Inspection on 17/01/07 for The Minstrels Residential Home

This inspection was carried out on 17th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Minstrels Residential Home 07/11/05

The Minstrels Residential Home 01/08/05

The Minstrels Residential Home 02/03/05

The Minstrels Residential Home 16/09/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Minstrels Residential Home 88 Sleaford Road Boston Lincs PE21 8EY Lead Inspector Mr Toby Payne Key Unannounced Inspection 17th January 2007 08:30 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 Minstrels Residential Home DS0000045083.V327239.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 Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Minstrels Residential Home Address 88 Sleaford Road Boston Lincs PE21 8EY 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) 01205 359797 01205 358515 www.the-minstrels.co.uk Minstrels Healthcare Ltd Mrs Sandra Elizabeth Copeland Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 Brief Description of the Service: The Minstrels Residential Home provides personal care for up to 38 elderly people. On the day of the inspection there were 36 people living in the home. The home is located in extensive grounds, which also accommodates the Minstrels Nursing Home and sheltered accommodation flats. The home is set in large landscaped gardens with car parking facilities. The complex is in a residential area close to the amenities of Boston Town centre. It is also on a bus route. Accommodation is provided in a mixture of single and double occupancy bedrooms with many having en suite facilities. There is a shaft lift serving accommodation on the first floor. A 9 bed extension is being built together with other facilities to meet the needs of the people who will live in this new accommodation. The fees at the inspection on the 17/1/2007 ranged from £336 to £4i6 each week. Extras are for hairdressing which range from £5 to £20, chiropody £14.50, toiletries, personal newspapers and magazines The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.30 am. It was undertaken using a review of all the information available to the inspector about the Minstrels Residential Home. It took place over 5½ hours. The inspector spoke to 8 residents, 5 staff and the deputy manager and manager. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. The inspector also examined a pre-inspection questionnaire, which had been completed by the manager. Comment cards were received from 32 residents. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 6 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 Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 7 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): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was information available to enable residents to make a choice as to whether or not to enter the home. People received an assessment, which resulted in their needs being met. EVIDENCE: The home had a statement of purpose and service user’s guide. A copy was given to each resident when coming into the home. There was a detailed admission procedure, which described the needs of residents coming into the home. All residents were assessed before entering the home and written confirmation was sent to them that the home was able to meet their needs. A comment card stated, “my daughter came to look around the home, I thought how spotlessly and clean it was. I find they are very helpful in all I ask them to do”. The home did not provide intermediate care The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 8 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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a clear and detailed care planning system in this home. The health and welfare needs of people living in the home were fully met. EVIDENCE: All residents had care plans, which described their health and welfare needs. Care records included admission details including a photograph for identification purposes, admission details, assessment of daily living activities, personal history, moving handling assessment, risk assessment, care plan and daily report. As part of the inspection process the inspector tracked 2 resident’s care plans. There were clear records outlining their care and welfare needs. Efforts have been made to include residents wherever possible in identifying their care needs and being involved in reviews of their care. There was evidence to show that care plans were up to date and reviewed. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 9 There was sufficient information to enable staff to know how to care and support each person. The 2 tracked residents felt staff knew about their needs and were satisfied with the care and approach of staff. Staff were seen to have evident pride in their work and attended to people promptly and with little fuss. Residents were satisfied with the way staff cared for them and had confidence in the staff. Comments were, “The staff are always there when we seem to want them which is very good” and “I am treated very well and could not ask for anything more. I am very happy with living here and am very grateful in all the care that I have received from everyone”. The last pharmacy inspection was on the 29/9/2006. The report considered the service was excellent. The Inspector observed a medication round. There were 7 named staff responsible for the administration of medication. Three staff had a certificate in safe handling medication. There were no concerns about the medication arrangements. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 10 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): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities were varied and provide daily stimulation and interest for people living in the home. Visitors were made to feel welcome. Meals provided were nutritious and varied. EVIDENCE: Staff provided activities in the home. There was no written activities programme. The manager had meetings with residents every 8 to 10 weeks and the minutes of the last meeting on the 4/11/2006 were seen. These were displayed on the notice board leading the lounge/dining room on the ground floor corridor and a copy was given to each person. The minutes showed residents were asked their views about activities and were quite satisfied with the range provided. Activities provided included hairdressing weekly (the home has its own hairdressing room), outside entertainment weekly and 2 church services each month and occasional trips out. One resident also told the inspector that she went out using the local dial a ride bus service. Comments were “We enjoy everything we do especially the dancing and all the outings we go on”. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 11 The last Environmental Health Officers inspection by Boston Borough Council was on the 17/10/2006 and as a result of this, the home was awarded a silver award for its catering service. There was a set menu but an alternative was available if a resident did not like what was on the menu. The kitchen was inspected and was seen to be clean, tidy, well organised and well stocked with meat, fresh fruit and vegetables. The cook was appropriately dressed and there were clear up to date records. Lunch was observed in the dining room, which was nicely decorated with residents having lunch attended by care staff who wore plastic aprons and served food in a discreet manner. No resident had any complaints about the food and it was well served and residents were not hurried. Comments were, “The meals are very good and we have a very good choice” and “ the meals are very nicely served and hot.” The menu was displayed on the wall for all to see. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 12 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints received were treated properly and residents and visitors knew that any complaints they had to make would be addressed and taken seriously. Staff were recruited correctly to ensure that residents were protected from abuse. EVIDENCE: Each person received a copy of the complaints procedure, which was in service user’s guide and also displayed on the wall at entrance to the home. No complaints had been received by the home or the commission since the last inspection None of the residents or staff had any complaints about the home and felt they could discuss any concerns with staff or the manager. Staff also knew what to do if they received a complaint from a resident. Comments were ““I find staff always listen carefully and respond promptly”. All staff were correctly recruited including a check by the criminal records bureau (CRB). During their induction each member of staff received information about abuse. One member of the staff confirmed this information and knew what she should do if abuse was suspected. Indirect observation made by the inspector on the day of the inspection noted that staff were polite and respectful when talking to or undertaking care duties with residents. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 13 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): Standards 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents lived in clean, well decorated, homely and safe accommodation. Any maintenance was promptly addressed ”. EVIDENCE: The home was clean, tidy, well decorated and odour free throughout. There was a decoration programme. A 9 bed extension was being built and hoped to be open in the near future. There were lounge and sitting areas throughout the home. All the residents spoke highly of the accommodation and how much they liked their bedrooms. Residents were encouraged to bring into the home small items of furniture, television, pictures and personal items. . The gardens were very attractive and well maintained The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 14 Comments were, “I am very comfortable” and “when I came here with my daughter I said the home was very nice and clean and the staff were very friendly. I am happy and comfortable”. The inspector spoke to 2 domestic staff who showed evident pride in what they were doing. They said they enjoyed their work and felt valued and supported. The home was clean and odour free throughout. A comment card stated, “being fresh and clean was one of the reasons my family were impressed with the home”. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 15 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): Standards 27, 28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was adequately staffed with employees who were experienced and competent to care for older people. A wide range of inhouse training and training in care was provided. Residents are protected by robust recruitment practices. EVIDENCE: The duty rotas were examined. Residents did not express any worries about the level or availability of staff. During the inspection staff were seen to promptly attend to residents needs. A member of staff confirmed they had been recruited in accordance with the regulations. This included a check by the criminal records bureau (CRB) and a supported induction programme. There was a wide range of training provided which had covered National Vocational Qualifications. There were 60 of staff who had or were studying for NVQ. One member of staff was training to be an assessor. Training had covered since last inspection, fire prevention, first aid, moving and handling, Control of Substances Hazardous to Health (COSHH) and food hygiene. There was a training programme for 2007, which included The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 16 safeguarding adults, first aid, infection control, food hygiene, documentation for carers, moving and handling, fire prevention and health and safety. Staff and residents felt there were sufficient staff in the home. The manager monitored dependency and was able to employ more staff where required. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 17 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): Standards 31, 33 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well lead by a competent, well trained and committed manager. This in turn had given rise to a confident, supported and trained staff team. Records show that residents’ health and general welfare and safety are promoted. The home ensures that that the residents have the opportunity to voice their views and opinions. EVIDENCE: The manager had been in post since 1998 and had obtained a management and care qualification. She was also an assessor. Staff and residents had confidence in the manager. Staff received supervision regularly and spoke of the support received from the manager and deputy manager. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 18 The manager acknowledged that no service users surveys had been carried out and the requirement had not yet been addressed. She felt that quality assurance needed to be addressed. She also acknowledged that with the new extension she needed secretarial support. There was a detailed equal opportunities policy, which referred to discrimination, disability and victimisation. There were no concerns about equality and diversity. Records examined were well maintained, available for inspection and up to date. The home had detailed health and safety procedures. There were also infection control policies and staff made use of alcohol hand rub bottles throughout the home to further prevent infection. Where required risk assessments had been carried out and documented. There were a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm; fire drills and emergency lighting checks and testing of hot water have been undertaken. Care staff also received fire training as part of the homes initial training and as a regular training event. The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 19 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x x x 3 The Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP33 Regulation 24(3) Requirement The home must carryout quality assurance audits and make the outcomes known to residents and visitors. The timescale of the 15/2/06 had not been met. Timescale for action 16/03/07 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 Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Minstrels Residential Home DS0000045083.V327239.R01.S.doc Version 5.2 Page 22 - 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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