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Inspection on 29/09/08 for Noss Mayo Residential Home

Also see our care home review for Noss Mayo Residential Home for more information

This inspection was carried out on 29th September 2008.

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

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.

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

The home provides a comfortable, safe and homely environment for people to live in. There are assessment and care planning processes in place. Residents have detailed care plans, which enables staff to know how residents needs are to be met by the resources of the home. Regular residents meetings and care reviews are held where residents comment on the services provided at the home. The home offers, a wide range of social and leisure activities. A balanced and varied diet is provided. Residents are encouraged to make their own choices, and they, their relatives and other visitors to the home are encouraged to give their views and opinions of the service, which means that they can influence the way the service is run.

What has improved since the last inspection?

Care records have improved and contain more details. They are personalised. All residents files are indexed allowing information to be found quickly.care plans are being reviewed regularly in line with national guidelines. The infection control policy and health and safety policy of the care home is now being consistently followed by staff. There is evidence of ongoing maintenance and improvements to the care home. A new registered manager is in post who is providing consistent support and guidance to the Staff team. Supervision are being provided to all staff. A staff training plan is in place. The range of activities offered to residents have been increased. A more comprehensive menu which meets residents needs, and choices has been put in place. There is evidence of increased cleaning imput into the care home.

What the care home could do better:

