Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 14/10/08 for Myford House Nursing And Residential Home

Also see our care home review for Myford House Nursing And Residential Home for more information

This inspection was carried out on 14th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Information about the service is provided in a service user guide which incorporates a statement of purpose. The documents have recently been revised and reviewed, are readily available and easy to read. The acting manager and staff have a good knowledge of the individual care needs of people living at the home, and provide a satisfactory standard of care. People living at the home expressed a general satisfaction and commented - the staff are very good Visitors to the home stated they were satisfied with the care being offered to their relatives.

What has improved since the last inspection?

Improvements have been made to ensure a safe system for the receipt, recording, storage, handling, administration and disposal of medications is developed and maintained. Additional care staff are available at peak periods of the day to ensure that the care needs of people can be met effectively. A social activities coordinator has been employed, people living at the home confirmed an improvement in this area. A member of staff has been allocated the additional responsibility to ensure that people are receiving breakfast and drinks at an acceptable time.

What the care home could do better:

The care plans should be in sufficient detail to inform staff of the actions needed to fully meet peoples assessed needs. They should be accurate, concise, comprehensive and person centered. When ever possible care plans should be developed, agreed and reviewed with the individual person and/or representative. A formal application for the position of registered manager of the service should be submitted to us in due course. The continuity and effectiveness of the improvements seen and evidenced during this inspection will be determined in the fullness of time

