Inspection on 18/05/05 for Muscliff Nursing Home

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Muscliff Nursing Home 19/07/07

Muscliff Nursing Home 30/05/06

Muscliff Nursing Home 13/10/05

Muscliff Nursing Home 26/01/05

Muscliff Nursing Home 17/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Muscliff 5 Tolpuddle Gardens Muscliff Bournemouth Dorset BH9 3RE Lead Inspector Chris Gould Unannounced 18 May 2005 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. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Muscliff Address 5 Tolpuddle Gardens Muscliff Bournemouth Dorset BH9 3RE 01202 516999 01202 527232 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) Muscliff Medical Limited Miss Dedrey Charles Care Home With Nursing - CRH N 40 Category(ies) of OP - Old Age, not falling within any other registration, with number category (40) of places Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The issued staffing notice must be adhered to at all times and staffing levels increased to meet the dependency levels of service users as necessary. Date of last inspection 18th May 2005 Brief Description of the Service: The Registered Providers are Muscliff Medical Limited a group of four doctors and a pharmascist who registered and opened the purpose built home in 1997. Muscliff Care Home is situated in the northern part of Bournemouth, close to the rural area of Throop, with a neighbouring Medical Centre, Pharmacy, convenience store and community facilities. The home is registered to accommodate 40 service users within the category of old age requiring nursing care. The bedrooms on the first floor are accessed by a passenger lift and the corridors are all spacious with wide doorways. All rooms are for single occupancy and provide en-suite facilities. The home is set in attractive gardens laid mainly to lawn with shrubs, herbaceous borders, paved areas and an ornamental pond. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five and a half hours on one day in May 2005. The inspection assessed 22 standards and the outstanding requirement from the previous inspection. A tour of the premises took place and three staff files and three residents care records were inspected. Twelve residents, seven visitors to the home and the staff on duty were spoken with during the inspection. Dedrey Charles the registered manager was present throughout the day. Christine Main, CSCI Pharmacy Inspector visited the home on the 11th May 2005 to check medicines storage and records and her findings are included in this report. What the service does well: People considering moving into the home are provided with clear information to assist them when trying to decide if Muscliff is the right home for them. A flexible approach is taken in the running of the home. Social activities and entertainment are provided and all the residents spoken with were pleased with the variety and choice available. A varied wholesome and well balanced menu is offered with a choice at each meal. Residents confirmed that the food is ‘good’, ‘sufficient’ and ‘suits me’. Residents spoken with at the home expressed confidence in the systems put in place for dealing with complaints and felt they would be listened to. The home provides a clean, comfortable and well-maintained place to live where residents are able to personalise their own rooms. The residents and visitors described the home as ‘very welcoming’, ‘clean’ and ‘friendly’. Staff training is provided to meet the residents needs. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 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. Muscliff D55 S20452 Muscliff V226881 180505 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 Muscliff D55 S20452 Muscliff V226881 180505 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) 1, 3, The home is not providing intermediate care at the present time therefore standard 6 is not applicable. The systems in place ensures that the resident knows that the home they are moving into provides suitable facilities and that their care needs will be met. EVIDENCE: Muscliff Care Home has a service user guide providing comprehensive detail of the homes provision and services. The information is given to all prospective residents. This was confirmed by the residents and relatives spoken with who agreed that the information provided a clear picture of the services and facilities available. Individual records are maintained for each of the residents. Inspection of three residents records contained a detailed pre admission assessment of care needs including information from professionals previously involved in providing their care. Discussion with staff confirmed that they were aware of the resident’s needs at the time of their admission. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 The care plans do not consistently include the detail required to adequately provide staff with the information they need to satisfactorily meet residents’ needs. Residents’ health care needs are fully met and they are treated with respect and their right to privacy is upheld. There are good systems for recording and administering medicines so that they are given to service users as prescribed. Arrangements for monitoring the correct storage of refrigerated medicines need to be improved for the protection of service users. EVIDENCE: All residents have individual plans of care based on a pre-admission assessment of need. Inspecting one resident’s records, discussion with the registered manager and staff and visiting the resident identified actions that were being taken that had not been included in the care documentation. Two resident’s care records inspected had been evaluated but changes identified had not been made to the action plan. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 10 The records included input from health care services including General Practitioners, physiotherapist, chiropodist and optician. Two residents care records contained documents relating to hospital outpatient appointments and on the day of inspection one resident attended the hospital. The residents spoken with were all in agreement that staff were aware of their needs and the help they required. One resident commented ‘I do as much as I can for myself and they just seem to know what I can’t do, they are very kind’. Staff induction includes respecting residents privacy and dignity. This was confirmed when speaking with staff. Staff were seen knocking on doors and waiting for an answer before entering residents rooms. Residents spoken with said that they were always addressed in the way they had requested. Christine Main CSCI pharmacy inspector visited the home on the 11th May 2005 to check medicines storage and records. Records are kept of the receipt, administration and removal of medicines and a count of a sample of medicines confirmed that they were given as prescribed. Temazepam was not stored in the Controlled Drugs cupboard and legally it must be. Two maximum and minimum thermometers for recording the temperature of the medicines fridge were giving different readings that were outside the recommended range but there was no evidence of any action taken to resolve this. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14,15 A flexible approach is taken in the running of the home and residents are helped to have a choice over their lives. Social activities provide variation and interest for the residents living in the home. Residents are able to maintain contact with their family and friends and to go out into the community if they wish and are able. Residents receive a varied and well balanced diet in pleasant surroundings. EVIDENCE: An activities organiser working thirty hours a week and outside entertainers provide a varied recreational programme. On the day of inspection a coffee morning and bring and buy sale took place for residents and visitors to the home. In the afternoon a number of residents enjoyed a game of bingo. One resident commented that ‘we all really enjoy the bingo’ and this was confirmed when speaking to other people. Posters around the home advertised the summer fete in July and music night later in May, both events to include nonresidents. It is recognised that not all residents are able or willing to participate in organised activities. The residents spoken with confirmed that they have access to books, newspapers and TV. One resident commented ‘I enjoy the music but would rather watch the television or read for the rest of the time’. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 12 All the residents who commented on the food said it was ‘good’, ‘sufficient’ and ‘suits me’. Menus are provided for residents to choose their meals for the day and this is supplemented with a further list of alternatives offering at least five pieces of fruit and vegetables a day. The menus were inspected and found to be varied and well balanced. The book in the reception area contained the names of residents’ visitors to the home and relatives spoken with said that they are made very welcome at any time. A flexible approach is taken in the running of the home. Residents spoken with all said that they choose the time they get up and go to bed, where they have their meals and how they spend the day. One resident commented ‘I can go downstairs but I prefer to stay in my room’. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18 The systems in place provide residents with the confidence that their complaints will be listened to and acted upon and that a safe environment is provided to protect them from abuse. Residents’ legal rights are protected. EVIDENCE: No complaints have been received by the home or the Commission for Social Care Inspection since the last inspection in January 2005. The home’s complaints procedure is available to service users in the Service User Guide. Residents’ spoken with said that they were aware of the procedure and what to do if they had a complaint. Although they had not had to make a complaint felt that if they did action would be taken. Inspecting residents care records and speaking with residents confirmed that they have representatives including family and solicitors to manage their affairs and act as their advocate. All residents are included on the electoral register and were provided with the opportunity to visit the polling booth or vote by post at the recent election. Policies and procedures are in place and staff have received training in adult protection. This was confirmed in discussion with staff and inspecting training records. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 14 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, 23, 24 25, 26 The standard of the environment is good providing the residents with a clean, comfortable, safe, well maintained and homely place to live with access to all areas of the home and garden. Residents are able to personalise their own rooms. EVIDENCE: The home is planning to commence refurbishing all bedrooms starting this year including a change of flooring in the en-suite facilities. A new flute system and valves have been installed in the boiler system to improve the provision of hot water and heating. Visiting residents in their rooms demonstrated that they had been personalised with their own small personal effects. One resident talked about their family referring to photographs and one resident has pictures of their own work displayed on the wall of their bedroom’. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 15 When talking to residents and visitors to the home the words used to describe the atmosphere were ‘very welcoming’ and ‘friendly’. One resident commented ‘very nice, I like it here’. All areas of the home and garden are accessible to residents and visitors. One resident commented that ‘it will be lovely when I can spend more time outside.’ A passenger lift provides access to the first floor. Residents’ bedroom doors are not fitted with locks. Unless their assessment suggests otherwise residents should be provided with locks and keys to their private accommodation to suit their capabilities and accessible to staff. On the day of inspection the home was clean and no malodours were noted. An infection control procedure is in place and all staff have received training. This was confirmed in discussion with staff. One visitor to the home commented ‘home always clean, no smells’. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 16 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) 29, 30 To protect residents, systems are in place to ensure that all checks are undertaken before a member of staff is employed. The staff training provided meets the needs of the residents. EVIDENCE: Three staff files contained the information required to evidence that the home is operating a recruitment procedure to protect the residents. Eight care assistants have achieved NVQ level 3 in care and 6 are currently undertaking NVQ level 2 training. The training records evidenced that all care staff have received training in health and safety, first aid, manual handling, food hygiene and infection control. This was confirmed by the staff spoken with during the inspection. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 17 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) 31, 33, 38 The registered person is fit to be in charge and able to discharge her responsibilities fully. The home is run in the best interests of the residents and their health, safety and welfare is promoted and protected. EVIDENCE: Since the last inspection in January 2005 Dedrey Charles has been registered as the manager of Muscliff Care Home. Muscliff has a residents’ forum with minutes and an action plan. Residents, relatives and friends are invited to join the meetings. N Qualified staff meetings and healthcare assistant meetings take place monthly and the Directors meet six monthly. A newsletter is produced monthly. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 18 The home has purchased and started working through the Registered Nursing Homes Association (RNHA) quality assurance tool. A questionnaire was completed by residents and relatives/friends in September 2004 and by staff in April 2005 in order to measure the home’s success in meeting their aims and objectives. The questionnaires are to be repeated on an annual basis. Fire records inspected showed that all checks on, fire warning, fire fighting equipment, drills and staff training had been completed. Accidents are recorded and evaluated monthly. On the day of inspection the annual check of electrical systems and equipment was taking place. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 19 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 2 x x STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 3 x x x x 3 Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 20 No 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 7 Regulation 15 Timescale for action The resident’s care plan must set 31st August out in detail the action to be 2005 taken by the registered nurses and care staff to ensure that all aspects of the resident’s health, personal and social care needs are met. Action must be taken to ensure 25th May that medicines requiring 2005 refrigeration are stored within the product’s recommended temperature range. Temazepam must be stored in the CD cupboard. Requirement 2. 9 13(2) 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 24 Good Practice Recommendations It is recommended that unless their assessment suggests otherwise residents are provided with locks and keys to their private accommodation to suit their capabilities and accessible to staff unless. Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole Dorset, BH17 0NF 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 Muscliff D55 S20452 Muscliff V226881 180505 Stage 4.doc Version 1.30 Page 22 - 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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