Inspection on 04/10/05 for Thomas Edward Mitton House

This inspection was carried out on 4th October 2005.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Thomas Edward Mitton House 28/02/08

Thomas Edward Mitton House 08/12/06

Thomas Edward Mitton House 08/02/06

Thomas Edward Mitton House 02/02/05

Thomas Edward Mitton House 05/08/04

Thomas Edward Mitton House 15/01/04

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

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

CARE HOME ADULTS 18-65 Thomas Edward Mitton House Belvoir Avenue Emerson Valley Milton Keynes Bucks MK4 2JA Lead Inspector Mrs Caroline Roberts and Guy Horwood Unannounced Inspection 4th October 2005 09:30 Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 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 Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 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 Adults 18-65. 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. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Thomas Edward Mitton House Address Belvoir Avenue Emerson Valley Milton Keynes Bucks MK4 2JA 01908 504778 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) The Disabilities Trust Miss Jane Hurrell Care Home 16 Category(ies) of Physical disability (16) registration, with number of places Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 16 people with a physical disability. Date of last inspection Brief Description of the Service: Thomas Edward Mitton House is a 16-bedded residential home for people with a physical disability. The aim of the unit is to provide rehabilitation for people with Brain injury back into more independent living or to move onto specific units more able to meet their needs. The accommodation consists of 16 single rooms all en-suite. The house has a library and a large dining area, as well as therapy rooms and lounges. Thomas Edward Mitton House is well located to take advantage of the facilities in Milton Keynes, with the public transport service running close by. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the unannounced inspection carried out at Thomas Edward Mitton House on the 4th October 2005. The lead inspector was Mrs Caroline Roberts who was accompanied by Mr Guy Horwood (Inspector). The inspection consisted of meeting with residents and staff, viewing records and documents pertaining to the provision of care and the running of the home. The inspectors toured the building, gaining permission from a number of residents to enter their bedrooms and viewing a further number from the doorway. The homes deputy manager, Mr Mike Walker, met the inspectors on their arrival, and was present throughout the course of the inspection. The inspectors discussed the inspection findings with Mr Walker prior to leaving the home. Throughout the course of the inspection staff were polite, helpful and welcoming towards the inspectors. The inspectors would like to thank staff for their assistance and co-operation throughout the inspection, and would like to thank the residents for allowing them into their home. What the service does well: What has improved since the last inspection? The Lounge has been decorated. The maintenance person has been fitting new wardrobe doors. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 6 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. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 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 the following standard(s): 2 and 4 A clear admission procedure is in place and all health care needs and rehabilitation needs are fully assessed prior to the placement-taking place. Visits to the home prior to admission are encouraged and take place where possible. EVIDENCE: All potential service users are fully assessed by the registered manager or one of the qualified staff prior to admission, ensuring through the assessment process that Thomas Edward Mitton House is the appropriate facility to meet the rehabilitation needs of the service user. All admissions to the home are planned and where possible depending on the health care needs and travelling arrangements of the prospective service user visits to the home are encouraged to view the facilities offered and meet with the staff before moving into the home. The records for two of the most recent admissions to the home were viewed and found to contain relevant information, which was detailed and included the views of health care professionals. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 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 the following standard(s): 6 and 7 The care plans fully address all aspects of rehabilitation treatment and care. Service users are supported where possible to make decisions about their own lives. EVIDENCE: Individual care plans were based on assessed needs and contained clear information of the care and support required by the service user. A weekly multidisciplinary goal-planning meeting takes place in the home to assess the progress made by service users, and any changes needed to the care plan. Personal decision making for service users during rehabilitation treatment is fully supported and encouraged by the care staff. However due to the medical conditions of some of the service users, communication may be limited and decision making for service users difficult to do and express. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 11 and 16 The privacy and dignity of the service users is respected by staff and their rights are respected. EVIDENCE: Staff spoken with said that they maintain the service users independence and dignity as much as is allowed by the medical condition of the resident. There was evidence that relatives can visit and get involved with the care of the resident. There are two areas within the home where independent living skills are practiced. Service users are encouraged to tidy their own bedrooms with the support of the domestic staff. It was observed during the inspection that staff respect the privacy and dignity of the service users. Even though there was sometimes no apparent response from the resident, the staff still knocked on the doors prior to entering and said who was entering and why. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 11 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 the following standard(s): EVIDENCE: Not assesses during this inspection. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 22 and 23 Policies and procedures are in place to ensure the safety of service users. EVIDENCE: There was a complaints procedure available for inspection. This included details of the Commission for Social Care Inspection and also the timescales for responding to complaints. There is a complaints log where the manager records any complaints made, and the outcome of any investigation. A concern was raised to the Commission three weeks prior to the inspection, this was discussed with the manager at the time, and the manager investigated the concerns and forwarded a copy of the investigation to the inspector as the individual who contacted the Commission wished to remain anonymous. The outcome of the investigation was satisfactory and further evidence gained during the inspection found that this concern raised was unsubstantiated. There are robust policies and procedures in place for adult protection, copies of the Milton Keynes inter agency abuse awareness policies are available in the home. Staff receive training in abuse awareness and this is also covered within the induction of new staff. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 24,25,27,28,30 The home provides a safe and homely environment for service users; unfortunately the home is starting to show signs of age and needs considerable financial input to refurbish area within the home. More attention needs to be paid to cleanliness of service users personal areas. EVIDENCE: Thomas Edward Mitton House has been purpose built; the home is on one level and has wide spacious corridors and large bedrooms, which are all en-suite. The house has been decorated and offers a homely environment, whilst being appropriate for the needs of service users. The office staff that operates the door opening system supervises the main entrance to the building. Out of hours this is operated by a code system. Furnishings in the home are of good quality. All of the bedrooms are single with en-suite facilities. There is a built in wardrobe, chest of drawers, bed and chair provided. Service users are encouraged to bring personal possessions into the home; evidence of this was seen during the visit. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 14 Some of the mattresses on the beds are in need of replacing; two were noted to have springs very close to the surface due to age and wear. All of the bedrooms have en-suite facilities it was noted that these are now in need of refurbishment. Floor to wall seals have lifted, stained flooring. Water not draining away due to uneven flooring. Cracked and broken tiles. Badly stained toilets. Damp smell in en-suites. A requirement is served that the provider submits a plan to address the above issues, within agreed timescales. Other areas noted as needing attention are: The lounge door does not close fully onto the stops. Curtains need re-hanging in the lounge. Toileting programmes taped to bedroom walls should be removed and placed in service users care plan files. Latex gloves should be stored appropriately. It was noted that one service user had recently changed bedrooms most of his belongings were still in boxes or piled in the middle of his new room, when the staff member was questioned as to why he had not been helped to unpack, she stated that he wanted to do this himself, this service user suffers from failing eyesight and the boxes and piles of belongings all round the walking space in the room present as a trip hazard. No evidence was available to say that anyone had tried to assist this service user or that he did not want any help. The home has a library room, which also doubles as a meeting room, a dining room activity room, and sitting room, separate smoking facility and a physiotherapy room with exercise equipment. There are two small kitchens, which service users have access to and which are used by Occupational therapy staff for individual cooking sessions. The home has adequate laundry facilities. Communal areas within the home were found to be clean and tidy however, more attention is needed to the bedrooms and en-suites. Dirty floors and toilets in the en-suites. Strong odours noticed in some of the bedrooms. Stained linen on some of the beds. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 15 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 32 Staffing in the home is appropriate to the needs of the service users. The staff on the day of the inspection were committed to their job and were highly motivated. EVIDENCE: Staff members spoken with said that they understand their roles and work well together as a team. Those spoken with said they felt valued and motivated. It was noted that they know the service users well and were respectful towards them. All staff spoken with stated that they felt included in the running of the home. Staffing appeared to be adequate on the day of inspection to meet the needs of the current service user group. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 16 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The Health and Safety of service users is promoted and protected. EVIDENCE: Maintenance schedules are kept and reports written. Health and Safety checks are made of the environment with records maintained. Fire alarms are tested weekly and recorded. Risk assessments are maintained for the environment. The home keeps a log of when items need servicing; this was thoroughly completed with certificates maintained for all services and safety checks. All mandatory training is undertaken by staff with appropriate records maintained. Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 17 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 3 x 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 x 2 3 X 2 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 X X X x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Thomas Edward Mitton House Score X X X x Standard No 37 38 39 40 41 42 43 Score X X X X X 3 x DS0000015072.V262919.R01.S.doc Version 5.0 Page 18 NO 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 2 3 Standard YA42 YA42 YA30 Regulation 13.4(a) 13.4(a) 23.2(d) Requirement The manager is required to ensure that latex gloves are stored safely. The lounge door is to be adjusted to ensure it closes fully onto its stops. The manager is required to review the cleaning schedules, to ensure that service users personal areas are maintained. The provider is required to undertake and audit of the ensuite bathrooms and forward an action plan to refurbish identified areas. Action plan to be forwarded by 1.1.2006. Identified work to be completed by 1.6.2006. The manager is required to undertake an assessment of the standard and quality of the mattresses in use in the home, replacing any identified as old and worn. Timescale for action 04/01/06 20/01/06 01/12/05 4 YA27 23.2(b) 01/06/06 5 YA26 23.2(c) 01/02/06 Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 19 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 Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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. Extracts may not be used or reproduced without the express permission of CSCI Thomas Edward Mitton House DS0000015072.V262919.R01.S.doc Version 5.0 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!