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Myford House Nursing And Residential Home Woodlands Lane Horsehay Telford Shropshire TF4 3QF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joy Hoelzel     Date: 1 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Myford House Nursing And Residential Home Woodlands Lane Horsehay Telford Shropshire TF4 3QF 01952503286 01952504966 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Alison Hubbard Type of registration: Number of places registered: Redwood Care Homes Ltd care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home may accommodate 30 persons requiring Nursing Care. The home must comply with the Staffing Notice issued by the Shropshire Area Health Authority dated 31 May 2000, in respect of the nursing care beds. Date of last inspection Brief description of the care home Myford House is a care home for older people, registered to provide both personal and nursing care for up to 40 Service Users, and offers both single and double bedroom accommodation. All three floors are accessible via a passenger lift. The home is situated in the Horsehay area of Telford and is a large detached property set in its own grounds. Information of the home and the provision of the service are available in a service user guide, which incorporates the statement of purpose. The booklet is available on request at the home. The service user guide states that the current level of fees for the service range from three hundred and forty eight to five hundred and Care Homes for Older People Page 4 of 26 Over 65 40 0 Brief description of the care home seventy five pounds per week. Commission for Social Care Inspection reports for this service are available from the provider or can be obtained from www.csci.org.uk Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over eight hours on Tuesday 14th October 2008. The acting manager was in charge of the home, supported by nursing and care staff and ancillary personnel. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of a number of people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and staffing records. Discussions were held with people living, visiting and working at the home. Some people were unable to fully comment about their experience of life at the home. Observations were made of how they spent the day and of the interactions Care Homes for Older People Page 6 of 26 offered by staff in an attempt to obtain an overview of how they may be feeling. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was posted to the home for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us the areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to us within a given timescale. The acting manager completed this document and returned it the commission. Comments from the AQAA are included within this inspection report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. This tells the home all about them, what they hope for and want to achieve, and the support they need. Evidence: Information of the service provision is detailed in the service user guide and incorporates the statement of purpose. It is available upon request at the home. The service user guide is reviewed annually or more often if changes to the information are required. The service user guide specifies the weekly fees for the service and what is and what is not included in the fee. The case file of the person who recently moved into the home was looked at to see if information had been sought regarding this persons needs prior to moving into the home. Information had been gathered from various outside agencies but an Care Homes for Older People Page 10 of 26 Evidence: assessment by the service had not been carried out prior to admission. The acting manager stated that on this occasion the person was known to the service and that the home were aware of the care needs. An assessment of their needs was made at the point of admission to the home. Other case files looked at did include a pre admission assessment by the home in addition to social worker reviews, assessments from Primary Care Trusts and community care services. This gathering of information ensures that the service can be confident of meeting a persons care needs. People living at the home described the process for deciding to stay permanently at the home and confirmed the homes procedures. The AQAA ( Annual Quality Assurance Assessment) completed by the acting manager confirms the regular procedure for ensuring that care needs can be met from the day of admission and plans for further improvements in this area by Improving the initial assessment ensuring that all details are on the form. The home does not provide an intermediate care service. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each individual has a care plan but the practice of involving residents in the development and review of the plan is variable. The plan includes basic information necessary to deliver the persons care but is not detailed or person centred. The care plan does not consistently reflect the care being delivered. Evidence: Three case files were selected for inspection, with people being at the home for varying lengths of time. Core care plans using the tick approach are used for recording the assessed individual needs. Each person has a file which records basic personal details, risk assessments, care plans and a daily report. There was little evidence in the selection viewed to suggest that the person and/or representative had been involved with the planning and review of their care. The plans varied greatly in information and content. For example one care plan Care Homes for Older People Page 12 of 26 Evidence: indicated that a specific intervention was required by the nursing staff for the treatment of a wound. A core care plan had been completed but did not give details of the type of dressing to be used, the frequency of the changes of the dressing or any indication of a deterioration or improvement in the wound. Staff commented that a healthcare professional had recently visited, offering further guidance for treatment but this information had not been recorded in the plan of care. One person was observed to be requiring staff interventions throughout the day for all activities of daily living. The care plan was looked at but did not have sufficient recorded details to support this observation. Staff spoken with were able to provide a verbal account of the care of people who use the service and described the individual and diverse care needs but again this was not supported in the care plans. The acting manager, quality manager and deputy manager discussed the shortcomings in the documentation of the care plans. All stated and agreed that the plans require a full review and confirmed that immediate action is being taken to ensure the care plans accurately reflect the care that is required. The acting manager confirmed that by 1st November 2008 all care plans will have been reviewed and revised. The home operates a monitored dose system for the administration of medication with some additional boxes and bottles of medicines. Five statutory requirements were made following concerns of the procedures at the random inspection in July 2008. On checking these requirements had been complied with. Two registered nurses are now available for the morning medication round ensuring that people are given their tablets at the required time. Amendments have been made to the receipt and safe disposal of medications and staff have had an assessment of their competency to further ensure safe procedures are maintained. The Medication Administration Record (MAR) had a photograph attached of the person for identity purposes. They appear to be fully completed as no gaps in the recording sheet were seen in the selection viewed. The care staff were observed to be assisting service users with personal care discreetly and in a manner which promotes dignity. The Annual Quality Assurance Assessment completed by the acting manager describes the plans for improvement over the next twelve months Introduction of a mini care plan completed by their carer, regular monitoring of medication procedures and designated treatment room in the new build. Care Homes for Older People Page 13 of 26 Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services are encouraged and supported to be involved in daytime activities of their own choice and according to their individual