Inspection on 13/07/05 for Musmajas

This inspection was carried out on 13th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Musmajas 06/10/08

Musmajas 19/05/08

Musmajas 05/11/07

Musmajas 11/09/06

Musmajas 21/03/06

Musmajas 11/08/04

Musmajas 17/05/04

Musmajas 27/08/03

Musmajas 17/06/03

Musmajas 29/08/02

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

CARE HOMES FOR OLDER PEOPLE Musmajas Priory Hall Wolston West Midlands CV8 3FZ Lead Inspector Suzette Farrelly Unannounced 13 July 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Musmajas Address Priory Hill Wolston West Midlands CV8 3FZ 02476 542701 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) Latvian Welfare Fund Mrs Diane M Springthorpe Care Home 18 Category(ies) of Old Age 18 registration, with number of places Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11 August 2004 Brief Description of the Service: Musmajas is a care home set in its own grounds approximately 1 mile from the village of Wolston. The property is owned by the Latvian Welfare Society and was developed into a care home to serve the Latvian community in the Midlands. The home can accommodate up to 18 service users in single room accommodation. Accommodation is sited in the large manor house and surrounding bungalows. Musmajas provides personal care to frail elderly people most of whom originate from Latvia. The home’s staff consists of English and Latvian speaking carers who can also converse in English. No intermediate or specialist care is offered at this home. Service users with nursing needs are cared for by the visiting community nurses. Medical services are provided by the local GP practice. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection started at 9:30 am and finished 03:30pm. The inspector toured the home and examined the home’s documentation and residents records. One relative and four residents were spoken to. The inspector also spent time with the manager, cook and four care staff. The home was organised well and the individual bedrooms had been personalised. A small number of rooms require decorating and some carpets need replacing. The day of the inspection was very sunny and most of the residents spent the time in the garden sitting under parasols, it was noted that regular drinks were offered and the staff spent time in various activities such as music and beauty therapies. The residents were seen to be interacting with each other and the staff. One resident asked to speak to the inspector and stated that the home was very good; the manager had time for all the residents and dealt with concerns quickly. The resident went on to say that she was very happy at the home and could not wish for a better life. What the service does well: The staff interact well with the residents, some of whom do not speak English. The home employs both English and Latvian care staff and it was noted that a number of the English staff had learnt basic Latvian and a little Russian. The daily meals supplied are well thought out and the home cooks both English and Latvian meals. Discussion with one of the cooks revealed that one cook is English and the other Latvian and that they are teaching each other various meals. This will enable both cooks to prepare and cook the variety of meals required. The residents experience of living at the home is positive and both through discussion and observation it was found that the residents are happy, well cared for and the outcomes of living at the home are very good. There are a number of activities and the residents spoken to stated that they felt included and were never board. Staff talk about the residents and were aware of their likes and dislikes and carried out a variety of activities that suit each individual. Musmajas E53 S4256 Musmajas V233128 130705 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. Musmajas E53 S4256 Musmajas V233128 130705 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 Musmajas E53 S4256 Musmajas V233128 130705 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, 2, 3, 4, 5 Standard 6 does not apply to this service. The homes’ Statement of Purpose and Residents’ Guide is not yet available and this could minimise prospective residents’ choice of home. Assessment prior to admission has commenced and these guide the care provided for residents after admission ensuring that their needs are met and they are safe and free from harm. EVIDENCE: The manager informed that the Statement of Purpose and the Residents’ Guide are still being developed. These will be fully assessed at the next inspection. All residents have a full assessment prior to admission to the home to ensure that their needs can be meet. Care plans are developed to guide staff to ensure that there is consistency in the care given. The home demonstrated that it is able to meet the variety of needs of the resident group and one relative spoken to stated that they were ‘..very happy with the care and that their relative had received and that they had settled well and become again more sociable.’ Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 9 Residents and their families are invited to visit prior to admission and can make as many visits as they wish until they are sure of the placement. All residents have a minimum of six week settling in period. This time can be extended if required. During the inspection it was noted through observation and discussion with staff, relatives and residents that the care needs of residents are met. One resident stated ‘ that all my care needs are met, they never keep me waiting and are always willing to listen.’ Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 The residents’ health, personal and social care needs are set out in individual care plans and are fully met which ensures that the residents well being is maintained. The residents are protected by the home’s policies and procedures for the storage, administration and disposal of medication. EVIDENCE: From observation and discussion it was found that the needs of the residents are met. Four residents care profiles were examined and it was noted that there are suitable care plans, which give direction to staff. These are not evaluated regularly relying on good verbal communication amongst the staff, which could result in omissions of care. There was no evidence in the plans that the resident, relative or representative was involved in the planning of care, this is necessary to ensure that the care prescribed is acceptable. The home risk assess for fall and pressure damage to the skin, in one profile a risk assessment was seen for smoking. The nutritional risk assessments are only carried out for residents with a known need. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 11 Care plans for prevention of pressure damage and falls were seen and found to be appropriate. Discussion with staff indicated that the needs of the residents are well understood and good risk assessments and care planning can only enhance this. The policies and procedures for the storage, administration and disposal of all medication was examined and found to meet all the criteria. The medication is carried to the bungalow in a locked case, once in the home all medication is transferred into the main cupboard for safekeeping. All care staff are attending the North Warwickshire Training for Medication Administration long distance learning course. The pharmacist visits the home every six months and assesses the administration and storage of medication leaving a report. The last visit indicated that there were no issues to be addressed. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 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 standard(s) 14, 15 The residents are assisted to exercise choice and control over their lives maintaining their independence. The residents receive a varied, wholesome and an appetising balanced diet that is served in pleasant surroundings encouraging socialisation and good dietary intake. EVIDENCE: Through observation, records and discussion with staff and residents it was found that the staff assist the residents to make choices about where and how they spend their time, what food they eat and other areas of daily living. Residents who do not have a representative are referred to the advocacy service at Age Concern and they allocate an advocate who will act on behalf of the resident. It was noted that the residents are encouraged to bring in personal items and to make their own rooms comfortable and familiar. The inspector ate a meal at the home and a choice was offered. The food was nicely presented, tasty and hot. The staff assist the residents if required, the philosophy is to encourage residents to maintain their abilities thus feed themselves. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 13 There are two cooks available on who cooks English meals and the other who cooks the Latvian meals. Through discussion it was found that they share their experiences and are learning from each other. A tour of the kitchen revealed a tidy and well organised space, with a good stock of fresh, dried and frozen food for all tastes. The records for cleaning and fridge/freezer temperatures were up to date. A more comprehensive cleaning schedule would assist the cooks and this was discussed. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 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 standard(s) 17 The residents’ legal rights are protected. EVIDENCE: The residents are all registered on the electoral role and are able to vote if they wish. The home does not manage any residents’ monies and where there is no representative an application to Age Concern Advocacy service is made. All residents can vote if they wish, one relative informed that their relative was able to go to the local polling station. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 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 standard(s) 19, 20 21, 22, 23, 24, 25, 26. The internal and external environment is safe and appropriate to meet the residents’ needs. The bathrooms in the main house require urgent attention to ensure that there are up to date and suitable facilities. The residents’ rooms are suitable and these are personalised and in the main clean and tidy ensuring a good quality of life. EVIDENCE: The home has extensive grounds that are tidy and well maintained. The area around the home is fenced and there are mature trees and shrubs with a variety of flowers. The home also has a conservatory to the rear of the bungalows; this is not used very often but has a selection of tropical type flowers. The outside of the building requires attention in places, window sills require painting and the home is recommended to consider a covered walk way for staff from the bungalows, laundry and staff area to the main home. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 16 Staff spoken to did not mind walking outside in all weathers and residents stated that they were happy with this situation. Some chose to remain in the bungalows during inclement weather and other put on a coat and wandered over to the main house. The laundry is situated in the outhouse and has suitable equipment to meet the needs and demands of the home. The laundress was clear about the level of washing and the temperatures that are required to reduce infection spread. There is a hand washbasin with liquid soap and towels. The policies and procedures are available and cover the process of laundering and infection control that reduces the risk of cross infection and harm to the residents and staff. The home has three bungalows that have housing for four residents in one bungalow and five residents in the remaining two bungalows. Each bungalow has its own shower facility and toilet. One bungalow also has a small lounge area, and a double room for couples; this area has its own toilet and small sitting room. The main house has the facility for a further five