. The management processes and recording of service users money could be improved to protect the financial interests of service users. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 7 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. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 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 Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 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): 1,3 and 6 Quality in this outcome area is good.This judgement has been made using available evidence including a visit to this service. The service user guide needs updating to give an accurate description of the services provided. The initial assessment documentation needs to be fully completed so that care staff members have all the necessary information to care for service users well. EVIDENCE: The statement of purpose was updated in January 2006 and is well written. It provides prospective and existing service users and their supporters with a brief description of the services provided. It contains information about the qualifications and experience of staff and explains the criteria for admission. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 10 The service user guide was produced in September 2003, this and the information folders for bedrooms need updating. This updating is awaited and annual reviews of the information provided will be undertaken. When the work is completed, service users should have accurate information to enable them to make an informed choice about placement. See Requirement 1. Service users’ needs are assessed before they receive care at the centre. During the site visit, three service users’ care files were checked. The assessments and care files were positively written, self –care abilities were described, and contact information was provided. Recent social history information and circumstances leading to placements were well described. There was insufficient information held on care files in service users bedrooms regarding the date of admission. One service user was in receipt of the ‘One Call’ service and had been directly admitted from hospital. The last assessment of need had been completed in late September 2005 and had not been updated prior to commencement of placement although there had been changes to care needs. One of three care files checked was complete and held up to date information. The care file information, held in the bedroom of a second service user had not been updated and did not match the information held in the senior carers files. One care file contained much contradictory information regarding the level of mobility experienced by this service user. The functional ability sheet was not dated but stated that the service user was independently mobile without aids. Information relating to mobility in the service users care programme indicated that the person had experienced recurrent falls, had left sided weakness, had osteoarthritis and difficulty with the right knee. The safer handling assessment completed in May 2006 stated that the service user was mobile with a walking stick, and needed monitoring whenever possible due to unsteadiness and being prone to falls. A third care file also held contradictory and misleading information related to a skin rash, the possible causes of which were not properly explained. The action taken upon discovering the rash was also not clearly indicated and again the information to present mobility was incorrect. See Requirement 2. During the site visit care staff were seen to encourage service users to retain their independence and to support them. Care staff members were attentive but sometimes a little rushed. The staff handover was observed and provided evidence of effective communication throughout the centre and between staff. The staff members at handover were knowledgeable about service users and were able to verbally communicate more information than was detailed upon the care files in a number of cases. The observed contacts between service users and staff members were kindly and reassuring. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 11 Within the centre two intermediate care beds can be used for rehabilitation for up to six weeks as a transitional arrangement. Staff members are deployed, and specialist services from relevant professions including physiotherapy are secured, to meet the needs of service users admitted for rehabilitation. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 12 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): 7,8,9 and 10 Quality in this outcome area is adequate.This judgement has been made using available evidence including a visit to this service. Health and personal care needs are assessed, addressed and met and service users are referred to health professionals as appropriate. Medication administration needs to be improved to ensure service users receive their medication as prescribed. Staff members should protect service users’ rights to privacy and dignity. EVIDENCE: The care records provided information regarding medical history and ongoing investigations. There was evidence of careful health monitoring and of staff promptly seeking medical help and advice to address the existing and changing needs of service users. A record of health care visits is now usefully included within the files containing medication administration records and include information relating to symptoms and treatment and detail the care giver responsible. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 13 Significant event sheets were completed at least twice daily during each planned short stay and aid continuity of care. Some service users are able to store and administer their own medications with supervision and lockable space is provided in most bedrooms for storage. Otherwise, medication is managed and administered by the senior support workers as necessary. Staff members had been provided with guidance notes regarding particular diseases and conditions to inform their practice. The medication administration records for each wing of the home are contained in separate files. Three of the four medication files were checked. There were numerous unexplained gaps in recording relating to prescribed medication, the application of cream and ointments and the use of eye drops. Staff members were recording medication to be given when required had been recorded in various ways. Some medication was not given as frequently as prescribed, other medication was given more frequently as prescribed. Special instructions were inappropriately recorded on loose paper. Omission code ‘F’ is used to indicate other reasons for non -administration. When used, the reason should be explained. Code ‘F’ had been used 27 times for one service users medication yet the reasons for not administering were only explained 4 times. The pre- inspection questionnaire stated that 7 members of staff were responsible for the administration of medication although the care files indicated that 14 staff had been responsible for medication administration. The high level of anomalies found within the administration records indicate that the administration and recording of medication has not been adequately monitored for some time. The controlled drugs records were checked and these however were found to be accurate. Requirements were made at two previous inspections and remain unmet. There is an urgent need for very close, monitoring and refresher training for staff. See Requirement 3. The Commission for Social Care Inspection pharmacist will be asked to visit to monitor the administration and recording of medication. Service users spoken with said that personal care was always given in the privacy of their own room and several service users spoke of staff being polite, courteous and kind but indicated that carers rushed from place to place with little time to converse. One service user spoke of being given her medication in an inappropriate place and at an inappropriate time. They said their privacy and dignity had not been regarded. The management team were advised of this incident at the time of the site visit and at feedback to the site visit. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 14 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): 12,13,14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including visits to the service. There is little social activity and involvement by local community groups to match service users’ preferences. Mealtimes are treated as social occasions and a wide variety of foods are presented and enjoyed. EVIDENCE: Three service users spoken with felt, that there was a local of activity and entertainment at Mountview and said that staff didn’t appear to have time to organise much activity. One service user commented, “Apparently there are activities on one floor, not on others- I was not told this until it was nearly time for me to go home”. Of nine service users questionnaires completed relating to this site visit, • 1 respondent said there are always activities arranged. • 1 respondent said there are usually activities arranged. • 4 respondents said there are sometimes activities arranged. • 1 respondent said there are never any activities arranged. • 2 respondents did not comment about activities. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 15 The quality standards report relating to the period from April 2005 to March 2006 stated 97 completed questionnaires were received from service users. When service users were asked if there were sufficient opportunities to keep them occupied or entertained during their stay 33 replied 43 replied 14 replied 9 replied - Always - Mostly - Sometimes - Never Mountview does not have an activities co-ordinator and although staff members are expected to organise activities within their role they are often busy caring for service users with high dependency needs and personal care tasks which does not allow time for organising and providing social activities. See Requirement 4. Service users are encouraged to maintain contact with family and friends as they wish, and are helped to exercise choice and control over their lives. Service users confirmed that they are able to see visitors in private, at any time. Although Mountview enjoys visits from the local school and church groups, there is little involvement in the centre by other local community groups and/or volunteers to accord with service users’ preferences. See Recommendation 1. Service users spoken with confirmed that they were enabled to make choices about their daily living routines, the management of their finances and medication and the meals that are provided. A number of service users said that the food was of good quality and plentiful. One service user spoken said the tea- time options were often very limited and sandwiches were often provided. The mealtimes were observed to be unhurried and social events and the meals provided were enjoyed. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 16 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 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including visits to this service. Full and complete complaints records need to be kept showing the action taken to find a resolution and outcome. Although staff are alert to the potential for abuse some yet need training to raise their awareness to help protect service users. EVIDENCE: The pre – inspection questionnaire stated that two complaints had been made within the last twelve months and that they were substantiated. 3 complaints had actually been made and these complaint records were checked. Although each complaint had been thoroughly investigated one record did not provide evidence of a response to the complainant. Two records did not provide information about the outcome and when a complaint was made about a staff members’ attitude, no information was available to outline the point of view of the member of staff. See Recommendation 2. Staff members have a basic awareness of adult protection and have the Department of Health guidance ‘No Secrets’ available to refer to. A whistle blowing policy is available to staff to enable them to respond appropriately to any suspicions or evidence of abuse.Staff members are being nominated for adult protection training and training resources are available to use. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 17 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including visits to this service. Mountview is clean, decorated and furnished to a good standard which helps to create a comfortable and welcoming environment for the benefit of service users. Regular monitoring to maintain the environment is necessary. EVIDENCE: Service users were seen moving freely between their bedrooms and the communal areas. Access for service users between the ground floor and first floor is via the passenger lifts or stairways. A call alarm system is in place and is soon to be replaced with a more advanced system. Service users have comfortable bedrooms and are encouraged to bring in some small personal items to make them feel at home during their stay. Ample communal space is provided and lounges are homely and varied in size. Dining areas are Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 18 attractively presented. There are adjacent satellite kitchens, which are well equipped. The premises were clean throughout but are in need of some minor refurbishment works and repairs to equipment are awaited. The refurbishment and repairs will enhance the environment and facilities. Regular monitoring is necessary to check the environment. During feedback to the site visit, the managers were advised of the following matters to be addressed. • Wiring was protruding from the walls in three toilet/bathroom areas and was uncovered. • 2 rooms containing lighting and fuse boards were unlocked although these were fire doors and should have remained locked. • A specialist bath had been out of order for many weeks and was awaiting either repair or replacement. • A commercial clothes dryer had been awaiting repair for more than 5 weeks. • 1 walk in shower did not contain an appropriate shower seat and a plastic garden chair was used instead. The electrical switchgear room beside the kitchen was left unlocked with the key in the lock. See Requirement 5 and Recommendation 3. Cheshire County Council has produced policies and procedures for the control of infection to guide staff members in the use of good hygiene practices. During a tour of the premises the following was noted. • 1 bathroom contained 2 canisters of sanitizers, a dirty soap tray a coffee mug, a wet flannel and a folded towel placed on the toilet cistern. A toilet area had a used disposable dish within it. See Recommendation 4. Advice was given at feedback to the inspection as 4 loose wheelchair footrests were seen on the floor of the stairwell near the payphone and a protective hat had been hung on food racking. Several items of food were in the freezer and had not been dated. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 19 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): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including visits to this service. Staffing levels are generous and staff members are encouraged to undertake appropriate training. The recruitment checks need to be more thorough to ensure service users are protected. EVIDENCE: Staffing levels are generous to ensure staff members have time to complete all necessary care and support tasks. The skill mix of staff is appropriate to meet the needs of the service user group. Cheshire County Council are committed to providing training opportunities to ensure staff have the appropriate skills and knowledge to deliver the necessary level of care to service users. 45 of care staff have been trained to NVQ level 2 or above and NVQ training is continuing for more staff members. 6 staff member have recently attended person centred approach training, 1 team manager has completed a dementia care mapping qualification and all staff members have received appropriate fire training. Induction training for new members of staff is on going. Future planned training is to include adult protection awareness, and principles of safe practice in the management and administration of medication. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 20 The recruitment files of three new staff members were checked. The recruitment checks and processes need to be improved as 2 recruitment files did not contain evidence of two satisfactory references. See Requirement 6. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 21 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): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including visits to this service. Mountview strives to run in the best interests of service users and promotes and protects their health, safety and welfare. The processes for the management and recording of service users money could be improved to protect the financial interests of service users within the centre. EVIDENCE: Two experienced people manage the centre, sharing a full time post within a job share arrangement. This arrangement commenced in September in 2005. One manager is currently undergoing the process to register with CSCI to register as a part time manager at Mountview. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 22 Both managers have had accrued leave entitlements to take and the leave absences and some sickness absences have created some tensions for remaining senior staff within the centre. During the week of the site visit one manager was working on Monday but was away from site undertaking training. Both managers were to be on duty on Wednesday and 1 manager was scheduled to be on duty on Friday. For all other days of the week a manager was not on duty. Currently 1 manager works one weekend in 4. The management arrangements were discussed with the managers and locality manager during feedback to the site visit. Work is being undertaken to resolve some management issues and to divide management roles and responsibilities. This will avoid duplication of tasks and ensure all necessary monitoring takes place regularly to support the running of the home and to support care staff. The results of a recent quality standards survey were available to view. Cheshire County Council Performance Assurance Information Development Unit had collated the following results. During the period April 2005 to March 2006, 97 completed questionnaires were received. 