Inspection on 23/09/05 for Neath House

This inspection was carried out on 23rd September 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

Neath House 07/06/07

Neath House 05/01/06

Neath House 31/01/05

Neath House 07/07/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Neath House Currier Drive Neath Hill Milton Keynes MK14 6NS Lead Inspector Nichola Cahill Unannounced Inspection 08.00 23 September 2005 rd 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 Neath House DS0000057170.V253937.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. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Neath House Address Currier Drive Neath Hill Milton Keynes MK14 6NS 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) 01908 607248 01908 231333 Excelcare Holdings Jacqueline Blease Care Home 41 Category(ies) of Dementia (28), Old age, not falling within any registration, with number other category (13) of places Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. It will be a condition of registration for Neath House that the refurbishment will be completed by April 2004. The categories of registration for Neath House will be 28 (DE) 13(OP), all aged 65 and over. All environmental requirements are maintained prior to the refurbishment. Staffing ratios to be maintained and not to fall below the current levels. 31st January 2005 Date of last inspection Brief Description of the Service: Neath House is a purpose built home situated in a residential area of Milton Keynes. It is close to local amenities and to the town centre. The home is registered to provide care for up to 41 elderly people with 28 beds allocated for elderly dementia type illness. All beds are block purchased by Milton Keynes Council. Accommodation is in single rooms with varied shared social spaces. There is limited garden space. The home is divided into five smaller units, each with its own sitting room/dining area. The home is owned and managed by Excelcare Holdings PLC. There is a planned development for the home. All service users are registered with local GP Practice and have access to local NHS Services through GP referral. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a summary of the annual unannounced inspection of Neath House, which was carried out on 23rd September 2005 by Nicky Cahill (inspector). The inspection visit commenced at 08.00 and took place over five hours. The inspection visit was largely spent assessing the daily living, care plans, environment, medication systems and administration and discussions with service users living in the ‘Woburn’ group. In addition, recruitment and training files were viewed for two recently appointed members of staff. Discussion and feedback of findings was delivered to Paula Bonner, the acting manager and Kay Shepherd, the regional operations manager. Further information has been requested from the home regarding areas not inspected at this time. This information will be forward to The Commission upon completion. What the service does well: Service users receive a full assessment of needs prior to being admitted to the home. This allows the home to ensure that the service users needs are appropriately met. Care plans are detailed and reviewed regularly. Service users are supported in accessing external services to ensure that all health care needs are met. Medication is stored and administered appropriately. The routine of daily living and activities made available are flexible and varied to suit the needs of service users. A choice of meals and snacks are available and meals can be taken in comfortable dining rooms. The layout and location of the home is suited for it’s stated purpose, it is accessible and, on the whole, well maintained. Comfortable seating and recreational space is available and easily accessible to all service users. There are adequate toileting and bathing facilities throughout. The home is kept clean and free from any offensive odours. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 6 The staffing numbers and skill mix of staff are appropriate to the assessed needs of service users, the home operates a thorough recruitment procedure, and staff are trained appropriately. The acting manager ensures that the management approach of the home creates an open, positive and inclusive atmosphere. Service users benefit from a comfortable, relaxed and inclusive atmosphere. 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. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Neath House DS0000057170.V253937.R01.S.doc Version 5.0 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 the following standard(s): 3, 4 Service users receive a full assessment of needs prior to being admitted to the home. This allows the home to ensure that the service users needs are appropriately met. EVIDENCE: Care plans for five service users were viewed during the inspection visit. Preadmission assessments had been completed by senior staff prior to admission and information had been obtained from care managers were applicable. Information viewed was in detail and outlined basic and specific needs to be addressed within the plan of care. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10. Service users care plans were detailed and up to date. Reference had been made to visits from other health care professionals and other services required. This information enables staff to deliver the appropriate care to service users in order to meet their individual needs. Systems are in place for the safe handling and administration of medications, therefore service users are protected against hazards to their safety. EVIDENCE: Five care plans were viewed during the inspection. Care plans were both detailed and had been regularly updated by the acting manager, Paula Bonner. During discussions with two service users and the subsequent viewing of their individual care plans all requirements described were documented. Care plan files also included pre-admission assessments, risk assessments, medical intervention records, activity records, tissue viability assessments and a record of monthly audits. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 10 Service users spoken to at the time of the inspection passed comment that privacy and dignity is respected at all times. This was also observed throughout the visit. From medical intervention records viewed it is clear that service users are fully supported in all health care and other specialist needs. The medication systems and records were viewed on ‘Woburn’ unit. Dossette boxes, distributed by the pharmacist were in place and all MAR sheets had been signed appropriately, with the exception of one viewed. This MAR sheet had three signatures missing for a gel applied at a time when personal care is delivered. Examples of staff signatures were in place for auditing purposes. The medication cabinet was securely fixed to the wall and one member of staff on duty was holding the keys. The medication policies in place were generally detailed and written in an appropriate format. However, there were no procedures in place for the use of the dossette box and the expectations on how staff should administer from these boxes. It is recommended that the procedures in place for the administration of medication be reviewed to include administration from dossette boxes. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 15. The routine of daily living and activities made available are flexible and varied to suit the needs of service users. The home offers open visiting and promotes contact with family, friends and the local community. Service users are able to exercise choice and control over their lives with full support from the care team. A choice of meals and snacks are available and meals can be taken in comfortable dining rooms. Service users are able to receive a well balanced diet in congenial settings at convenient times. EVIDENCE: Care plans highlighted the social interests and hobbies for service users and the activity co-ordinator had completed individual assessments. Each service user had an individual diary highlighting visits from family, hairdressing appointments attended, reading of daily newspapers etc. All structured activities are recorded in an individual diary; this was not viewed at this time. It is recommended that reference be made within individual diaries indicating activities offered to service users. Observations throughout the morning of the inspection would indicate that service users may get up and go to bed at a time of their choosing. On the day of the inspection visit there was a relaxed feel with some service users Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 12 choosing to lie in bed later into the morning. Service users spoken to confirmed the relaxed feel to the home. The inspection visit took place during breakfast time. Service users were asked what they would like to eat and requests for further hot drinks were facilitated without question. A menu was taken around the unit during the morning asking service users to make a choice for the following day’s main meal and supper. The choices were varied and appealing. The menu choices, which had been made during the previous months were available for inspection and showed a wide variety of meals being offered. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 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 the following standard(s): This group of standards was not inspection during this visit. EVIDENCE: Neath House DS0000057170.V253937.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 26 The layout and location of the home is suited for it’s stated purpose, it is accessible and, on the whole, well maintained. Comfortable seating and recreational space is available and easily accessible to all service users. There are adequate toileting and bathing facilities throughout. The home is kept clean and free from any offensive odours. Some areas of concern were noted, which detract form an otherwise pleasant, comfortable and safe environment for service users. EVIDENCE: The front entrance and ‘Woburn’ group was viewed as part of this inspection visit. The front entrance to the home is spacious and welcoming. Major work is being carried out in the centre of the home at present, which will, in the future, make way for an increase in the bed numbers for Neath House. ‘Woburn’ group has a small kitchenette and lounge area. Both areas were clean, tidy and well presented. An exit is available to access the small patio Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 15 area at the front of the home. It was noted that this area needed to be swept and garden chairs cleaned. It was noted that food items stored in the kitchenette were being stored in unnamed or dated containers. The fridge handle had been broken and had left sharp hazards on the door. All bedroom areas are single accommodation; the home has two small respite bedrooms. ‘Woburn’ group has two toilets and one assisted bathing and toilet facility. One toilet has been rendered out of order due to the works being completed in the centre of the home, which affects one interior wall the length of this and other ground floor units. This work had also affected the light coming into these areas due to windows being blocked off. It was also noted that there was no opening windows and no extractor fans fitted. One toilet area was being used for storage of other items such as a linen bin, chest of drawers, trolley and a hoover. The sluice room, although clean, was also without a functioning window, air vent and was also cluttered with equipment not in use. Both the front area of the home and ‘Woburn’ group were clean, pleasant and free from offensive odours. All concerns noted during the tour were fed back to the acting manager and regional operations manager. It is a requirement that all areas of the home are kept free from hazards to service users safety and that urgent attention is given to lighting and ventilation in bathing, toileting and sluicing facilities. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 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 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): 27, 29, 30 The staffing numbers and skill mix of staff are appropriate to the assessed needs of service users, the home operates a thorough recruitment procedure, and staff are trained appropriately. The numbers and skill mix of staff enable service users needs to be fully met; service users are protected by the homes recruitment procedures. EVIDENCE: The Commission were consulted throughout this process and duty rotas duly sent for comments. The home is covered by five care staff working from 08.00 until 20.00, with the support of two ‘floating during the morning / early afternoon and evening shift and one team leader. The acting manager is available during the day. Three care staff work a ‘waking’ night shift from 20.00 until 08.00. From discussions with staff, the acting manager and regional operations manager it was confirmed that staff not wishing to make the changes to the new shift pattern would be accommodated, however, any new appointments would be based on this shift pattern. The recruitment and training files were viewed for two recently appointed members of staff. All recruitment documentation required was present within files viewed. Training files would indicate that fire training, abuse awareness training, medication training and manual handling had been completed. It was noted that certificates were not on file at the time of the inspection visit as evidence Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 17 of training; the acting manager, following the inspection forwarded these to The Commission. It is recommended that the acting manager arrange for certificates of training, or copies, to be retained in the individual staff files for inspection and reference purposes. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 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 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): 31, 32, 37. There is currently no registered manager working full time within the home due to an organisational restructure, however, the acting manager is fully supported by the organisation and is fully able to run the home in the best interests of the service users. The acting manager ensures that the management approach of the home is open, positive and inclusive. Service users benefit from a comfortable, relaxed and inclusive atmosphere. Records required by The Commission for the protection of service users are maintained and kept in order. Service users rights and best interests are safeguarded by the homes documentation. EVIDENCE: The named registered manager for Neath House has recently been reappointed to manage a new home run by the organisation, which is due to open later this Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 19 year. At the time of the inspection Paula Bonner, an experienced senior carer, was running the home on a daily basis. Full support and regular visits are in place from representatives of the organisation. During the inspection it was noted that there was a positive ethos, service users appeared to be relaxed and unhurried. Documentation viewed was found to be up to date and in order. Confidential information was being stored in accordance with The Data Protection Act 1998. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 2 X X X X 2 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X 3 x Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 21 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 19 Regulation 13 Requirement It is a requirement that all areas of the home are kept free from hazards to service users safety and that urgent attention is given to lighting and ventilation in bathing, toileting and sluicing facilities. Timescale for action 30/11/05 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 9 Good Practice Recommendations It is recommended that the procedures in place for the administration of medication be reviewed to include administration from dossette boxes. It is recommended that the acting manager arrange for certificates of training, or copies, to be retained in the individual staff files for inspection and reference purposes. It is recommended that reference be made within individual diaries indicating activities offered to service DS0000057170.V253937.R01.S.doc Version 5.0 Page 22 2 30 3 14 Neath House users. Neath House DS0000057170.V253937.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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. 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