Inspection on 12/01/06 for Murray House

This inspection was carried out on 12th January 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.

Other inspections for this house

Murray House 06/12/06

Murray House 02/08/05

Murray House 22/02/05

Murray House 13/07/04

Murray House 30/01/04

Murray House 03/09/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Murray House Royal Borough of Kingston Community Care Services Acre Road Kingston Upon Thames Surrey KT2 6EE Lead Inspector Diane Thackrah Unannounced Inspection 12th January 2006 11:55 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 Murray House DS0000033769.V277906.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. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Murray House Address Royal Borough of Kingston Community Care Services Acre Road Kingston Upon Thames Surrey KT2 6EE 020 8547 6300 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) Community Care Services Miss Nicola Axon Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Approved only for persons aged 60 years whose assessed needs can be met by the Home. 2nd August 2005 Date of last inspection Brief Description of the Service: Murray House is a purpose built resource centre, built in 1974 and owned and operated by The Royal Borough of Kingston Upon Thames. The resource incorporates a day centre which provides a range of activities and events for older people from throughout the Borough, and a care home providing 38 residential places. The home is situated in a residential area of north Kingston, yet is close to the town centre and local transport facilities. Murray House is one of four resource centres for older people operated by the Community Care Services division of The Royal Borough of Kingston. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place between 11.55 and 15.30. A partial tour of the premises took place and care records were examined. Observations of care practices occurred. The Acting Manager, staff members, and a number of service users were spoken with. What the service does well: What has improved since the last inspection? There have been a number of environmental improvements since the last inspection. Toilets on the ground floor have been refurbished and a new visitors area has been created. A Requirement made at the last inspection regarding the need to ensure that a service user’s bedroom does not have an offensive odour has been met. Staff training has been ongoing Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 6 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. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 There is a detailed Service User Guide and Statement of Purpose, however, there is a need for minor improvements to these guides to ensure that service users have the information they need. There are, in general, good arrangements for ensuring that service users have their needs assessed prior to them moving into the home. However, a failure to fully assess the needs of prospective service user’s may result in their needs not being fully met. EVIDENCE: There is a Service User Guide and Statement of Purpose that provide information required by Regulation. Copies of these were available in the bedrooms viewed. There is a need to ensure that there is clear information in the Service User Guide about how to make a complaint to the home, and to the Commission for Social Care Inspection. A staff member said that there are plans to update information in these documents and compliance with this will be examined at the next inspection of the home. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 9 In general, there are good arrangements for ensuring that the needs of prospective service users are assessed. There was a written needs assessment in place for the most recent admission to the home. The needs assessment was detailed and included information about the health, personal and social care needs of the service user. A social history had been compiled which included information about the service user’s leisure interests. Risk assessments had been completed as part of the assessment. However, there were no records detailing that a risk assessment in relation to moving and handling had been carried out. The Acting Manager reported that it is normal practice to ensure that any risks in relation to moving and handling a service user are assessed and recorded, prior to them moving into the home. A moving and handling risk assessment must be carried out for this service user and systems must be put in place for ensuring that no other service user moves into the home without such an assessment. The home must be confident that it can meet a service user’s needs before it agrees to do so. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 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): 7, 8 and 10. There are, in general, good arrangements for planning for care, however, there is a need to ensure that care is reviewed in order to ensure that the individual health, personal and social care needs of service users continue to be well met. EVIDENCE: Service users spoken with were content with life in the home. One service user said, “I couldn’t wish for better care” and another service user said “The staff are very good” Individual service users have a plan detailing how staff members should address their needs. The Service User Plan for the most recent admission was examined. This set out in detail how staff would meet their needs. There were daily observation notes that indicated that staff members provided care in accordance with the Service User Plan. The Service User Plan detailed how staff members should observe dignity and privacy and how the service user could maintain their independence. One staff member said that Service User Plans are reviewed on a monthly basis. However, there were no records detailing that the most recent admission’s Service User Plan had been reviewed. Service User Plans must be reviewed at least monthly, taking into account the views and wishes of the service user, or their representative. Records of these reviews must be maintained. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 11 The last inspection of the home highlighted that medication was, in general handled safely. A recommended was made that the date of opening is recorded on eye drops as an additional measure for ensuring that they are not used after there ‘use by’ date. A number of eye drops examined during this inspection had been labelled with the date when opened. However, there was one container of eye drops in use that did not have the date of opening recorded. It is strongly recommended that all staff members responsible for handling medication be reminded about their responsibility for labelling eye drops. Also, there was a fridge containing medication on the top floor of the home that was unlocked. All medication must be stored securely at all times. Records indicate that issues about respecting service users, and upholding their dignity, are discussed with staff members during induction. One service user spoken with said that staff members consulted with them about daily living issues. Staff members were observed to share respectful interactions with service users, and to knock on bedroom doors, and wait for a response before entering. Some service users have a private telephone line in their bedroom and all bedrooms are for single occupancy. One service user confirmed that the home has a good laundry service. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 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 and 15. There continues to be a varied activities programme and wholesome and enjoyable meals are provided; therefore differing expectations and lifestyles are well catered for. EVIDENCE: An activities programme is available for those service users who wish to take part in organised activities. The home’s notice board detailed that there would be a film club and a newspaper reading group on the day of this inspection. A number of service users were noted to be taking part in the reading group. Other service users were spending time in their bedroom, or sitting in one of the communal lounges. Records and photographs highlighted that activities such as shopping, artwork and theatre visits have recently taken place. One service user said, “We had a marvellous Christmas here, they really know how to put on a good Christmas party” Another service user said that the Christmas party in the home had been “Fantastic” Since the last inspection of the home new furniture has been purchased for a new ‘visitors area’ This has created a comfortable and more private area for service users to spend time with their visitors. The Acting Manager said that this area had been well received by many service users and visitors. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 13 Records detail that there continues to be a varied menu with choices available. One service user said that the cook always cooks something different for them if they do not like what is on the menu and another service user said that they liked the meals provided. Minutes of a recent service user meeting detailed that service users have been given opportunities to discuss menus. Some service users have complained that some meals are not served hot enough. The Acting Manager said that action has been taken to address to issue. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 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 and 18 There is a system in place for the effective handling of complaints and service users and their relatives are encouraged to raise any concerns they have. Service users therefore know that their concerns will be acted upon. Arrangements are in place for handling allegations and instances of abuse. This ensures that service users will be protected from harm. EVIDENCE: The home’s complaint book was examined. No complaints have been logged since the last inspection of the home. The home has plans to amend the Service User Guide to ensure that information about how to make a complaint is clear. Staff members spoken with confirmed that they had undergone training in the protection of vulnerable adults and there were training records to back this up. The most recent staff member was spoken with and was well aware of the home’s ‘Whistle Blowing’ procedure. The home has a copy of the Royal Borough of Kingston Upon Thames adult protection procedures. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 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 and 26. The home continues to be maintained, decorated and furnished to a good standard and in general facilities are clean and safe. This ensures that service users live in a pleasant, homely and comfortable environment. However, a shortfall in hygiene maintenance has potential for placing service users’ health and well being at risk. EVIDENCE: The building and grounds were well maintained, homely and comfortable. A service user said that there bedroom was always kept clean and tidy. There have been a number of environmental improvements since the last inspection. Toilets on the ground floor have been refurbished and a new visitors area has been created. The Acting Manager said that a review of the lighting in the home has recently been carried out and there are plans to improve lighting throughout the home. The kitchen was found to be well organised and generally clean. Requirements made at an Environmental Health Inspection on 13/12/05 have been addressed. There were records of fridge and freezer temperatures and cleaning schedules. A Requirement was made at the last Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 16 inspection of the home regarding the need for a fridge base and seal to be cleaned. It was noted that this fridge had been cleaned, however, there remains a need for further cleaning and the Requirement is repeated. All other areas of the home viewed were clean and hygienic. Action has now been taken to remove the unpleasant odour in one service user’s bedroom and this is no longer an issue of concern. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 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, 29 and 30. The numbers and skills mix of staff members are sufficient to meet the needs, and ensure the safety of the current service user group. The procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. EVIDENCE: Staffing levels, evidenced in staff rotas, and in numbers on shift at the time of this inspection were found to be appropriate and safe, in accordance with the care and social needs of the service users. There was a skills mix of staff on shift, including management and care staff, cleaners, a laundry worker, a kitchen assistant and cook and administration staff. All service users spoken with spoke very highly about staff members. One service user said that staff members are “wonderful” and another said that staff members have “such patience” There were records detailing that thorough pre recruitment checks had been made in relation to three new staff members, including Criminal Records Bureau and Protection of vulnerable adults checks. However, only one written reference was available for one of these staff members, and a copy of their Criminal Records Bureau check did not contain details about their Protection of vulnerable adults check. The Administrator stated that this staff member had previously worked in another the Royal Borough of Kingston Upon Thames care Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 18 home, and had undergone all necessary checks. These checks should be made available at the next inspection of the home. There are good arrangements for staff training. The home has implemented an induction and foundation training programme that is in line with Skills for Care specifications. Records were available detailing that the most recently employed care staff member had undergone a thorough induction programme that had been supervised by the Registered Manager. Training records detail that since the last inspection of the home training has occurred in ‘Care and Control of Medicines’ ‘Managing Conflict’ ‘Protection of Vulnerable Adults’ ‘Recording Skills’ and ‘Stroke Awareness’ Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 19 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 and 38. There continues to be good leadership and guidance to staff members, ensuring that service users receive consistency and good quality care. There are good systems in place for maintaining safety in the home. This ensures that service users are protected and that their well being is prompted. EVIDENCE: The home has consistently demonstrated a consistent and well-organised approach to the provision of care and is clearly run with the best interest of service users in mind. There has been a change in manager since the last inspection. Both staff members and service users report that this change in leadership has been managed well. The new manager has good experience and qualifications necessary for managing the home. She has stated her intentions to make an application to become registered with the Commission for Social Care Inspection. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 20 Health and safety issues are managed well. At the last inspection of the home it was noted that all necessary safety checks in the building had been carried out. Induction records for new staff member’s detail that training in safe working practices occurs. Fire records were examined. These detailed that regular fire alarm tests and fire drills are carried out. There is an updated risk assessment in relation to fire in the building. The most recent visit to the home by The London Fire and Emergency Planning Authority was in February 2004 and the home was found to comply with fire safety regulations. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 21 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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 22 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 OP3 Regulation 13 (4)(b) Requirement The Registered Provider must ensure that a risk assessment in relation to moving and handling is carried out for all service users at the point of moving into the home. The Registered Provider must ensure that Service User Plans are reviewed at least monthly with records kept. The Registered Provider must ensure that medication is stored securely at all times. The Registered Provider must ensure that the kitchen fridge is kept clean at all times. Repeat Requirement. Timescale of 01/09/05 unmet. Timescale for action 01/02/06 2. OP7 15 (2)(b) 01/02/06 3. 4. OP8 OP28 13 (2) 23 (1)(a) 16 (2)(j) 01/02/06 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000033769.V277906.R01.S.doc Version 5.1 Page 23 Murray House 1. Standard OP9 The Registered Provider should ensure that the date of opening is recorded on eye drops that are prescribed to service users. Murray House DS0000033769.V277906.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. 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