72 of respondents were very satisfied with the service provided. 24 were quite satisfied,3 thought the service was alright and 1 were not at all satisfied with the service provided. The Commission for Social Care Inspection service user questionaires completed around the time of the site vist provided mainly positive comments about the service. Service users stated that they were made to feel welcome, that the food was good, that the premsies were fresh and clean and rooms were comfortable. Negative comments were made however regarding the level of social activity and the lack of space in toilet areas for wheelchair users. Regular monthly monitoring visits of the provision are undertaken by the locality manager and any comments received are acted upon for the benefit of service users. Examples of service users’ balances of personal monies held for safekeeping and the related records were checked and need improvement. For money received into the safe operated by the senior care staff a personal allowance record sheet should be completed and passed to administration staff for further completion, for checking of money received and checking of the current balance.The safe contents list was checked , three amounts had been deposited, the money had been returned to the individuals but the records did not reflect this.Day care money was within the safe but had not been recorded on the safe contents list. See Recommendation 5. During the site visit all appropriate environmental risk assessments were in place and health and safety guidance was available to staff. Staff members had been appropriately trained to recognise and report any health and safety issues. Staff members are currently being provided with a pocket guide to health safety and welfare. The accident records were fully completed and signed by the manager to show awareness. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 23 To improve safe working practices the metal cage to the outside of the building used to store some corrosive cleaning solutions must be kept locked. A combination lock, which had been obtained for the cage was not in place. See Requirement 7. Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 24 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 2 X 2 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 X X 2 Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 5 and 6 Requirement Timescale for action 2 OP3 14 The registered person must produce a written guide to the care home, keep it under review and where appropriate revise it 30/09/06 and notify the Commission of any such revision within 28 days. (This requirement was also made on 27/01/06 and remains unmet). The registered person must ensure that the needs of the service users have been 30/06/06 assessed by a suitably qualified or suitably trained person, there has been appropriate consultation regarding the assessment with the service user or their representatives and, service users’ needs are accurately recorded and kept under review. The registered person must make arrangements for the recording, handling, safekeeping, 30/06/06 safe administration and disposal of medicines received into the care home. (This requirement was also made at the previous inspections on DS0000036720.V289400.R01.S.doc Version 5.1 Page 26 3 OP9 13 Mountview Community Support Centre 30/06/05 and 27/01/06 remains unmet). 4 OP12 16 The registered person must consult service users about the programme of activities within the centre, and provide facilities for recreation, having regard to the needs of service users, activities in relation to recreation, fitness and training. Ensure all parts of the centre are kept clean, reasonably decorated and in a good state of repair and all equipment maintained in good working order. (This requirement was made at the previous inspections on 30/06/05 and 27/01/06 and remains unmet). 31/07/06 5 OP24 23 31/07/06 6 OP29 19 7 OP38 23 The registered person must not employ a person to work at the centre unless they have obtained 30/06/06 information and documents specified in paragraphs 1 to 7 of Schedule 2 of The Care Homes Regulations 2001. Keep the metal cage to the outside of the building near to the laundry locked to ensure safe storage of some corrosive cleaning solutions. (This requirement was made at the 30/06/06 previous inspections on 30/06/05 and 27/01/06 and remains unmet). Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 27 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 OP13 Good Practice Recommendations Consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities. Encourage involvement in the home by local community groups and/or volunteers to accord with service users preferences. (This recommendation was also made at the previous inspections on 30/06/05 and 27/01/06 the situation remains unchanged). Ensure all complaints records contain full information, copies of all communications, evidence of a response to the complainants and details of outcomes. Ensure an appropriate and safe shower seat is obtained and used within the walk in shower facility. Ensure through regularly monitoring that the bathroom and toilet areas are kept uncluttered and clean and ready for use. Ensure service users’ financial interests are safeguarded , by maintaining clear and accurate records of all transactions. 2. OP16 3 4 OP19 OP26 5 OP35 Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Mountview Community Support Centre DS0000036720.V289400.R01.S.doc Version 5.1 Page 29 - 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. 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