The home needs to ensure that the progress made since the last key inspection is maintained. It is important to consider a formal long-term maintenance plan for the building.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Noss Mayo Residential Home 2 High Street Burgh Le Marsh Skegness Lincs PE24 5DY     The quality rating for this care home is:   two star good 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: Ken Hague     Date: 2 9 0 9 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 24 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 24 Information about the care home Name of care home: Address: Noss Mayo Residential Home 2 High Street Burgh Le Marsh Skegness Lincs PE24 5DY 01754810729 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jane Goodwin Type of registration: Number of places registered: Mr Parbat Chana Kadchha,Mrs Shanta Kadchha care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 14. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Old age, not falling within any other category - Code OP. Dementia - Code DE. Date of last inspection Brief description of the care home Noss Mayo is a detached listed property, which was formally a vicarage. It is set in its own grounds, with a large garden to the rear and a car park at the front of the premises. The home is set back from the main road near the centre of the village of Burgh-le-Marsh approximately six miles from the seaside resort of Skegness. The Care Homes for Older People Page 4 of 24 Over 65 0 14 14 0 Brief description of the care home home is registered to provide care for thirteen service users over the age of 65 who require personal care and one place for the category of MD (Mental Disorder). Service users are accommodated in six single and four double rooms on the ground and first floor, the latter being reached by the use of a stair lift. Mr Parbat C Kadchha and Mrs Shanta Kadchha own the Home. At the time of the inspection the home confirmed that the weekly fees ranged from 350 - 390 pounds depending on the residents assessed needs. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report, can be found in the reception area or from the homes office. The home has a statement of purpose and service user guide, which sets out resources and services offered, by the care home. These documents are made available to all new potential residents. Care Homes for Older People Page 5 of 24 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: two star good 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: The inspection took place over 5 hours. The registered manager was given feedback at the end of the inspection. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of three residents were sought. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to this report being completed. This is a self assessment Care Homes for Older People Page 6 of 24 document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called have your say. This was not possible on this occasion due to time constraints. However residents were spoken to do during the site visit. Their opinions are reflected within the 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 24 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 24 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. All new residents needs are assessed by a competent person before they are admitted to the care home. This ensures that all identified needs can be met by the resources of the care home. Evidence: The files of three individual residents were viewed as part of the case tracking process. They all contained a detailed assessment carried out prior to the residents admission. The assessments identified the social and care needs of each individual resident. Assessment confirmed that all identified needs could be met by the resources of the care home. The registered manager stated that she carries out all new assessments. A home visit is often made and the family and resident are involved in the assessment. All assessments were signed and dated by the new resident. She stated a full risk Care Homes for Older People Page 10 of 24 Evidence: assessment is carried out as part of the assessment. If any risk is identified the management of that risk using the resources the care home is recorded. Residents spoken to as part of the case tracking process confirm that they have been involved in initial assessment. They confirmed that the details recorded on t the assessment were correct. The annual quality assurance assessment (AQAA) contained further evidence that it is the policy of the home that an initial assessment must be completed in detail before a resident is admitted to the home. The home does not offer a dedicated respite care service. Care Homes for Older People Page 11 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans set out the identified needs of individual residents and state how these needs will be met by the resources of the care home. Staff respect the dignity and privacy of residents. The medication procedure the care home is being followed by staff ensuring the safe administration of prescribed medication. Evidence: The care records for the three residents been case tracked all contained a comprehensive assessment which included a detailed risk assessment. If the risk is identified the management of that risk was included in the care plan and clear instructions were given to staff how to reduce or remove the risk entirely. The choice of the wishes of the residents in respect of social activities and the manner in which care should be provided was recorded on all care plans. The health care needs of residents were recorded on the individual residents care plan. This included where there was a needs for input from the community health care services. Care plans were reveiwed in line with national guidelines. They were signed and dated by the assessor and the individual resident. Care Homes for Older People Page 12 of 24 Evidence: Residents confirmed in discussions that they were involved in the writing of their own individual care plans. The residents spoken to during the site visit stated that they believe all of the needswere being met by the care home. The comments recorded in the residents comments book were all positive. Residents spoke very highly of the quality and sensitivity of the staff. They feel safe living within a care home which they feel is staffed by competent trained staff. Residents stated in the comments book in discussions at the site visit and through a relatives comments book that their privacy and dignity is protected by staff. Care plans give clear instructions that the dignity and privacy resident is paramount and advice on how the should be preserved in individual care practice. The registered manager stated staff have been trained in the Administration and storage of medication. Training record support to the statement. Staff also confirmed that this training had been provided. Staff stated that they feel competent to be able to give medication safely. The annual quality assurance assessment(AQAA) provides evidence that the medication procedure has been updated ensuring the safe administration of medication. Observations on the day supported the fact that the medication procedure is being followed. Pharmacy reports resulting from visits to the home were found to identify no problems with the Administration and storage of medication Care Homes for Older People Page 13 of 24 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. A range of activities are organised which meet the needs and social choices of the residents. Residents maintain contact with their families and take part in community events maintaining independence. The varied food provided meets the dietary needs and choices of residents. Evidence: Activities offered to residents are set out in the annual quality service review (AQAA). Residents