Inspection on 07/07/08 for Murreyfield House

This inspection was carried out on 7th July 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Murreyfield House 10/07/07

Murreyfield House 20/07/06

Murreyfield House 12/01/06

Murreyfield House 18/08/05

Murreyfield House 24/02/05

Murreyfield House 21/04/04

Murreyfield House 18/03/04

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Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Murreyfield House 342-344 Beverley Road Hull East Yorkshire HU5 1LH Lead Inspector George Skinn Key Unannounced Inspection 7th July 2008 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 Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 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. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Murreyfield House Address 342-344 Beverley Road Hull East Yorkshire HU5 1LH 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) 01482 492778 01482 470084 Carol Lesley Olive Murrey Mrs Ann Elizabeth Murrey Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23) of places Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th July 2007 Brief Description of the Service: Murreyfield is one of two homes privately owned by Carol Murrey and is part of a small family run business with a sister home in Cottingham. Murreyfield was originally two terraced townhouses that have been converted into a care home. The home is registered to care for up to 23 older people of either gender, who may also suffer from dementia. Accommodation is on three floors with 9 double and 5 single rooms. Communal space consists of a 3 separate lounges and an open plan lounge/dining area. There is an enclosed patio/garden area to the rear of the home. Murreyfield is situated on Beverley Road approximately 1 mile from Hull city centre. Nearby are local shops, pubs, churches and the home is on a major bus route into Hull. There is some available car parking to the rear of the home and on nearby side streets. The current scale of charges are £348.50 per week. Additional charges include hairdressing, chiropody, magazines, papers, toiletries and taxis when requested. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment (AQAA) Comment cards returned from people who live at the home, relatives and staff A visit to the home carried out by one inspector. A site visit was carried out which lasted 6 hours. We spoke with the people who live at the home, their relatives and staff. Records relating to the people who live at the home, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home The Deputy Manager was available to assist throughout the day. What the service does well: The people who live at the home told us they liked living there; one person said, “It’s like home from home”. They told us that the food was good one person told us that “there is always plenty of it and there is always a choice at all meal times”. They told us that they could come and go as they pleased. They told us that there were plenty of activities to choose from but they did not have to join in these if they didn’t want to. We saw that the home encourages people to be as independent as possible but there were always the right amount of staff on duty to help people and make sure they are cared for properly. We saw that the staff receive a lot of training about the need of older people and that they are trained in those areas which protect people from harm. We saw that the home make sure all the proper checks have been done before someone starts working at the home. This makes sure the people who live at the home are protected from harm. We saw that the home makes sure that they have all the information they need before some one comes to live at the home so they can meet their needs properly. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 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 Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. EVIDENCE: We looked at the files which belong to the people who live at the home and these contained evidence of a full needs assessment being made prior to them moving in by both the home and the placing authority. We saw that the assessments involved all relevant parties including the person or their relatives. The home then develops a care plan from their own assessment and the local authority’s assessment. The home does not admit people for intermediate care. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine the care home supports them with it in a safe way. EVIDENCE: We looked at a number of care plans, which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan; these contained risk assessments around the area of falls, tissue viability, nutrition and diet. At the last inspection it was noted that some of the care plans had not been agreed with the person or their representative, we saw that this had now been done. We saw that the care plans looked at had been updated regularly and changed along with the changing needs of the person. The daily notes were comprehensive and reflected how the home met the needs of the people who live there. Risk assessments were in place for those people who had bedrails fitted to their beds to ensure their safety; we Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 10 saw that these were in line with current guidelines and recommendations issued by the Department of Health. We saw that the people who live at the home can access healthcare professionals like doctors and nurses when needed, some people also have input from specialist nurses like community psychiatric nurses (CPN). Some people have involvement with psychiatrists, specialist social workers, physiotherapist and dieticians. Occupational therapist, optical, dental and chiropody services are arranged when needed. When we spoke with the staff they were clear about how to maintain someone’s dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when dealing with those people who have dementia. At no time did we hear any of the staff using any derogatory language or belittling any one in any way. We saw that staff treat the people with respect and their dignity was upheld. Shared rooms are fitted with privacy curtains and staff were observed to take people to their rooms if they needed any personal tasks undertaking. We looked at the way the home handles and stores medication. We saw that the way this was done ensures the safety of the people who live at the home. The medication was stored in the proper cabinets and secured in a locked room. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can take part in activities that are appropriate to their age and culture and are part of their local community. People are able to keep in touch with family and friends. People are helped to be as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. EVIDENCE: The home provides activities for the people who live there to join in with if they wish. We saw that people’s interests are recorded on their care plans. At the last inspection it was noted that some of the people who live at the home were sat for long periods of time un-stimulated, especially those with dementia. During this visit we saw that staff were more proactive in engaging those people with dementia, we saw examples of good interaction and a sensitive approach from the staff. At the last site visit it was noted that the main lounges were being used as a thoroughfare and many times when staff walk through there was no Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 12 interaction with the people who live at the home. During this visit we saw that staff were more sensitive when walking through the lounges and we saw them interacting well with the people who live at the home. The homes AQAA indicates that improvements that have been made in this area are: “Trained a member of staff to co-ordinate activities tailored to individual needs. Made staff more aware of not using the lounges as thoroughfares and to use an alternative route when possible. In the event that the lounge has to be used in this way, staff has been made more aware of interacting with the residents at this time. Spent more time with service users with dementia to give them the opportunity to engage in meaningful activities. Appointed a full time cook. Regular audits have been carried out by key workers on toiletries etc”. At the time of the site visit the assistant cook was on duty and we saw that she was coping very well in cooking the mid day meal and preparing for the evening teatime meal. People who we spoke with were complimentary about the food provided they told that the meals were very nice and that there was plenty to eat, one man told us that “the meals here are second to none”. We saw that visitors were made welcome at the home and they told us they were more than satisfied with the over all service offered by the home. