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Inspection on 30/06/05 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 30th June 2005.

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 residential care and day care. It offers flexible services, including regular respite care to service users in the area and is the base and contact point for the home care team supporting service users in the wider community. Staff recruitment practices are thorough and appropriate training is provided. Care staff, provide attentive, friendly care and support and have a good knowledge of service users` needs. Domestic staff ensure that the premises are kept clean and homely and welcoming. The centre is fully adapted to provide care for older service users. Service users are complimentary about the quality of food provided. Clear lines of accountability exist within the centre and the quality of the service provided is closely and regularly monitored.

What has improved since the last inspection?

Mountview now receives support from a Specialist Practitioner Nurse from Eastern Cheshire Primary Care Trust on a sessional basis, usually every Tuesday. The input has proved to be beneficial to both service users and staff and has aided the assessment process and liaison with General Practitioners. New armchairs and dining chairs have been provided to Astbury Lounge and two additional electrically operated/remote controlled beds have been provided within the centre. Much staff training has taken place and 45% of staff are now qualified to NVQ level 2 or above. The amount of activities on offer has increased; two care assistants are now in post specifically to plan and organise a programme of activities for service users. A service user involvement group is being encouraged.A folder entitled `Information and Briefing Documents for All Staff` kept within the staff room has helped communication with the staff group and keeps them aware of any changes. Each new member of staff now receives a personal induction handbook which, helps to inform practice and is kept in the employees personal development portfolio for future reference. This booklet provides guidance about whistle blowing to advise staff and to safeguard service users. The Fire Policies, Procedures Manual and Record Book has recently been reorganised and provides clearly presented and up to date information. A new medication policy has been drafted and is being considered.

What the care home could do better:

Greater care could be taken when recording information within the care folders as some information provided was contradictory and the assessments of functional abilities were not always dated. The records regarding medication were incomplete in some cases. There were unexplained gaps in recording and inappropriate omission codes used. Some medication was not securely stored within bedrooms. The quality standards department has been asked to review the `Death Procedures and Funeral Arrangements` policy and provide clearer guidance for staff about who would take responsibility to notify the doctor if a death occurs when the manager is unavailable. Staff members await adult protection training, which, is currently being planned. The management and staff hope to encourage the involvement of local community groups within the centre. The manager is considering ways to improve storage facilities within the home. Several bedrooms need lockable storage space and need to be redecorated in keeping with the rest of the facilities. Staff members should ensure hygienic practices when storing items that need laundering. COSHH products must be safely stored and a fire door giving access to the electrical switchgear must be kept locked. Care should be taken to ensure the records of service users personal allowances are accurate.

CARE HOMES FOR OLDER PEOPLE MOUNTVIEW COMMUNITY SUPPORT CENTRE Melton Drive Congleton Cheshire CW13 4YE Lead Inspector Sue Dolley Announced 30 June 2005 09:00 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. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mountview Community Support Centre Address Melton Drive Congleton Cheshire CW13 4YE 01260 272925 01260 272925 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) Cheshire County Council Helen Margaret Riley Care Home 36 Category(ies) of OP Old Age (36) registration, with number PD Physical disability 55-64years (5) of places PD Physical disability 52-53 years (1) MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 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 of OP (old age, not falling within any other category) * Within the total of 36, up to 5 service users in the category of PD (physical disability) within the ages of 55 and 64 years, may be accommodated * 1 named service user aged 52 to 53 in the category of PD for a period of respite care from 7th February for approximately six weeks 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 3 November 2004 (Wednesday) Brief Description of the Service: Mountview is a community support centre providing personal care and accommodation, on a shortstay/respite basis, for 36 older service users and up to 5 people with disability aged bewteen 55 and 64 years. It is owned and managed by Cheshire County Council, which operates a number of similar facilities in Cheshire. Mountview is in Congleton, close to a small shopping arcade with a variety of shops including two supermarkets, a post office, a newsagent, a chemist a bakery and a public house. It opened in August 1988 and consists of a twostorey building. Part of the ground floor has been adapted to provide office accomodation 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 F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on 30th June 2005 over 9 hours to assess if service users’ needs were being met. A tour of the premises included all bedrooms, the kitchen and laundry and shared areas such as lounges and dining areas, shared bathrooms