Inspection on 29/12/05 for Musgrave Court

This inspection was carried out on 29th December 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

Musgrave Court 30/11/06

Musgrave Court 18/01/05

Musgrave Court 13/07/04

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

CARE HOMES FOR OLDER PEOPLE Musgrave Court Crawshaw Road Pudsey Leeds LS28 7UB Lead Inspector Chris Levi Unannounced Inspection 29th December 2005 09:45 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 Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 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. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Musgrave Court Address Crawshaw Road Pudsey Leeds LS28 7UB 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) 0113 2146186 0113 2477228 Leeds City Council Department of Social Services Mrs Judith Levine Care Home 36 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (35) of places Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd June 2005 Brief Description of the Service: Musgrave Court is owned by Leeds City Council Social Service Department, and managed by Mrs J Levine. It is a care home providing personal care and support to thirty-six older people with dementia. District nurses provide services to those service users with nursing needs. Three places are allocated for respite services. It is situated in Pudsey a suburb of Leeds and close to the shops and amenities. The home is on two levels and has a passenger lift to the second floor. All rooms are single occupancy without en-suite facilities. The home has mature enclosed gardens and car parking facilities. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. It started at 9.45am finishing at 3.45pm The person in charge at the time of the inspection was Mrs J Levine the registered manager. Most of the day was spent talking to residents, and staff about living and working at Musgrave Court. A number of visitors were at the home during the inspection. Their opinions of the service are included in the report. People living at the home liked to be referred to as residents in the inspection report. Some documents were inspected including, management of residents monies, care plans, staff recruitment files, minutes of meetings with residents and staff and maintenance records. The inspector looked around part of the building. The atmosphere within the home was open, friendly and welcoming. There was evidence Christmas festivities . On the afternoon of the inspection the residents were enjoying a musical get together with an external entertainer. The person in charge was given feedback about the inspection findings at the end of the inspection. What the service does well: The staff team led by the manager provide the residents of Musgrave Court with very high standards of care. The staff use a model of care that is “ person centred.” That is, they treat each resident as individuals, and meet their individual needs, despite the fact that all the residents have dementia. This was observed and confirmed by a visitor who said “ I am very happy with the care provided by staff for my wife.” Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 6 Staff work well as a team. A new member of staff said, “ initially I had concerns about caring for people with dementia, but now it’s the best move I could have made. The staff are great and have been very supportive to me.” The providers, Leeds Social Services, have a very thorough recruitment process for staff employed at the home. This ensures that staff are suitable to work with vulnerable older people. The local health professionals provide an excellent support service to ensure the health needs of residents are met. The management of resident’s personal allowances demonstrated good practice. The home has very thorough systems in place to ensure the health and safety of residents and staff. What has improved since the last inspection? What they could do better: The providers Leeds Social Services should consider issuing respite service users with contracts identifying their rights and responsibilities during their stay at the home. The residents would benefit from additional communal space. The manager did state that funds had been allocated to build a conservatory in January 2006. The grill in the kitchen must be repaired or replaced, as it is faulty. The communal toilet that does not lock must be repaired and consideration should be given to replacing the flooring in the toilets. Staff must be trained in food handling and hygiene. 50 of staff must achieve NVQlevel 2 When new assessment systems are introduced staff must be trained how to use them. The malnutrition form recently sent out is complex and useless without training on how to use it effectively. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 7 Staff who do not attend staff meetings should read the minutes and sign they have understood them. 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. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3. Representatives of, and people who use the service are able to access clear and accurate information to help then decide whether or not they wish to live in the home. All permanent residents are given contracts that states the current charges made by the providers. The contract also identifies the rights and responsibilities of the resident, and provider, for people living at Musgrave Court. Effective systems are in place to assess service user’s needs before admission. EVIDENCE: Written information about services provided at Musgrave court had been updated in September 2005. It identifies that the home provides personal care for people with dementia. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 10 All permanent residents or their family are provided with contracts that identify the financial charges made by the provider. It is recommended that respite residents be issued with contracts. It is positive to note that the providers have introduced a system whereby contracts are reviewed annually. This provides written evidence of accurate charges made to residents by the providers. There was documentation in both care plans looked at confirming residents had been assessed prior to moving to the home to ensure their care needs could be met. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 11 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): 7,8,10,11. Staff at Musgrave Court meet the health and care needs of residents. It was observed and confirmed by a number of residents and visitors that they are treated with dignity and respect by staff at Musgrave Court. Staff with the support of external health professionals can meet the needs of residents in their final illness EVIDENCE: Two care plans were looked at. They contained relevant information to provide staff with information about the care needs of each resident. It is positive to note that they continue to include information about the person before they had dementia. This information is provided by relatives and friends and is essential in enabling staff to provide “person centred care” to the individual residents. Staff at the home ensure they respect residents dignity. They are trained to understand the different approaches needed when caring for people with Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 12 dementia, and they are very good at understanding the individual’s needs and how to meet them in a confident friendly manner. Observation and a visitor confirmed this. Information seen in the Lifestyle plans included how residents prefer to spend their day. A separate plan of care was in place to meet their needs during the night. Staff on a regular basis, to ensure the plans of care were still relevant, reviewed them. Residents nutritional needs appear to be well met. The providers have introduced a new malnutrition assessment form. Staff need to be trained in how to use this for it to be of real benefit to residents who may be at risk of malnutrition. Residents are weighed monthly and those of low weight more frequently. Risk assessments were in place for residents who smoke or at risk from falls. There was evidence they are reviewed regularly. Where a resident has a medical condition such as diabetes, a separate detailed plan of care, accompanied by a risk assessment, should supplement the general information held in the Lifestyle plans. This is in addition to notes completed by visiting district nurses. The manager stated the local GP surgery was able to provide an improved service to residents at Musgrave Court. This now includes weekly routine visits by the GP’s and an annual health check that includes a review of resident’s nutrition, weight, falls, and medication. Other health professionals visit on a regular basis and their visits are recorded in the care plans. Information relating to a residents final illness and subsequent death was recorded in the lifestyles. The manager said she was due to provide training for staff in caring for residents during their final illness. Leaflets were seen of agencies offering bereavement support. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 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 the following standard(s): 12,13. Residents are given opportunities to choose how they spend their day. Residents are supported and enabled to maintain contact with family, friends and the local community. EVIDENCE: All the residents living at Musgrave Court have varying degrees of dementia that affects their ability to care and make decisions for themselves. Despite this, staff have the knowledge and skills to ensure that individual residents likes and dislikes are known. They work hard to offer residents opportunities to make decisions about how they want to spend their day. This was noticed throughout the inspection. A relative praised the work of the staff. “ They make me feel welcome and keep me informed about what’s happening with my wife”. The manager continues to hold relatives meetings and sends out newsletters to inform relatives on what’s going on at Musgrave Court. The November issue Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 14 was looked at and identified the planned Christmas celebrations to which relatives were invited. Social activities are appropriate to the needs of residents with dementia. During the morning a recognition quiz and in the afternoon a lively music session was enjoyed by a number of residents. There was a very happy lively atmosphere. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 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 the following standard(s): 16,18. Systems are in place to protect residents from abuse, and encourage them or their relatives to make complaints. EVIDENCE: Copies of the complaints procedure are displayed in the hallway and lounges. No complaints had been received since the last inspection. Staff undertake training in recognising and reporting any allegations of abuse. Staff understood the term whistle blowing and who to talk to if they had concerns. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 16 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): 19,20,21, Systems are in place to ensure the environment is safe, but also welcoming and comfortable. The residents would benefit from additional internal communal space. Communal toilets are situated on both floors of the home. There are no ensuite bedrooms EVIDENCE: A new carpet has been fitted to the downstairs communal area. As identified in previous reports the residents would benefit from additional communal space. The manager stated that in January 2006 funds have been allocated to incorporate a conservatory and replace all windows in the home. All residents have single occupancy bedrooms. They do not have en-suite facilities. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 17 One toilet did not lock and the floor covering should be replaced. Domestic staff work hard to maintain a clean and odour free environment. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 18 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): 28,29,30. The home has yet to achieve the 50 target of care staff with NVQ level 2. The procedures for the recruitment of staff are robust, and offer protection for people living in the home. The staff team at Musgrave Court are well trained and supported to provide very good levels of care to residents. EVIDENCE: Eight of eighteen care staff has achieved NVQ level 2. A further three are currently undertaking the award. The home will then reach the 50 target of staff with the qualification. The staff recruitment file of one new member of staff was looked at. All relevant information was in place. This included evidence that she had not commenced employment before the results of a CRB check had been received by the employers Leeds City Council social Service Department. All new staff receive induction training this includes caring for people with dementia. The values of respect and dignity in relation to residents with Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 19 dementia are instilled in staff during their induction period. A new member of staff, and looking at their training files confirmed this. Recent training included moving and handling, understanding epilepsy. It was noted and confirmed by the manager that staff that handle food had not received training in safe handling of food and food hygiene. This training must be provided as a priority. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 20 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): 32,33,35,38. Musgrave Court is a very well managed home where residents, relatives and staff are consulted about the standards of service. An annual audit takes place to evaluate the standards of service provided for residents at the home. Robust systems are in place to ensure that residents monies held at the home are secure, but accessible when needed. The health and safety of residents and staff is promoted. EVIDENCE: The manager has a very open style of management. She continues to make herself and the staff team aware of new initiatives and care practices relating to caring for people with dementia. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 21 There was written evidence of regular resident meetings for residents, relatives and staff. The November newsletter to relatives identified the Christmas activities at the home and invited relatives to participate where possible. It is recommended that when staff are unable to attend a staff meeting, they read and sign that they have understood the minutes of the meeting. The manager undertakes an annual quality review of services provided for residents. This includes questionnaires to residents, relatives, staff and external professional that visit the home. The results are evaluated where appropriate changes to the service are made. The manager then writes to all participants telling them of the changes made. This is good practice. The home has a robust procedure for managing resident’s money held at the home. Some residents have a locked drawer facility in their own rooms. However, some residents and relatives prefer that the home hold their personal money. The systems for managing this facility were looked at in detail. One resident’s personal allowance money was checked and accurate. The home has a visiting administrator who undertakes routine weekly audits. The system is such that a resident or relative can, at anytime of day, access money held on their behalf. This is good practice. A very comprehensive health and safety monthly check is undertaken to ensure the safety of residents and staff. A new format was looked at and includes additional checks. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 22 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 x x x x 3 STAFFING Standard No Score 27 x 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 3 x 3 x x 3 Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 23 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. 1 Standard OP15 Regulation 13 Requirement The providers must repair the kitchen grill, as it is unsafe. All staff must undertake food handling and hygiene training. The lock on a toilet door must be repaired. Staff must be trained to use new assessment forms introduced by the providers.50 of care staff must achieve NVQ level 2. Timescale for action 30/01/06 2 3 OP21 OP28OP30 13 18 30/01/06 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP2 OP20 OP32 Good Practice Recommendations Respite service users should be issued with a contract of the providers terms and conditions of occupancy. The home would benefit from additional communal space. Staff who do not attend staff meetings should read and sign the minutes of those meetings. Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Musgrave Court DS0000033196.V264808.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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