Inspection on 25/05/05 for The Mount And The Olives

This inspection was carried out on 25th May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Mount And The Olives 10/07/06

The Mount And The Olives 10/01/06

The Mount And The Olives 09/07/04

The Mount And The Olives 17/03/04

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

CARE HOME ADULTS 18-65 The Mount and The Olives 9, 11 & 13 Delamark Road Sheerness Kent ME12 1RB Lead Inspector Grahan Cummings Unannounced 25 May 2005 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Mount and The Olives Address 9, 11 & 13 Delamark Road, Sheerness, Kent, ME12 1RB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01795 665048 Isle of Sheppey Mencap Mr Kenneth Shaw CRH 16 Category(ies) of Care Home for Younger Adults (18 - 65) - LD registration, with number Learning Disability - 16 of places The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Service User over the age of 65 whose date of birth is 23.08.1932. Date of last inspection 9 November 2004 Brief Description of the Service: The service offers 11 beds in the main house, The Mount, and 2 in the adjoining property, The Olives, where service users are semi-independent.The main house has three floors, with bedrooms on the first, second and third floor. The adjoining property has two floors only, the bedrooms being on the first floor.Both homes are located next door to each other in the centre of Sheerness within a short walking distance of all local amenities. The facility was first registered in 1977, having been built and supported by the local community, from where service users are admitted.Within the confines of the physical layout of the premises, some efforts have been made to comply with the environmental standards, largely by using former double rooms as singles when service users have left. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and carried out by Graham Cummings, Lead Inspector, and Sue McGrath Regulatory Inspector. The Inspectors arrived at 10:00am on Wednesday 25th May and were met by Pam Balchin, Deputy Manager and Alison, a member of care staff. The Mount and Olives is registered for 16 residents and presently there are 13 residents living at the home, most of them have been living at the home since it opened 29 years ago. The Provider has requested a Variation Form to reduce the occupancy from 16 to 14. There were 2 staff and the Deputy Manager on duty at the time of the Inspection. The Inspectors spoke to staff, Residents, viewed documentation and toured both properties. Since the last inspection chairs, carpet and curtains have been renewed, medication procedures have improved, some redecoration has taken place and the Deputy Manager has successfully completed their NVQ 4 in Care. There are still some outstanding issues regarding the recording of residents finances and care plans. What the service does well: What has improved since the last inspection? What they could do better: The Inspectors noted that there appeared to be a reluctance to change some of the methods of recording so that individual residents details were confidential and their finances were accounted for and recorded in an individual book. Recording of individual staff supervision, staff meetings and residents meetings needs to take place. Window restrictors need to be put in place on upstairs windows to the front and rear of the property. The Manager has informed the Inspector that window restrictors have now been fitted. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 6 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 Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5, Residents do not have a Statement of Terms and Conditions on their file. EVIDENCE: Inspectors were informed that the residents had been informed verbally of their terms and conditions but copies were still written in a format that residents were unlikely to understand and need to be written in a more user friendly way. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9,10 The care planning system is consistent and provides staff with the information they need to meet Residents needs. Resident’s finances are recorded inappropriately. Residents are supported to take risks as part of an independent life style. Residents confidentiality cannot be guaranteed. EVIDENCE: Residents care plans were seen by inspectors and found to contain relevant information for staff to be able to meet the individuals needs. The Manager keeps the finances of residents at his home address and Inspectors were unable to view them, this raises issues of confidentiality and security. The Manager was asked to rectify this at the last inspection and this will now be made a Requirement. The records must be stored securely within the home and in accordance with the Data Protection Act 1998. It was also noted that on the homes form, Care and Administration of Residents Finances, page 2, that all of the residents names were on the same form giving information of their individual benefits, this breaches Residents confidentiality. The Manager has informed the Inspectors that this has now been addressed and Residents finances are now detailed individually. Resident’s individual finances need to be recorded in individual books and receipts must be gained for all expenditures made. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 10 Inspectors also noted that on page 1, point 2 of the document, that £3 per week would be paid into an activity fund from each Resident, if the Resident did not attend activities one week then ‘it would remain in the fund and be used for the benefit of all residents’, there was no evidence that Residents were given a choice in this decision or that the matter had been discussed with them. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,16,17 Links with the community are good and support Resident’s social and educational opportunities. Appropriate activities are available to Residents. Meals offered are healthy and nutritious. EVIDENCE: On the day of the Inspection 8 of the Residents had chosen to attend the Crawford Day Centre and 1 was at college attending a Basic Skills course. 3 Residents remained at The Mount and 1 at The Olives. The 2 Residents who live at The Olives are semi independent and do their own shopping, cooking and are responsible for keeping the house clean and tidy. The Olives is monitored on a daily basis by staff from The Mount. One Resident from The Olives said that they had lived there for about 20 years and was ‘happy with his life’ another Resident from The Mount said that they were ‘not well and missed going to the Crawford Centre’. The Crawford Centre arrange outings on a regular basis and recently had organised for attendee’s to go up in a tethered Air Balloon. Risk assessments were found on Residents care plans. Other activities include swimming and Ten Pin Bowling. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 The medication at this home is well managed promoting good health. EVIDENCE: The medication procedures in place were in line with the Royal Pharmaceutical Society of Great Britain. The storage cupboard is on the wall in the laundry room and Inspectors were conscious of how warm the room was, Inspectors have suggested that the room temperature is monitored and recorded. The Manager has informed the Inspectors this is now being carried out. Inspectors cross referenced an accident recorded in a Residents file with the accident book and found this to be well recorded. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Arrangements for protecting Service Users are not satisfactory placing them at possible risks of abuse. EVIDENCE: Inspectors saw no evidence that residents finances are protected from abuse. The home does not keep individual records of Residents finances at the home and they are kept at the Managers home address and could not be viewed. The Manager is still acting as appointee to the Residents money and no progress has been made regarding the Requirement from the last Inspection relating to Residents money being pooled to pay transport costs and no formal written agreements were seen to show their agreement. As already stated in the Individual Needs and Choices section (Standards 6 – 10) Residents activity money is also pooled with other Residents money and if it is not used it is left to accumulate, this means that Residents individual monies cannot be fully accounted for. Inspectors are concerned that the Manager and Deputy are not protecting themselves from possible allegations of financial abuse by having a clear audit trail. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,27,28,29,30 Recent investment has significantly improved the appearance of the home creating a more homely atmosphere. Bedrooms reflect Residents independence. Toilets and bathrooms provide sufficient space to meet Resident’s needs. The home is clean and hygienic. EVIDENCE: The purchase of new chairs, carpet and curtains has made a significant improvement to the home. Some internal redecoration has taken place, and although the hallway was repainted white, several bathrooms have been painted in pastel colours. Inspectors were still concerned to hear that Residents had not been offered a choice in the colours chosen. External redecoration to the front and rear has also taken place. The rooms that had 2 beds in at the last inspection were still in place, Inspectors were informed that the Resident in the Olives had requested it remained in the room, Inspectors noted that this bed had a broken leg, the other bed would be removed as agreed. None of the fluorescent lights have been changed in the bedrooms or do not have diffusers on them. The wardrobe that at the last inspection was found to have a very rough interior surface has been sanded down and although not smooth the risk has been reduced significantly. Inspectors were The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 15 concerned that all upstairs windows did not have restrictors on them and raised concern about the safety of Residents falling from them deliberately or by accident. Radiator covers have not been fitted to any of the radiators. Inspectors observed furniture with materials stored on it placed in front of the lift door on the first floor, this was pointed out to the Deputy who said that it would be removed that day. The home was clean and tidy and free from offensive odours. The Manager has informed the Inspector that the window restrictors are now fitted and that all fluorescent lights of 4 and 5 foot would have diffusers fitted within 3 months and the 2 foot ones would be completed soon after as they are linked to the emergency lighting system. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35,36 Residents appear to be well supported by staff. Staff have access to training courses. Records of staff supervision were not kept. EVIDENCE: Most of the Residents living at The Mount and Olives have been there since it opened in 1977. Inspectors felt that it may be helpful if the Manager could arrange a Dependency review of the Residents and enable them to meet any of their changing needs and assist the home plan it’s training program. The Deputy Manager has now completed her NVQ 4 and is looking to become the Home Manager in the near future, 2 staff have started their NVQ 2, 2 have refused and 4 staff have already got their NVQ 2’s. The Deputy Manager informed Inspectors that she had recently attended a half day training course on Supervision and started to supervise staff, however there were no records kept of any of the supervisions she had carried out with staff. There were no records of any staff meetings being held. No new staff members have been employed since the last Inspection so the recruitment process could not be checked to see that procedures had been followed following the Recommendations of the last inspection. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41,42,43 The management of this home is satisfactory overall but records are not well managed and this practice could place Residents at risk. The systems of recording for Resident consultation are poor with little evidence that Residents views are sought or acted on. EVIDENCE: The physical care of the Residents is good. However, there are no records of any discussions or meetings with Residents to show that they are included or have any say in the running of the home. The Home Manager is still the Responsible Individual and Appointee for all of the Residents finances, records of finances are also still kept at the Managers private home, this is of concern to the Inspectors as it leaves the Manager unprotected from allegations of financial abuse. The home is a charity and should have a board of Trustees, however there is still some difficulty in recruiting members to the board and it is still unclear if regular effective board meetings take place. The Deputy Manager has requested an application form to become Manager of the home now that she has completed her NVQ 4. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 18 The present Manager appears to be reluctant to move forward and consider some of the current good practice theories including National Minimum Standards. It is important that Residents choices and involvement in the running of the home starts to improve along with the arrangements for the recording of incomes and expenditure of individual Residents finances. It is also essential that individual Staff supervisions are recorded and that Residents and staff meetings take place and are recorded on a regular basis. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 2 Standard No 22 23 ENVIRONMENT Score x 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 1 x 3 1 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 3 3 2 3 Standard No 11 12 13 14 15 16 17 x 3 x x x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Mount and The Olives Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 2 1 x 2 1 x 2 H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 20 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 7 Regulation 17.(2) Requirement The Registered Person must ensure that where Residents cannot manage their own finances the home keeps records of how their personal finances are spent and that records are kept of monies given to Residents. The Registered Person shall ensure that the records referred to in paragraphs 1 and 2: are at all times available for inspection in the care home by any person authorised by the Commission to enter and inspect the care home. The Registered Person shall make suitable arrangements, by training staff or by other measures, to prevent Residents being harmed or suffering abuse or being placed at risk of harm or abuse; in that Residents have given written agreement to a specified individual to make decisions on their behalf. The Registered Person shall ensure that the care home is conducted so as - to promote and make proper provision for the health and welfare of Residents; in that window Timescale for action 30th November 2005 2. 10 17.(3)(b) 30th November 2005 3. 23 13.(6) 30th November 2005 4. 24 12(1)(a) 30th November 2005 The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 21 5. 36 18(2) 6. 38 12(3) 7. 24 12(1)(a) restrictors should be fitted to all upstairs windows to a maximum opening of 100mm. The Registered Person shall ensure that persons working at the care home are suitably Supervised. Records of these 1 1 meetings should be recorded and placed on the individual staff members file. The Registered Person shall, for the purpose of providing care to Residents, and making proper provision for their health and welfare, so far as is practicable ascertain and take into account their wishes and feelings; in that Residents views are sought and recorded individually or at group meetings. The registered Person shall ensure that the care home is conducted so as - to promote and make proper provision for the health and welfare of the Residents; in that the storage of furniture be removed from blocking the exit/entrance to the lift on the 1st floor. 30th November 2005 30th November 2005 Immediate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 20 Good Practice Recommendations That temperature of the medication cupboard is taken and recorded daily to ensure that the teperature falls within 16 and 25 degrees as stated in the Guidelines of The Royal Pharmaceutical Society of Great Britain. The 2nd bed in the Residents room at The Mount be removed by the end of 2005 as stated in the last Inspection report That the lighting in Residents bedrooms and communal areas are changed to pendant lighting or diffusers are put H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 22 2. 3. 24 26 The Mount and The Olives 4. 5. 29 33 6. 7. 37 24 on the existing fluorescent lighting. That radiator covers are fitted to all radiators in Residents bedrooms and communal areas. That all Residents are assessed for their dependancy to ensure that the staffing requirements are able to meet their changing needs and training for staff can be arranged to meet any changing needs. That the Manager discuss with the Board of Trustees and take action to ensure an effective Board of Directors are put in place to suport the management of the home. The 2nd bed in a Residents room at The Olives is repaired as one of the legs is broken, the Resident has requested that the bed remain in her room. The Mount and The Olives H56-H05 S24026 The Mount and The Olives V227866 250505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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