spoken to during the site visit stated that they were happy with the range of activities offered. The home has a policy of encouraging friends and relatives to visit and maintain links with residents. Relatives were seen to visit during the site visit. Residents spoken to on the day of the site visit said that their families were made welcome. The details of residents extended family were found recorded on their care records. This included the contact numbers and addresses of the family members. The Home supplied a copy of the homes menu, which demonstrates choices are offered. The Inspector spoke with residents and discussed the menu. Comments from Care Homes for Older People Page 14 of 24 Evidence: residents were all positive. A resident stated the food is excellent. Other residents stated the food here is good and it looks nice. staff stated that they ensure residents are provided with a choice of food which answers their dietary needs. Residents and staff stated that the menu has improved since a full time chief was appointed. The residents comment book contained only positive comments regarding food offered by the home. The registered manager stated relatives are invited to share a meal with the residents when they visit. This policy is contained within the service users guide and the statement of purpose for the home. There were comments written in the relatives comments book which supported the registered manager statement. A relative had recorded I enjoyed eating a meal with my relative it was of excellent quality. The Inspector shared lunch with the residents on the day the site visit. The food provided was of good quality and quantity and presented in an attractive manner. Care Homes for Older People Page 15 of 24 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. Residents benefit from updated comprehensive complaints and adult protection procedures. Evidence: No complaints have been received by the home or the commission for social care inspection since the last key inspection. Residents stated they were confident in being able to raise concerns with staff and the manager of the home. Residents and staff interviewed during the site visit stated the registered manager is very approachable and would act immediately if any complaints or concerns were raised with her. There have been no notifications since the last key inspection that have raised any concerns. There has been no adult protection enquiries held at the home since the last key inspection. The inspection of training records and discussion with staff provided evidence that staff have received training in the identification and prevention of abuse. Care Homes for Older People Page 16 of 24 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. Residents live in a clean and well-maintained care home which provides them with a comfortable and safe accommodation Evidence: The registered manager stated that the home has an ongoing maintenance programme. A bathroom have been refurbished completely and equipment repositioned to make the provision of care easier and more comfortable for residents. Positive comments regarding this refurbishment were found in comments made by the residents and relatives. Several areas of the home had been decorated with the residents choosing the colour scheme. The home was found to be clean and free from any odour. The registered manager stated that staff have been trained in infection control and health and safety. Staff confirmed that this training had been provided and was recorded in training records. There were no health and safety issues identified. The requirement in respect of the infection control procedure made at the last key inspection was found to be addressed. Care Homes for Older People Page 17 of 24 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 are sufficient numbers of competent trained staff on duty to meet the needs of residents Staff are recruited safely which ensure residents are protercted. Evidence: Duty rotas show that there are there are currently enough staff to meet the needs of residents. Residents made comments staff are kind the service we get here is wonderful A resident who came to the home for rest care recorded in the comment book staff are wonderful I would be very happy to come back here for further rest car. .A relative commented staff are second to none. A second relative records in the comments book staff are brilliant and so caring towards everyone even me. Staff records contain recruitment information such application forms and criminal record bureau checks, and there is also further evidence of induction and training. Records contain proof of identity, including a photograph of the person. Records show that staff are studying for, or have achieved nationally recognised care qualifications at various levels on the day of the site visit 72 of staff held under NVQ or equivalent in care. Records and AQAA information shows that update training for subjects such as moving and handling, food hygiene, first aid and infection control are booked to take place in the near future. Induction records show that staff are made aware of equality and diversity issues and staff demonstrated their understanding of Care Homes for Older People Page 18 of 24 Evidence: these issues throughout the visit. Staff said that training about dementia has been provided.There were records of staff meetings, which show that they have opportunity to discuss things like training needs and rotas. Care Homes for Older People Page 19 of 24 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 home is managed by a competent supportive manager who ensures the needs of each resident is met. The quality assurance system is in place to allow residents to comment on the quality of service being provided and effect changes. The infection control policy and health and safety policy of the home is up to date and followed by all staff Evidence: There was evidence found of professional leadership and good team working which had not been found at previous inspections. Staff stated theywere now clear about their own roles and the registered mangers expectation of their care practice. Staff stated we have a manger who suports us and give us excelent leadership. The proprietor and registered manager are working well together to ensure that the needs of residents and met. Roles are now clearly defined which benefits staff and residents There are comments recorded by residents and relatives within quality assurance systems which pass positive comments regarding the improvements in the home and about the Care Homes for Older People Page 20 of 24 Evidence: leadership of the registered manager. Staff stated in formal interviews that she is very approachable and supportive.The registered manager plans to complete the registered manager by December 2008. Pre inspection information contained in the AQAA shows that regular residents meetings are held.There are financial procedures in place to ensure that resident’s financial interests are safeguarded and protected. No health and safety issue were identified at this key inspection. The registered manager said that she carried out the staff supervision in accordance with national guidelines. Staff confirmed in formal interviews that they had received formal supervision. Staff confirmed that the registered manager supports them in their work and helps them to develop their skills. There are financial procedures in place to ensure that residents financial interests are safeguarded and protected. Care Homes for Older People Page 21 of 24 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 22 of 24 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 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 Care Homes for Older People Page 23 of 24 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. 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