interests and capability. Evidence: A social activities coordinator currently works two days a week and arranges activities based on the preferences of the people at the home. The coordinator discussed the recent coffee afternoon and the cake making session that people had participated in and enjoyed. Following meetings with people to determine their preferences plans have been made for a small group of people to go to a restaurant for Christmas lunch. People living in and visiting the home commented that the frequency and content of the activities on offer had recently improved. Relatives and friends are free to visit the home at times suitable to the resident. Visitors to the home expressed a satisfaction with these arrangements and went on to say how important it was to be able to see their relatives regularly. The service user guide includes a section on the arrangements for contact between service users and their relatives and friends Residents are given every possible help to maintain the links they wish to retain with their friends and families outside the home, but can Care Homes for Older People Page 15 of 26 Evidence: choose whom they see and when and where. The main front door is kept locked for security reasons, entry to the home is gained by staff answering the door or releasing the door lock remotely. A number key pad is sited at the door to allow exit. Number key pads are also sited in some other areas of the home restricting access to certain parts of the premises. The dining area is prepared in advance of meals with people being encouraged to sit at the table, but people are able to have their meals in their preferred place. People spoken with confirmed that they had had breakfast that morning, some people were having their second breakfast midmorning and appeared to be enjoying it. Lunch was served at around 12:30, staff were observed to be assisting with the meal where needed. Generally people expressed a satisfaction with the food provided and the mealtimes. The AQAA completed by the acting manager documents some improvements that have been made during the last twelve months - Regular update of menus taking into account resident choice and preference. Assistance given at mealtimes if required whist encouraging independence where possible. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is supplied to everyone living at the home and is displayed in a number of areas within the service. Residents and others involved with the home generally understand how to make a complaint and are clear about what will happen if a complaint is made. Evidence: The homes complaints policy and procedure was reviewed in February 2008, a copy is placed on the notice board and is included in the service user guide. People stated they would discuss any concerns with their relatives, manager or staff member. Two referrals have recently been made to the safeguarding adults team for consideration following allegations. The acting manager and quality manager both confirmed their cooperation with the procedures. Both referrals have yet to reach a satisfactory conclusion. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this were seen. All transactions are recorded on individual balance sheets with invoices and receipts kept. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. Evidence: Myford House is situated in a quiet residential area in Horsehay near Telford. It is a period building that has been extended and developed over the years. There are now plans to further extend the building to provide additional accommodation and to upgrade and refurbish the existing building. During the tour of the premises, the bedrooms appeared to be comfortable with an assortment of furniture either provided by the home or the persons own, so each bedroom was very different and personal to the occupant. People stated that they were generally satisfied with their accommodation. The gardens are maintained and accessible with people stating they havent had the opportunity to enjoy the gardens as much this year due to the inclement weather. Hand wash facilities have been provided in all communal areas and at the point of the delivery of care for general hygiene purposes and to ensure effective infection control. Care Homes for Older People Page 18 of 26 Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There appear to be enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. Staff receive relevant training and a good recruitment procedure has been developed. The procedures ensure that suitable people are caring for people living at the home. Evidence: A duty rota is maintained on a weekly basis to identify the people working in the home at any one time. The acting manager stated that care staff numbers have recently been increased with more care staff available during peak periods of activity. The staff numbers reduce during the afternoons and at night, the acting manager confirming that the staffing compliment is sufficient for the needs of the current resident group. The service user guide indicates that of the 19 care staff 8 have a National Vocational Qualification at levels 2 or 3 in care. The AQAA completed by the acting manager indicates that an additional 10 staff are working towards the award. Two staff personnel files were selected for inspection and indicated that suitable recruitment procedures are in place. Each file contained references, criminal record bureau disclosures and confirmation of identity. The acting manager demonstrated a good sound knowledge of the recruitment procedures and stated that recruitment is ongoing for all grades of staff. Care Homes for Older People Page 20 of 26 Evidence: The acting manager is currently identifying the training needs of all staff and is updating the training matrix with the current information. Staff discussed the training undertaken this year and the sessions arranged for later on in the year. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The acting manager promotes equal opportunities, has good people skills and understands the importance of person centered care and effective outcomes for people who use the service. Evidence: Helen Ellerby was offered the position of acting manager of the service in July 2008 following the resignation earlier on in the year by the registered manager. A formal application for the position is still to be submitted to us for approval. Mrs Ellerby discussed the changes she has already made and the changes she has is planning but also spoke of the challenges and difficulties with change management. Through out the time of this inspection it was obvious that good relationship have been developed between quality manager and existing staff. People spoken with offered positive comments of the management and leadership qualities. Care Homes for Older People Page 22 of 26 Evidence: Mrs Ellerby completed all sections of the AQAA and the information gives a good picture of the current situation within the service. The AQAA gives us some detail about the areas where they still need to improve and the ways that they are planning to achieve this are explained. Quality assurance and monitoring of the service is ongoing with satisfaction surveys being distributed to people living, working and visiting the home. Regular residents meetings are arranged giving people the opportunity to discuss how they perceive life at the home, with amendments being made to practices following suggestions made. Staff meetings are also arranged at regular intervals. The registered provider of the service or a representative visits at very regular intervals as part of the monitoring process. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. Weekly, monthly and annual testing of the equipment and premises are conducted with records kept and available for inspection. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 12 The service must make proper provision for the health and welfare of people who live at Myford House To ensure that people receive the nursing, personal care and monitoring that their conditions require. 01/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 When ever possible care plans should be developed, agreed and reviewed with the individual person and/or representative. A formal application should be submitted for the position of registered manager to ensure an experienced competent person manages the home. 2 31 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!