and toilets. Several members of the management and care staff on duty, and 4 service users were spoken to. What the service does well: What has improved since the last inspection? Mountview now receives support from a Specialist Practitioner Nurse from Eastern Cheshire Primary Care Trust on a sessional basis, usually every Tuesday. The input has proved to be beneficial to both service users and staff and has aided the assessment process and liaison with General Practitioners. New armchairs and dining chairs have been provided to Astbury Lounge and two additional electrically operated/remote controlled beds have been provided within the centre. Much staff training has taken place and 45 of staff are now qualified to NVQ level 2 or above. The amount of activities on offer has increased; two care assistants are now in post specifically to plan and organise a programme of activities for service users. A service user involvement group is being encouraged. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 6 A folder entitled ‘Information and Briefing Documents for All Staff’ kept within the staff room has helped communication with the staff group and keeps them aware of any changes. Each new member of staff now receives a personal induction handbook which, helps to inform practice and is kept in the employees personal development portfolio for future reference. This booklet provides guidance about whistle blowing to advise staff and to safeguard service users. The Fire Policies, Procedures Manual and Record Book has recently been reorganised and provides clearly presented and up to date information. A new medication policy has been drafted and is being considered. 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. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 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 MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 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) 2, 3 and 6 The admission process is well managed. Needs assessments are thorough, ensuring that care needs are identified. The people who stay at Mountview, and their relatives, know what to expect and that their needs will be met. EVIDENCE: One service user living at the home for the long term and had a suitable statement of terms and conditions/contract. All service users’ needs are assessed before they receive care at the home. Mountview gathers information from the potential service users, their relatives, social services and health care representatives to ensure individual assessed needs can be met. 3 service users’ care files were checked. The assessments and care plans were positively written, self-care abilities were described, and relevant information and contacts were provided. Records of health visits had been completed advising of symptoms and treatment prescribed. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 9 Conflicting assessment information was found in one care file about functional ability and behaviour and information about a significant event was not found in the care folder. See Recommendation 1. Two intermediate care beds are and 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 assessed needs of service users admitted for rehabilitation. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 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 and 11 Service users are looked after very well in respect of their health and personal care needs and family carers are also supported. Service users are closely monitored, with potential health problems promptly addressed by the appropriate health care services. Staff members treat service users with respectfulness and courtesy. Service users` independence is encouraged and their dignity and privacy is maintained. EVIDENCE: The service user’s care manager prepares an assessment of need and care plan which highlight any possible problems, before service users move into the home. These are compiled with information from service users and their family. The information is used by the care co-ordinator to develop a care programme to provide all necessary details to the care staff regarding the level of care and support necessary during a persons stay. Copies of the care programme are kept in the service user’s room whilst they are staying at the home and securely in the office. The programmes are updated and signed by staff when they complete the care tasks identified. Advice was given during the inspection, as the assessments of functional ability were not always dated when completed. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 11 Most service users can kept their own GP during their stay at Mountview, as the placements temporary. Where this is not possible, the centre can make arrangements with GP surgeries locally. Mountview receives support from the Residential Homes Nurse Triage Team and in addition a Specialist Practitioner Nurse from Eastern Cheshire Primary Care Trust visits on a sessional basis, usually every Tuesday. Community-based nurses and other health professionals may provide support to service users during their stay. The centre is equipped to meet the care needs of older service users and the care files showed that appropriate referrals for specialist medical and therapeutic care are made. The daily records checked accurately reflected the care provided and indicated continuity of care. Health care needs are closely monitored and care plans are reviewed continuously. 