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Inspection on 02/08/05 for WCC Mayfield

Also see our care home review for WCC Mayfield for more information

This inspection was carried out on 2nd August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Staff working in the home were observed to be caring towards residents and were aware of residents likes, dislikes and needs. Residents said that their relationships with the staff was good and staff were caring and hard working. One resident advised that he was "waited on hand and foot". Another resident said that "if you want anything, you only have to ask." Visitors said that they felt welcomed by the staff and could visit at any time.

What has improved since the last inspection?

A garden and patio area with wheelchair access has been built at the front of the home, making this a very pleasant area for residents to sit in. During handover of each shift the manager ensures that there is a member of staff available on each floor to attend to residents needs.

What the care home could do better:

There are a number of things that the manager and staff need to do to make sure that the residents get the care that they need from staff. Assessment and care planning must improve so that the staff are able to know what to do for each resident. Residents` personal accommodation and communal areas would be improved by replacing dated and worn wall coverings and carpets. The County Council are in the process of addressing the need for the registered provider or delegated person to visit the home monthly and write a report upon the conduct of the care home.

CARE HOMES FOR OLDER PEOPLE Mayfield Mayfield Close Bedworth Warwickshire CV12 8ES Lead Inspector Patricia Flanaghan Unannounced 2 August 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 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. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Mayfield Address Mayfield Close Bedworth CV12 8ES 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) 02476 313600 Warwickshire County Council Mr Raymond Durkin Care Home 35 Category(ies) of Old Age ( 65 years and over ) Number 35 registration, with number Mental Disorder Number 1 of places Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 8 March 2005 Brief Description of the Service: Mayfield is a Local Authority home for older people, with thirty-five beds. It provides permanent care, phased care (which means that people come in for regular, planned periods) short stay and day care. Four assessment beds are also available for rehabilitation. The home is situated on a housing estate, within easy walking distance of Bedworth town centre. The town is a small but busy community, with a variety of shops, a local market and a civic centre. These are all in a pedestrian zone. The home is close to local ‘bus routes as well as being provided with services from Coventry and Nuneaton. It is also close to the M6 motorway. There is car parking to the front and rear of the home. Mayfield was refurbished in 1995 and provides accommodation on two floors. There are three lounges with kitchenettes as well as the main dining area. There is a day care area with its own lounge with kitchenette. All bedrooms have en-suite lavatory and washbasin, and on each floor there are bathrooms and lavatories suitable for people with physical disabilities. The main kitchen, laundry and staff offices are on the ground floor. As well as the two staircases, there is a shaft lift to the first floor.The home has a registered manager, an assistant manager, and three care officers, domestic staff and care staff, which covers the home over twenty-four hours. The home does not provide nursing care. Service users who require nursing attention receive this from the community nursing service as they would in their own homes. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection and took place over one day between the hours of 10.45am and 5.30pm. This was the first visit for this inspection year. The care officer on duty in the home was present during part of the inspection. The registered manager was also available during the day. The inspection process involved a tour of the home, talking with the care officer and manager, examining records and care plans, observation of care practices along with discussions with residents, staff and relatives who were visiting during the inspection. What the service does well: What has improved since the last inspection? What they could do better: There are a number of things that the manager and staff need to do to make sure that the residents get the care that they need from staff. Assessment and care planning must improve so that the staff are able to know what to do for each resident. Residents’ personal accommodation and communal areas would be improved by replacing dated and worn wall coverings and carpets. The County Council are in the process of addressing the need for the registered provider or delegated person to visit the home monthly and write a report upon the conduct of the care home. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 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. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5. Standard 6 is not applicable for this service. Assessments are undertaken to ensure that the home can meet the person’s identified care needs. Prospective residents and/or relatives have the opportunity to visit the home in order to assess the facilities and suitability. EVIDENCE: All potential residents are assessed before being offered a place in the home and three pre-admission assessments were seen and examined. All assessments were comprehensive and provided sufficient information which would support staff in meeting the needs of residents in their care. A relative spoken with advised said that his mother, who had only recently been admitted to the home had received a visit from a member of staff working in the home and he had the opportunity to visit and view the home on behalf of his mother prior to making a decision about moving in. He expressed that he was happy with the home and was impressed by the friendly and caring attitude of the staff stating that there was a ‘lovely homely feel to the home’. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Care plans require review to provide the staff with the necessary information to meet individual residents health, social and personal care needs. Service users feel they are treated with respect and dignity. EVIDENCE: Three resident care records were examined. Service users health, personal and social care needs were set out in the care plans examined. The care plan documentation examined does not allow for staff to fully identify the care needs of residents from the information available, which results in the lack of a detailed action plan explaining how care staff should meet residents needs. Individual care plans should detail what staff intervention is required and where possible be measurable so that staff are quite clear on what is required of them. A discussion was held with the manager regarding how this could be improved. Daily entries seen in care records tended to be repetitive and the manager should monitor these entries to ensure that staff individualise daily records rather than using standardised phrases and statements. Daily notes completed by care staff should provide comments relevant to each service users needs. There was evidence that there is good liaison between care staff, residents GPs and District Nurses who visit the home daily. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 10 Staff also seek assistance and professional help from others outside the home, such as dieticians, community nursing services, and community psychiatric nurses. Staff spoken to were able to describe the care given to individual residents and this was appropriate to the needs described in their care plans, however, lack of written information could result in all care needs not being identified and therefore the omission of care. Care plans contained written evidence that residents had access to health professionals, which include the dentist, dietician, district nurses and a GP. Service users confirmed that they had received visits from the GPs and District Nurses when necessary. There was evidence of relatives and residents involvement in care planning and review. The residents were seen to be treated respectfully by staff and appropriate facilities and space is provided for their personal care needs and private visitors. The residents spoken with confirmed that privacy and dignity was respected and that they were assisted tactfully and sensitively. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14 Residents were satisfied with their lifestyle in the home and they had been able to exercise choice and influence decisions affecting them. Contact has been maintained with relatives and friends of residents. Opportunities to access the local community have been made available. EVIDENCE: Staff undertake regular activities with residents. Activities include bingo sessions, reminiscence, life history, card making, painting, dominos and movement to music. A number of outside trips are undertaken throughout the year, for example, canal barge trips, pub lunches and concerts The home has the use of a minibus. Entertainers also visit the home and church services are held monthly to meet residents’ religious requirements. Residents said that they could choose how they spend their day and could take part in the social activities if they wished to. Most residents felt that the level of activities provided by the home was adequate. However, one resident advised that there is “not enough to do” and another stated that the home “have spells of doing a lot, then nothing.” A resident on respite stay in the home also advised that she goes to bed early as there is nothing to do in the evenings. It is recommended that the registered manager ensures that suitable and varied social and leisure opportunities are available to all residents. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 12 Residents meetings are held regularly. The minutes of the meeting held on 26th May was displayed in the entrance hall. The minutes demonstrated that residents have a say in the running of the home with several suggestions on activities they would like to see delivered. Observations made during the inspection showed that staff allowed service users time to carry out their daily living routines. Relatives, friends and other visitors are encouraged to visit throughout the day and maintain contact and involvement in the care of their relative. A member of staff was heard to advise the relatives of a recently admitted resident that they were welcome to join their relative for a meal at the home. Numerous relatives were observed to visit on the days of inspection and conversations were held with five visitors. Visitors were positive about the home and said they were happy with the care their relative was receiving and felt involved in the care and day to day living in the home. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection. EVIDENCE: Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 24 and 26 The home is generally well maintained and residents live in a safe, clean and comfortable environment. EVIDENCE: A tour was carried out of the home with the care officer. Generally, the home is well presented clean, free from offensive smells, light, airy and homely in resident areas. The walls and door frames in corridors were marked and scuffed. This creates a poor first impression for visitors. The corridor on the second floor was very dark which was due to the dark coloured wallpaper in this area. Residents live in comfortable rooms and are encouraged to bring personal items in with them. Personal possessions were noted in the bedrooms viewed during the inspection visit. Some bedrooms require re-decoration with torn or faded wallpaper evident. The carpet in one room was stained with an offensive odour evident. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 15 All bedrooms have an en suite toilet and wash hand basin. There are sufficient toilets and assisted bathing facilities near communal areas. Gardens in the home are well kept with the grounds being easily accessible to residents and their visitors. A number of residents were seen to sit outside during the inspection visit which was undertaken on a warm pleasant day. A number of residents advised the inspector that they enjoyed going into the gardens for tea on sunny days. A patio area with wheelchair access has been built at the front of the home since the last inspection visit. The laundry was clean and in good order with systems in place to manage dirty laundry. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The home employs sufficient trained and competent staff to meet the needs of its residents. EVIDENCE: It was evidenced from duty rotas and the number of staff on duty on the days of inspection, that there was sufficient care staff available to meet the needs of residents during the day. Rotas examined showed that there are five staff on duty in the morning, four in the afternoon and two during the night. Some residents and visitors spoken with were of the opinion that there are not always enough staff on duty. One resident advised that the home has a “staffing problem” and that “staff are always phoning in sick.” The manager must ensure that there are sufficient staff on duty at all times to assist residents with their daily needs. Training records were examined which demonstrated that staff have regular training on the diseases and illnesses associated with old age ensuring they are competent to do their jobs. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 The home appeared to be well managed and quality assurance was in place. Resident’s monies are handled appropriately, safeguarding them from financial harm. EVIDENCE: From observations made, and discussions with residents, visitors and staff, it was evident that the home was being run in the interests of residents. Quality assurance, including feedback from residents and their representatives, was seen documented. A formal quality system was evidenced. The County Council are in the process of addressing the need for the registered provider or delegated person to visit the home monthly and write a report on the conduct of the care home. A check on the records and a discussion with residents evidenced that all had the opportunity to handle their own finances and all residents and families had chosen to do so. Day to day monies of residents were checked and money held reconciled with the ledger. Inventories of valuables and belongings brought into the home were recorded. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 x COMPLAINTS AND PROTECTION 2 3 3 x x 2 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 2 x 3 x x x Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 19 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. Standard 7 Regulation 15 Requirement Care plans must be further developed, which clearly advise staff how specific care needs are to be met. The registered provider must ensure that the home is kept in good decorative repair. The odour in the individual room must be attended to and the carpet cleaned where necessary. The registered provider or delegated person must visit the home monthly and write a report on the conduct of the care home. A copy of this report must be left with the manager and a copy forwarded to the Commission for Social Care Inspection (Time scale of 11/10/04 not met). Timescale for action 31 October 2005 31 October 2005 30 September 2005 30 November 2005 2. 3. 4. 19 23 33 23 16(2) 26 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. Mayfield Refer to Standard 12 Good Practice Recommendations The registered manager should ensure that suitable and varied social and leisure opportunities are available to E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 20 residents. Details of how the home aims to ensure residents have opportunity to pursue their interests/hobbies should recorded. Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Mayfield E53 S34958 Mayfield V243499 020805 Stage 4.doc Version 1.40 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. 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. 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