Inspection on 02/05/08 for The Malthouse

This inspection was carried out on 2nd May 2008.

CSCI found this care home to be providing an Excellent 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.

Other inspections for this house

The Malthouse 17/06/09

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Malthouse Bay Road Gillingham Dorset SP8 4EW Lead Inspector Unannounced Inspection 2nd May 2008 9:10 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 The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 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. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Malthouse Address Bay Road Gillingham Dorset SP8 4EW 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) 01747 822667 01747 821270 malthouse@affinitycarehomes.co.uk Malthouse Healthcare Ltd Mrs Susan Elizabeth Bracher Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 33. Date of last inspection Brief Description of the Service: The Malthouse is a 17th Century building with attractive gardens situated on the outskirts of Gillingham, which has been considerably extended to provide residential care for 33 older people. The home is located approximately half a mile from Gillingham town centre in a quiet lane. The home has recently come under new ownership and the Registered Providers are Malthouse Healthcare Ltd. The Registered Manager is Mrs Sue Bracher. The accommodation is arranged over three floors with a passenger lift serving the first floor and a stair lift providing access to the three second floor rooms. There are 31 bedrooms, 4 of which are suitable for a couple, friends or relatives wishing to share. Bedrooms are of good size and all but one has ensuite facilities. In addition to personal care and support, the service provided includes all meals, laundering of clothes etc., and all housekeeping; a range of social and leisure activities are also provided, and the manager and staff provide help to make and attend healthcare appointments, where this is necessary. In the grounds of the home five “lodges” have been built offering an independent lifestyle. On the ground floor there are three apartments also offering an independent lifestyle. The lodges and apartments do not form part of the registered premises. The home has achieved the “Investors in People Award”. At the time of this inspection the weekly fees range from £625 to £715. Additional charges are made for hairdressing, chiropody, newspapers and personal shopping. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 5 The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced inspection took place on the 2nd May 2008 over a period of approximately five hours. The purpose of the inspection was to assess all of the key standards. This is the first inspection of the Malthouse under the ownership of Malthouse Healthcare Ltd. The Registered Manager, Mrs Sue Bracher, was on hand throughout to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment completed by the home. • 12 questionnaires completed by residents and 7 by relatives and visitors. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. During the course of the inspection six residents, one visitor and five members of staff were spoken with and asked their views on the service provided at the home. Comments received through the questionnaires and discussion included: “The staff are always very helpful and polite.” “I and all the other residents are lucky to be here. It is a very well run establishment.” “I am happy with the care and support I am receiving.” “ Staff are very good at making themselves available for one to one talking, which my Mother finds particularly helpful.” “The Malthouse has provided excellent care for my relative over a period of some years. He has been treated with care, respect and dignity throughout despite deteriorating health. The Malthouse have constantly reviewed their care programme and adjusted it to meet needs as they change. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 7 What the service does well: This is the first inspection at the Malthouse since Malthouse Healthcare Ltd purchased it. However Mrs Bracher has been managing the home very well for several years and continues to ensure that residents living there are provided with an excellent service. The Malthouse continues to provide a very homely and comfortable atmosphere in which to live. Residents are well care for by well-trained and experienced staff. Residents say that staff are very kind and considerate and their privacy and dignity is respected at all times. The home carries out thorough assessments prior to residents moving in and this includes finding out about all aspects of care. Prospective residents and their families are encouraged to visit the home before making a decision about admission. Residents’ health needs are well met by the home and community health professionals. Where necessary staff were available to accompany residents to hospital appointments. Medication is well handled at the home to promote the health and well being of residents. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents are helped to exercise choice and control over their lives as far as possible. Meals are wholesome and nutritious and planned around the likes and dislikes of residents. The complaints and quality assurance procedures reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home protects the residents from abuse by ensuring robust policies and procedures are in place, which staff find easy to follow. The house and grounds are well maintained which provides residents with a comfortable place to live. Residents are encouraged to personalise their rooms with small items of furniture, pictures and a variety of mementos. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. The home has an ongoing training programme for staff, which means that residents will be cared for by skilled staff. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 8 The home is very well managed by Mrs Bracher. She has a very competent staff to help her and this ensures the home is run in the best interests of the residents living there. Financial procedures within the home also ensure that residents’ interests are protected. The health and safety of the residents and staff are protected by the policies and procedures that the staff follow at The Malthouse. What has improved since the last inspection? What they could do better: Mrs Bracher confirmed that she was looking to improve the nutritional screening tool the home is currently using. However residents’ comments indicated they felt their nutritional needs were being well met. To ensure that all the safety measures are in place to protect residents from being cared for by unsuitable staff written POVA first checks must be obtained prior to a new member of staff starting work. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 9 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. The summary of this inspection report can be made available in other formats on request. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 10 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 The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. New residents move into the home having had their needs assessed and been assured that these needs will be met fully. EVIDENCE: The home has a very detailed handbook, which provides sufficient information to prospective residents prior to them making a decision to move to the home. The care files for three residents were inspected. These showed that the home has a good procedure in place. Prior to anyone moving into the home a full assessment of needs was undertaken with the prospective resident. Sufficient information was obtained so that a care plan could be drawn up and made available to staff. Residents spoken with confirmed that the Registered The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 12 Manager had encouraged them to visit and given them all the information they needed to make an informed decision about admission. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Robust systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The Malthouse continues to provide an excellent standard of care to the residents living at the home. Residents expressed a high level of satisfaction with the service provided. Three care files were reviewed and they contained the relevant assessments and care plans needed so that staff had the information to be able to give a very good standard of care. Where the need for specialist equipment was identified it was provided. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 14 It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, district nursing services and chiropodists. One health care professional said, “There is a family feel to the home. Carers of all grades take care to know and meet each resident’s needs. Manager communicates well with us and takes our advice.” Mrs Bracher stated that she was looking to improve the nutritional screening tool the home is currently using. However residents confirmed that their nutritional needs were being well met. The home has a good medicines policy and procedure in place. Examination of records indicated that medicines are properly administered in accordance with the prescriber’s instructions. Regular pharmacy audits are carried out to ensure that medications are given safely and that the home’s medication policies and procedures are adhered to. Residents and the visitors spoken with were very happy with the care they or their relative received and confirmed that staff treated them with respect and were supportive and kind. Comments received included: “All the staff are very kind and caring.” “My relative is treated with care, respect and dignity.” “Staff are always helpful and always come as soon as the bell is pressed.” “Staff are marvellous.” - The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service are supported to maintain their life skills and are encouraged to make choices as far as possible. Social, spiritual and recreational activities meet the needs of the residents very well. EVIDENCE: The Malthouse continues to provide an excellent level of social, religious and recreational support to residents. Residents spoken with said they were happy with the lifestyle that living at the home afforded them. Some chose to spend time on their own but knew they could join in with any organised activities if they so wished. Activities included: • Quizzes • Outings • Visiting entertainers • Visits from local clergy. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 16 Activities were based on the preferences of the residents and are recorded. Residents and visitors confirmed that they could visit in private and were always made welcome. Residents said that they were free to choose whether they wanted to handle their own financial affairs. Some preferred to have a family member to act on their behalf. All residents spoken with confirmed they enjoyed the food provided. Records showed that residents’ likes and dislikes with regard to food were known and residents were aware that alternatives to the main menu were always available. Residents said: “Meals are cooked by proficient cooks and consequently most enjoyable.” “The food is very good and there is always a choice.” The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. EVIDENCE: To ensure residents and their representatives have access to the complaints procedure it is included in the information pack given to each resident. Residents said that they knew how to complain and felt confident that if they had concerns or complaints they will be listened to and taken seriously. No complaints had been received since the last inspection. The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides all staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. Care staff spoken with during the inspection confirmed that they had received such training. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of the environment at The Malthouse is very good providing residents with an attractive, homely and safe place to live. EVIDENCE: A tour of the premises and review of maintenance documentation showed the home is well maintained inside and out. There was evidence that equipment is serviced regularly. Residents have easy access to all communal areas. The well-tended garden is attractive and easily accessible. New paths had been laid to improve access for those residents using mobility aids. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 19 Resident’s rooms were of a good size and furnished appropriately. The home has recently purchased several new items of furniture, including armchairs. Bedrooms were personalised with a variety of mementos, pictures and small items of furniture. All areas of the home seen during the inspection were clean, bright and free from any unpleasant odours. Surveys completed indicated that the home was always kept clean. The laundry continues to be well managed. Adequate supplies of clean linen were seen to be available. One resident said, “The laundry facilities are exceptionally good.” The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are given the training and support so that they can give a high standard of care to the residents living at The Malthouse. EVIDENCE: At the time of inspection staff rosters demonstrated that there are sufficient staff on duty at that time. Mrs Bracher had made sure that she increased staffing levels at certain times of the day, when residents’ needs were higher, for example, in the morning when people need help to get up and at meal times. During the inspection staff were on hand to meet the needs of the residents. Residents spoken with confirmed that staff were on hand when they needed them and they were not kept waiting. The home has an ongoing training programme, which includes NVQ level 2 and 3 in care and over 50 of the care staff hold the minimum of a level 2 award in care. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 21 Three staff recruitment files were reviewed. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. However written confirmation of POVA first checks need to be held. At the time of inspection Mrs Bracher stated that the umbrella body, which processed these applications gave verbal confirmation that POVA first checks were clear. Training files demonstrated that staff were receiving induction training. Staff confirmed that they were encouraged to take up training opportunities provided. Recent training including: • Fire safety • Moving and handling • Induction • First aid • Protection of vulnerable adults • Medication • Care of residents with dysphagia Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is very well organised and the daily management and running of the home centres completely round the care of residents. Very good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: Through discussion it was evident that residents, visitors and staff enjoy the way the home is run and find the Registered Manager is very approachable. Mrs Bracher demonstrated throughout the inspection that she runs the home well. She follows robust procedures to ensure that she has a well trained and The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 23 competent staff to care for those people living at the Malthouse. Recruitment processes are thorough. There is a quality assurance and quality monitoring system in place. The home takes steps to review its performance regularly and residents’ views are sought and suggestions put forward are acted upon. One resident said, “The home is particularly well run and our retirement needs are appreciated.” One visitor said, “Excellent management.” The Registered Manager and residents spoken with confirmed that residents either deal with their own finances or have a representative to do so. The home will hold a small amount of money for residents if they so wish. Records showed that staff had received recent training in fire safety and manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and appropriate action was taken as necessary. The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 24 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 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19 Schedule 2 Requirement Written POVA first checks must be obtained prior to a new member of staff starting work in the home. Timescale for action 02/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © 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 The Malthouse DS0000070846.V362985.R01.S.doc Version 5.2 Page 27 - 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. 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