residents. The bathing and toilet facilities that are situated on the first floor are in desperate need of refurbishment, they are very old and the bath is not assisted and therefore not used. The home also has an outside toilet block, this is used during the summer by residents and relatives when they are using the garden. The bedrooms are personalised and residents are encouraged to make the bedrooms their own space, during the tour this was seen and one resident discussed their personal items and what they meant. Some bedrooms have been re-decorated, however the remaining bedrooms need to be done and a number of carpets require changing. The home has a programme to carry out this work over the next twelve months. The home has ramps where required and a stair lift, due to the age and design of the home a shaft lift is not viable. There is one hoist and a variety of slide sheets that are used. Most residents have some mobility and the use of lifting equipment is rarely used. The home is fitted with valves to control the temperature of the hot water outlets and these are checked regularly to ensure that they are working. The home has suitable lighting in all the residents areas. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 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 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) 28, 30 The residents are cared for by a trained and competent work force ensuring their safety. EVIDENCE: It was noted from discussion and records that one member of staff has completed her National Vocational Qualification in Care and a further two staff are in the process. The home has applied for the remaining five staff to commence this training. The home has a basic induction training, this was not adequate to ensure that all areas of the homes management, philosophy and ethos were covered. The manager shared a new programme with the inspector that meets all these areas. This will be implement when new staff are employed. All staff have a minimum of three days training each year. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 18 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, 36 The residents live in a home that is well run and managed by a person who is fit to be in-charge and they benefit from the ethos, leadership and management approach of the home. All staff are appropriately supervised ensuring consistency in care and safety of the residents. EVIDENCE: The manager has worked at this home for ten years and has been the registered manager since 2004. She has recently commenced her National Vocational Training level 4 in Care Management and discussed the areas that she has been addressing. From discussion it was clear that the manager knows the residents and the capabilities of her staff and works along side them to ensure that there is a good ethos and care practices. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 19 The manager has asked the residents to complete a survey which was seen, this has not been analysed and this was discussed. The manager will carry this out. The home does not have a quality monitoring system in place, this was discussed and the manager stated that she will explore this area. The manager has commenced supervision of all care staff, it was discussed that this must be done every two months and the manager demonstrated her commitment to this proceed through discussion and records. Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 20 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 2 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 1 3 3 2 2 3 STAFFING Standard No Score 27 x 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 x 3 x 1 x x 3 x x Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation Sch 1 4&5 Requirement The registered provider and manager must ensure that there is a suitable Statement of Purpose and Residents Guide available in the home. The Residents Guide must be given to all prospective residents to assist them to make a decission about admission to the home. (This is outstanding from the last inspection) The manager must ensure that all care plans are evaluated monthly and that where there are changes in needs a new care plan is devised. Where possible the manager must ensure that the residents and/or their relatives are involved in the planning of care and that this can be inspected. The manager must ensure that nutrional risk assessments are carried out for all residents and that they are weighed at least monthly. Where there is a recognisable risk a care plan must be devised. The registered provider must ensure that the bathroom and toilet area on the first floor is Timescale for action 31.10.05 2. OP7 15(2)(b)( d) 30.09.05 3. OP7 15(2)(c) 31.10.05 4. OP8 13(4)(b) 30.09.05 5. OP21 & OP19 23(2)(b) (j) 15.09.05 Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 22 6. OP24 & Op19 7. OP25 & OP19 8. OP33 reorganised and refurbished as soon as possible. An action plan with time scales must be forwarded to the Commission before publication of this report. (This is outstanding from the last inspection) 23(2)9b) The registered provider must ensure that the worn carpets in the bungalows are replaced and the remaining rooms are decorated to an acceptable standard. 13(4)(a) The registered provider must ensure that all the radiators in the residents private and communal areas in the main house are either low surface temperature or have suitable covers. (This is outstanding from the last inspection) 24, 15, 13 The registered provider and manager must ensure that there is a usable quality assurance and monitoring system in the home and that the outcomes are available for inspection. (This is outstanding from the last inspection) 31.12.05 31.10.05 31.12.05 9. 10. 11. 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 Good Practice Recommendations Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Musmajas E53 S4256 Musmajas V233128 130705 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!