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. All the medication administration records were checked. Each file contained a list of omission codes for staff members to refer to and use and special instructions were provided regarding, for example, when there was a need for staff to prompt service users or to check that medication to be self administered had been taken. Despite these areas of good practice and monitoring, some medication administration records showed the use of an unrecognised omission code. There were some unexplained gaps in the recording of medication and some staff members had indicated administration by ticking the records instead of initialling them. Medication was not securely kept in eight bedrooms. See Requirement 1. A new county -wide medication policy has recently been drafted and is at the consultation stage. Care staff were seen to encourage service users to retain their independence and to support them. There was evidence of effective communication throughout the home and between staff. Contacts between service users and staff members were kindly, patient, reassuring and respectful. One of the underpinning values at the centre is treating service users with respect. All staff are instructed during induction on how to treat service users with respect at all times and staff members were heard to use their preferred term of address. Respectful interactions between staff and service users were observed and service users spoken with, described staff members as kindly, courteous and friendly. Staff can refer to a policy entitled Standards of Conduct for Staff, which explains the principles of care and confidentiality. Service users have access to a public telephone and are able to make any calls of a private nature from an office upon request. Any health care visits are undertaken in the privacy of service user’s own rooms. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 12 The management team and senior care staff are very experienced in the care of older people, and would support and supervise care staff in handling seriously ill and dying service users with dignity and sensitivity. A policy and procedure is in place to provide guidance to staff in the event of a death. Although the centre is currently used for short stay/respite care and residential intermediate care it is important that staff have sufficient contact information and/or information regarding service users wishes regarding death and dying should an unexpected death occur. See Recommendation 2. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 13 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 and15. Service users are individually spoken to and encouraged to make choices regarding all aspects of daily life. A high level of liaison and communication is maintained between service users, their relatives and staff, to ensure daily routines are maintained and service users are enabled to maintain contact with people important to them. Regular opportunities for leisure and recreational activities are being planned to ensure sufficient stimulation, social interaction and enjoyment. The food is of a high standard and meals are varied with ample choice to satisfy service users` preferences and dietary needs. EVIDENCE: A recent re-organisation of available staffing hours has enabled the centre to provide 2 care assistants to plan and organise regular and appropriate activities for service users. Activities are arranged for 10-day care service users and day care and short-term service users share joint activities. Planned activities and events were advertised on notice boards. There are plans to encourage and facilitate a service user involvement group and a recent application has been made to The Princes Trust to request a sensory garden. 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 were able to see their visitors in private, at any time. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 14 A local primary school visits at harvest festival time and work experience is provided for pupils from two local schools. Apart from this there is little involvement by local community groups. See Recommendation 3. The written information produced for the home, and conversations with staff reflected a clear understanding that service users are encouraged to remain autonomous and independent. Service user preference sheets are completed to record personal choices. Bedroom furniture can be arranged to suit individual needs and preferences and service users can bring along some personal possessions to make their stay more comfortable. Service users have a choice of meals and mealtimes and can eat in the privacy of their rooms if they prefer. A copy of a three-week menu cycle was seen. This identified meal options for each day. The main meal of the day is served at lunchtime, with a choice of two first courses, a choice of sweet, or cheese and biscuits, or fruit. Cooked breakfasts are available if ordered in advance and alternative meal selections are always available. Small satellite kitchens next to lounge areas were well stocked with food to enable service users to have snacks when required. The catering staff review the menus three times a year and try to incorporate popular meal choices and favourites. Care staff always advise catering staff of any special dietary requirements and food allergies. Several service users were complimentary about the food provided during their stay. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 15 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 and 18 Arrangements are in place to protect service users and to respond to their concerns; to ensure they stay safe and are satisfied with their care. EVIDENCE: Cheshire County Council’s policy is to receive all critical comments positively. Mountview uses the local authority’s complaints procedure. Service users are encouraged to speak freely to staff if they feel unhappy about the care or surroundings. If a service user cannot get satisfaction by speaking to a senior member of staff, they are invited to make a formal complaint. A leaflet outlining the complaints procedure is included in the service user guide held in each bedroom. Staff members encourage feedback, give support in making comments and complaints and will contact the care manager. The complaints file was seen. One complaint had been received since the last inspection. A complete record of the complaint was retained, and included full details of the action taken as a result. Cheshire County Council’s adult protection procedure is known and understood by staff and managers at the centre. There is an adult protection protocol on file for staff to view and a copy of the recently updated Department of Health ’No Secrets’ guidance is to be issued shortly. Further adult protection training is going to be provided to staff and has commenced with training for managers and for purchasers of services. Care staff have been given some guidance notes until training is available. The guidance tells care staff what constitutes abuse and the processes for addressing the issues. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 16 A leaflet explaining Cheshire County Councils ‘Integrity Code’, which deals with preventing fraud and corruption, is given to staff during their induction. A leaflet entitled ‘Whistle Blowing and You’ is available along with further information supplied in a new handbook for new employees to encourage staff to pass on their concerns about bad practice and to safeguard service users. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,24 and 26 Mountview Community Support Centre is well maintained and clean with only a few areas requiring redecoration and some additional furniture. The centre provides a comfortable, homely and welcoming environment for service users. EVIDENCE: The location and layout of the centre is suitable for the needs of the service user group. A programme of routine maintenance and renewal of the fabric and decoration was being implemented and recorded. Maintenance logbooks, premises log books and service records were well kept and detailed all improvement work and safety checks undertaken. Since the last inspection, 14 new armchairs and 20 new matching dining chairs have been provided in one lounge. Staff and service users have helped to plant many flower baskets and pots. Ample communal space is provided in which a variety of social activities can take place. Lounges are homely and varied in size and dining areas are attractively presented with neatly laid tables. The adjacent satellite kitchens are well equipped. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 18 Clearly marked accessible toilets for service users are, close to lounge and dining areas. Each service user has a toilet close to his/her private accommodation. All toilet areas, washing and bathing facilities are clean and well maintained. A large well -equipped shower room is now available, which helps to promote service user independence. The sluices provided are located separately from service users’ toilet and bathing facilities and are also well maintained and clean. 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 lift. There are 2 electrically operated beds, a specialist commode, grab rails, hoists, a toilet for the disabled and other aids to assist service users who have mobility difficulties. The call alarm system was tested and staff members responded promptly to the alarm call. Since the last inspection staff have spent time reorganising cupboard space to improve storage for records and other items. There is a lack of storage space for larger equipment. See Requirement 2. All bedrooms were seen. Service users have comfortable bedrooms encouraged to bring in some small personal items to make them feel during their stay. Advice was given as 2 bedrooms were odorous and in one toilet was sticky possibly due to use of an inappropriate substance. and are at home the floor cleaning Three bedrooms require some lockable space for storage, 1 bedroom had a wardrobe with ill fitting doors, 3 bedrooms had cracks to plasterwork, 3 bedrooms were in need of redecoration, 1 bedroom had a hole in the wall where previous electrical work had not been capped, 1 washbasin in a bedroom had a dripping hot water tap and the ceiling to one corridor area needs to be repainted. See Requirements 3 and 4. Cheshire County Council has produced policies and procedures for the control of infection to guide staff members in the use of basic good hygiene practices. The laundry and kitchen areas are well equipped, clean and well organised except that used tea towels, a hand towel and an apron were on the laundry floor awaiting washing. See Recommendation 4. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 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 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 and 30 The generous staffing levels ensure service users’ needs are met promptly and staff members have time to spend with individuals. Appropriate staff training is provided, and staff members are keen to complete training to ensure they are competent and confident to do their jobs. EVIDENCE: Staff rotas were seen, showing sufficient care staff, domestic staff, kitchen and maintenance staff, are employed to ensure the smooth running of the centre. At least 3 care assistants and 1 senior carer are on duty for each day and evening shift. In addition a member of care staff gives extra support between the hours of 9.00am and 4.30pm. Two members of staff are on waking duty each night. As the occupancy levels increase the staffing ratio is kept under review and is increased as necessary. Training continues to progress for staff who have been registered for NVQ levels 2 and 3. 45 of care staff now have NVQ level 2 or above.1 member of staff is to be registered for NVQ level 4 training, 1 member of staff holds a current first aid certificate and 7 members of staff have been trained to administer medication. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 20 All staff members have received appropriate fire training and recently several staff have attended a palliative care training course, a supervisory skills course and risk assessment training. Future planned training will include diversity and adult protection awareness training. A process for training nominations has been developed and individual training records are kept on a computer database. A folder entitled ‘Information and Briefing Documents for All Staff’ is kept within the staff room. This helps to increase staff awareness of some of the current policies and briefing documents and provides staff with useful reference material for their NVQ training. Each staff member is given a personal induction handbook. This includes a personal induction checklist and useful reference information for guidance. A sample of three recruitment files showed a thorough recruitment procedure was in place to ensure the protection of service users. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 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 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) 33,35,37 and 38 Mountview has good organisation systems and clear lines of accountability, which enables it to run in the best interests of service users and their relatives. Careful attention in the recording of service users’ finances would ensure greater accuracy. COSHH products need storing securely. The fire door to the room containing switchgear must remain locked to maintain safe working practices. EVIDENCE: Mountview, as all other local authority support centres in Cheshire, operates a user forum system, which enables and encourages service users to voice their views on care arrangements. A well -used quality standards questionnaire, is given to service users every twelve months or at the end of their short stay, to obtain their views of the service received and the manner in which this was achieved. Quality standards questionnaires seen, provided positive comments regarding the care provided. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 22 There was evidence of self- monitoring of the service and of a good system of communication between management, staff and service users within the centre. Four examples of service users’ balances of personal monies held for safekeeping and the related records were checked. One discrepancy was found. The actual money held amounted to £20.00 more than the records indicated. See Recommendation 5. Through looking at records and talking with service users, it was clear that individuals can access their records and see personal information held by the centre, as well as help maintain their personal records. Individual care plans had been signed by service users. Individuals had also signed receipts for property and money kept by the home. Individual and home records were securely kept. The management staff ensure that staff members receive suitable induction training in moving and handling, fire safety and infection control. A detailed training record is kept for each member of staff. Maintenance records are well kept and showed that appropriate maintenance of electrical equipment and central heating equipment had been undertaken. The COSHH file and all products used were itemised with guidance notes provided. A record of accidents was fully completed. The fire policies and procedures manual had been reorganised and was well maintained and a fire risk assessment was in place. Accident records were thoroughly completed and a certificate of employers liability insurance document was in place. Advice was given as 2 blocks of bar soap were present in a communal bathroom and cleaning brushes and a dustpan were inappropriately stored in a dry goods area. To improve safe working practices the door to the room containing electrical switchgear must remain locked and staff must not store their personal belongings in this room. The metal cage to the outside of the building near to the laundry is used to store some corrosive cleaning solutions must also be kept locked. See Requirement 5. MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 23 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 x 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 1 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 2 x 2 x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 2 x x 3 x 2 x 3 2 MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 24 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. Standard 9 Regulation 13 Requirement Arrangements must be made for the accurate recording, administration and safe storage of medication. Ensure that suitable provision is made for storage for the purposes of the centre.(This requirement was made at the previous`inspection on 3.11.04). Provide lockable space in service users bedrooms. Ensure all parts of the home are reasonably decorated. Keep the door to the room containing electrical switchgear locked and do not allow staff to store their personal belongings in this room.Keep the metal cage to the outside of the building near to the laundry locked to ensure safe storage of some corrosive cleaning solutions. Timescale for action 31.08.05 2. 22 23 31.10.05 3. 4. 5. 24 24 38 16 23 23 30.09.05 30.11.05 31.08.05 MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 25 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 3 Good Practice Recommendations Ensure information about significant events is included in the care folders and that all information within the care folders is accurate and not contradictory. . Ensure staff have sufficient contact information and/or information regarding service users wishes regarding death and dying should an unexpected death occur. Encourage involvement in the home by local community groups and/or volunteers to accord with service users preferences. Ensure all laundry is placed in suitable storage containers prior to washing. Ensure accurate records are kept of service users money. 2. 3. 4. 5. 11 13 26 35 MOUNTVIEW COMMUNITY SUPPORT CENTRE F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, 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 F51 F01 S36720 Mountview V224236 300605 Stage 4.doc Version 1.30 Page 27 - 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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