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. If people have concerns with their care they, or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. EVIDENCE: The home continue to have a complaints procedure and this is made available to the people who live there and their relatives. Information on how to make a complaint is posted a round the home The AQAA sent back by the home indicated that no complaints have been received by the home since the last inspection. The CSCI have received no complaints about the home since the last inspection. In discussion with the people who live at the home they were aware that they had the right to make complaints and told us that they would talk to their key worker or the manager. The home has a policy and procedure for safeguarding adults and the staff interviewed were aware of this, all had received training about Protection Of Vulnerable Adults (POVA). They told us that they were confident that if they Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 14 had concerns the management would take these seriously and deal with it properly. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. EVIDENCE: The home was generally clean and tidy. People’s rooms were clean and there were no malodours. The home provides the equipment to meet people’s needs; we saw staff using hoists to help those people who had limited mobility. The home provides the require amount of toilets and bathrooms. We saw that one of the bathrooms on the ground floor has been refurbished since the last inspection and the bath provided better meets the needs of the people who live at the home. There are two lounges for people to choose from but the majority tend stick to the same lounge. There is a seating area near the dining area and those Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 16 people who are more dependent on the staff to meet their needs sit in this area. The majority of the accommodation in the home is in shared rooms there are no en-suite facilities. There was written evidence that people have agreed to share a room. The home has limited ability to accommodate those people who do not whish to share; however, one person has a double room to herself as she chose not to share. We saw that the home have a routine maintenance programme and redecoration is undertaken as and when required. The deputy stated that some bedrooms were due for re-decoration and this would begin soon. The home has a secluded garden to the rear and people can sit in a courtyard area. Those people who smoke also use this area. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. EVIDENCE: There is a satisfactory staff rota in place that records the role of each member of staff. The staffing levels are based on the needs of the people who live at the home. There is a cook on duty each day as well as a kitchen assistant, and other ancillary staff. This enables care staff to concentrate on assisting people with personal and social care activities. There is a separate rota for night staff. Training records indicated that that more than 50 of the staff are trained to NVQ level 2 which includes training on equality and diversity and an awareness of abuse. The recruitment and selection procedures remain robust and all checks are undertaken prior to staff commencing work at the home. The staff files looked at contained references from previous employer; an application form which Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 18 identified gaps in employment and a completed Criminal Record Bureau (CRB) check. There is a training and development plan in place that shows all staff have undertaken core training and that some staff undertake more specialised training such as Challenging Behaviour, Dementia and Palliative care. We saw that staff records include information about individual training achievements and a copy of training certificates is kept on their file. Staff have refresher training as appropriate to ensure that their skills and knowledge are kept up to date. All staff have received mandatory training in Health and safety, Manual handling, Basic Food Hygiene, First Aid and Fire. Staff receive regular supervision and developmental opportunities are given for the staff to attend further training. When we spoke with staff they said they found the training excellent and where pleased that the managers encouraged them to attend lots of training. They felt this gave them the skills needed to care for the people who live at the home. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is run and managed appropriately. The environment is safe for people and staff because health and safety practices are carried out. EVIDENCE: The manager of the home has long experience of caring for older people; she is registered with the CSCI but has not completed the Registered Managers Award (RMA). The deputy is mostly in charge of the daily running of the home and she has the RMA qualification. The homes AQAA tells us that future plans are to submit an application for the deputy to become the registered manager. Every one we spoke to both staff and people who live at the home state that the management team was approachable and listened to what they had to say. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 20 The home have a quality assurance system in place which seeks the views of people who live there; the AQAA submitted by the home states that: “We do regular audits/questionnaires, pre-assessments, speak to residents daily and hold residents meetings and hold reviews. We have a relaxed open atmosphere and residents express themselves freely on a regular basis, this is then noted and decisions can be made.” The home promotes the health, safety and welfare of people there and the staff. Mandatory training and updates are all taking place and a health and safety poster is displayed for all staff to see. All the relevant maintenance certificates were available for us to look at. We saw that all the appliances had been serviced since the last inspection. The AQAA returned by the home was comprehensively completed and showed that the home had plans for future improvement. It showed that the home had identified areas of improvement and were addressing these. The AQAA indicated that the owners of the home felt they could do more but were restricted by the Local Authority fee structure and sited this as the main barrier to improvement. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 2. Refer to Standard OP31 Good Practice Recommendations It is recommended that the registered person submit an application for registration of the deputy manager as the registered manager. Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Murreyfield House DS0000000863.V367233.R01.S.doc Version 5.2 Page 24 - 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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