Inspection on 29/01/09 for The Mews Nursing Home

This inspection was carried out on 29th January 2009.

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.

Other inspections for this house

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Dystlegh Grange

The Good Companions

Springfield Cottage

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Sue Ryder Care Birchley Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Mews Nursing Home Boundary Street/Fenton Street Rochdale Lancashire OL11 3TH     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: Bernard Tracey     Date: 2 9 0 1 2 0 0 9 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. that people have said are important to them: They reflect the things 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: The Mews Nursing Home Boundary Street/Fenton Street Rochdale Lancashire OL11 3TH 01706359540 01706766414 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leyton Healthcare (No 2) Limited Name of registered manager (if applicable) Mrs Alison Mary Ireson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of users who can be accommodated is: 60 The registered person may provide the following category of service only: Care home with nursing - code N to service users of the following gender - Either Whos primary care needs on admission to the home are within the following categories: Physical disability - Code PD, maximum number of places: 60 Date of last inspection Brief description of the care home The Mews is situated in Rochdale, near to local shops and the town centre. It is close to the railway station, main bus routes and the motorway network. There is adequate car parking both to the front and back of the home. The Mews is registered to care for young adults aged 18 years and over with physical disabilities. It comprises of three units situated on four floors. Twenty-four hour nursing care is provided by suitably qualified nurses supported by care assistants. The staff are also able to access specialist nursing services if required. The Mews employs Care Homes for Adults (18-65 years) Page 4 of 28 care home 60 Over 65 0 60 Brief description of the care home its own physiotherapist and access to chiropodists, dentists and opticians is provided. The current scale for charging for care is determined through a social services financial assessment for each individual and therefore varies according to personal circumstances. The home makes the following charges over and above the weekly care: Chiropody 8.50 Hairdressing From 5.25 to 18.50 Newspapers As charged Outings/Activities Cost dependent on outing Care Homes for Adults (18-65 years) Page 5 of 28 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We (the Commission of Social Care Inspection) undertook a key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. The manager was asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, these comments have been included in the report. Comment cards were posted out to Five residents but none were returned. Comment cards were received from staff working at the home. We spent Five and a half hours at the home over one day. During this time, we looked Care Homes for Adults (18-65 years) Page 6 of 28 at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. Time was spent talking with the Unit Manager who has specific responsibility for the training in the home. We spent time speaking to eight residents, two visitors as well as speaking to eight staff, the manager and the Deputy Manager. 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. Care Homes for Adults (18-65 years) Page 8 of 28 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 Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 thereby ensuring that the home can meet the assessed needs of the person using the service. Evidence: Before any resident is admitted to the home an assessment of their needs is undertaken, by a senior member of the staff from the home and from the professional, requesting their admission, such as the social worker. The three files we examined showed that care management assessments had been completed by social workers. Two residents who had recently been admitted to the home said it was helpful to meet someone from the home before they moved in as well as having the opportunity to visit. Potential residents and their relatives were given a copy of the Service User Guide either when they visited the home or during their assessment visit. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: The assessment documents of three residents were looked at. The assessments were detailed and gave a clear indication of the residents needs and their capabilities. The assessments looked at the physical, mental and social care needs of the residents, as well as the involvement, if any, of their relatives. Particular emphasis was placed on the wishes of the individual in relation to personal choices and preferences. This ensures that an individuals diverse needs are addressed and are able to be met within the home. We spoke with the relative of a resident who had been admitted from home. The relative stated that the manager had been out to the residents home to undertake an assessment of his needs and felt confident that the home would be able to meet the neeeds of her husband. Feedback from discussion with residents indicated that they felt they had been given sufficient information about the home prior to moving in. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 living at the home are provided with information and support enabling them to make decisions about activities of daily living. Evidence: The care plans we looked at are extremely informative, enabling the care staff to identify with residents specific care needs, together with their preferences, likes and dislikes. All health, social and emotional care needs are identified and individual care plans are prepared for each of the identified need. The care plans are signed by the resident to confirm agreement with them. Residents spoken to confirmed that they had discussed the care plans with the manager or nurse and were able to discuss their preferences in relation to meals, times of going to bed and getting up and how they liked things done. Residents have choice over their personal care and are encouraged to be independent Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: and responsible for their own personal hygiene where possible. Risk assessments are undertaken on all residents in relation to daily living and appropriate measures are put in place to reduce or remove any potential risk. These are recorded in the care files. Residents felt they were treated with respect and in a dignified manner at all times. Privacy is respected at all times. Residents are free to meet with their visitors in the privacy of their own bedroom or in one of the communal areas. Residents spoke highly of the manager, the care and ancillary staff and commented on how committed and caring they were. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to enjoy a full and stimulating lifestyle with a variety of opportunities to choose from. Staff are skilled at promoting choice and control in residents lives. Evidence: The range of leisure activities available in the home was varied, reflecting the diversity of residents and their social, intellectual and physical capacities. The home has dedicated activity co-ordinators who organise events and activities within the home, as well as trips out to various places of interest. The programme of activities was displayed in the reception area and in other strategic places throughout the home, so that residents were aware of what was available. The staff have sought the views of residents and considered their varied interests and Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: abilities when planning the routines of daily living and arranging activities. Routines are y flexible and residents told us that they can make choices in major areas of their life. The routines, activities and plans are resident focussed, regularly reviewed and can be quickly changed to meet individual residents needs. Each resident has their own activities and interest assessment completed and their interests are recorded and a programme agreed to reflect their personal preferences. Links with the community were good and valued the role which relatives and friends continued to play in the lives of residents. Residents benefited from being able to exercise choice and control over their lives. The manager and staff are aware of promoting equality and diversity and encourage the residents to develop a lifestyle and interests that are individual to them. Some residents choose to take part in group activities, such as going for bar meals, walks, bowling, or choose to go on holiday with other residents within the home. Residents we spoke to said they enjoyed the food and that they receive enough to eat and drink. We observed staff being attentive during the lunchtime period, asking if people had finished their meal before they removed their plate, asking if they wished for some more and offering a choice of starter, main meal and dessert. The dining tables were set appropriately - tablecloths, cutlery, serviettes and jugs of water. Staff were observed assisting the residents during mealtimes in a discrete way but ensuring each person was able to enjoy food of their choice. Staff carried out their care and support duties in a way that enables residents to maintain choice and control over their daily lives wherever possible. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Health care needs, including medication, are carefully monitored and residents and relatives are confident that the home can meet their needs. Evidence: Individual care plans are in place for each resident. The plan sets out how the current and anticipated needs of each resident are to be met. The unit manager was able to describe how relatives are involved in the drawing up of the care plan and understood the meaning of a care plan to describe the assessed needs of a resident and how the needs were to be met. The care plan would also include any changes in the residents condition. Signatures in the care plans, indicating that the individual agreed with the plan and any alterations made to it after consultation with the individual, confirmed this involvement. Risk assessments are in place for residents and records are maintained in the residentscare plan. The care plan is generated from the single care management assessment and the assessment provided by the home. The plan sets out how the current and anticipated Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: needs are to be met. There is evidence that the resident together with family, friends or advocate are involved in the drawing up of the plan. Care plans examined had been reviewed on at least a monthly basis, which is above the necessary requirement of this standard. The review of care is conducted on a group basis that involves the resident, the key worker and the named nurse and, on occasions, the representative. Any potential restrictions on choice, freedom, services or facilities that become part of the residents daily life, had been discussed and agreed with the resident during assessment and recorded in the care plan. Two residents spoken with confirmed that they had been given all the information about how the home is run before coming in the place One resident said she had received all the care and help I could have wished for from the wonderful staff. Information in respect of residents is shared within the home team and visiting professionals in the interests of the resident. In this respect, it also necessary for the home to share personal identification and some medical detail with the local police when concern surrounds an individual who is absent from the home without prior arrangement and the home feels that the person may be at risk. Procedures for responding to unexplained absences and who should be notified are confirmed in a written policy. Wherever possible, residents are encouraged to manage their own finances and, at the time of the inspection, most residents were taking personal control over their money, but where the home does manage the finances for individuals, records are maintained and a recognised tool for audit is incorporated in the monthly review of finance supplied to the Registered Provider by the homes administrator. Observations made during the inspection indicated that staff had developed a good rapport with residents and there were several examples of spontaneous and humorous interactions between residents and staff. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Residents were confident that complaints would be listened to, taken seriously and acted upon. Appropriate systems were in place to protect residents from abuse. Evidence: A clear, detailed formal complaints procedure is displayed in the reception area of the home and provided to each resident, supporting the homes open culture, where residents were encouraged to express their views informally and in the regular residents meetings. Residents felt staff listened to them and they knew who to talk to if they were unhappy or had any concerns. A resident stated It would be difficult to complain about anything here the staff are brilliant, the place is good. The Commission for Social Care Inspection has received no complaints about the home since the last inspection. Abuse awareness training was provided to all new starters, with annual updates. Staff understood the importance of listening to residents concerns and how to respond to any issues that were raised. Care Homes for Adults (18-65 years) Page 19 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 is an ongoing maintenance and refurbishment programme in place making sure that the home continues to meet the needs of the people living there. Evidence: A tour of the home confirmed that the home was well maintained, clean and free from any offensive odours. Ramped access was provided to the front door and level access throughout each of the two floors. A passenger lift was provided and handrails fitted to corridors throughout. Everyone spoken with thought the home was a safe place to live and work in. Eight residents spoken to were very pleased with their individual rooms and said that they had 2brought in a number of personal possessions to make them feel more homely. All bedrooms were fitted with door locks and lockable storage space to ensure residents valuables were kept safe. Staff have a master key, which could be used to gain access in an emergency. Residents said staff kept the building clean and odour free; inspection of the premises supported this view. Discussion with two domestics verified that sufficient staff and Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: equipment were provided to ensure the home was maintained in a clean and hygienic condition. An infection control policy was in place and training was provided in this area. Staff spoken with described safe infection control practice. Disposable gloves and colourcoded aprons were provided for staff use and liquid soap was available throughout. Satisfactory practice was in place with regard to disposal of clinical waste. The laundry was sited away from the food preparation area and was seen to be clean and orderly. Sufficient and suitable equipment was provided and laundry was attended to efficiently. Five residents said that they were satisfied with the laundry system at the home and that there was a quick turnaround on the clothes sent for cleaning. Care Homes for Adults (18-65 years) Page 21 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 staff team had the collective skills, training and expertise to undertake their roles effectively and good recruitment and selection procedures were in place to ensure that the residents were protected. Evidence: Staffing levels within the home were seen to meet the needs of residents. Care staff undertook their duties in a friendly and caring manner, promptly supported residents needs. Residents confirmed that staff were always respectful and met their needs competently. In the main, residents were satisfied with the support they were given and described staff as ok, nice people, who find time to listen. Sufficient ancillary staff were employed, e.g., domestics, laundry and kitchen assistants, cook and handyman. Staff were, in the main, knowledgeable about the needs of residents and demonstrated that they understood their own role. Staff files demonstrated that a robust recruitment process is in place, with all appropriate checks being undertaken. These include references, Criminal Record Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Bureau disclosures and, for nursing staff, registration with the Nursing and Midwifery Council. New staff undertake a full induction programme that is followed by further in-house training. Several staff are presently undertaking National Vocational Qualifications in care at Level 2. The home has an ongoing training programme that staff can apply for. Several staff have received training in abuse awareness and more are booked to attend in the future. Staff spoken with showed that their knowledge had increased since the training and that they were more aware and confident in reporting concerns. Computerised, individual staff training records provided a clear summary of both induction and ongoing training. This was extensive and wide ranging, with mandatory courses, i.e. moving and handling, medication, fire safety, and first aid. Specialist training included care planning, risk assessment, mental health, self-harm and challenging behaviour. This training package was confirmed by the manager and was identified in the written AQAA she had provided us with. Similarly, staff who were interviewed confirmed that training was available, that they were encouraged to attend and that it gave them appropriate competencies to meet the needs of the residents. A staff member commented, the training is excellent here. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 living in a well-run home where their safety and welfare are promoted and protected. Evidence: The manager has the required qualifications and experience, and is competent to run the home. There is a strong emphasis of being open and transparent in all areas of running of the home. The manager and staff work hard to maintain a culture, where everyone feels they are included in decision making and feel valued as an individual. There is a good system in place to gather staff, residents and relatives views through regular meetings and satisfaction questionnaires as part of the monitoring of quality. Staff spoken to had a clear understanding of their role and what was expected of them. Documentation was examined that confirmed that staff received regular supervision and annual appraisal. Residents and visitors spoke well of the management team and the care and support Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: that they give. We were able to witness their approach to the residents and staff and confirm the comments made. Information provided by the manager in the AQAA and examination of the records, confirmed that all safety equipment is regularly serviced. The policies and procedures in the home ensure that the health, safety and welfare of the residents and staff are promoted and protected. Care Homes for Adults (18-65 years) Page 25 of 28 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 Adults (18-65 years) Page 26 of 28 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 1 24 A programme of routine renewal of the furniture and carpets in the home should be maintained so that residents can live in a suitably equipped and furnished home. Care Homes for Adults (18-65 years) Page 27 of 28 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 © (2009) Commission for Social Care Inspection (CSCI). 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