Care Home: Mallard House

What the care home does well People using the service benefit from a home which is appropriately staffed and which can readily draw on the skills and approaches of a range of healthcare professionals. The home employs staff to provide social care and rehabilitation activities that focuses on people`s psychological and social needs. The home invests in developing the skills of its staff to ensure that they have the appropriate knowledge and qualities to deliver a good service to people using the service. What the care home could do better: Staff`s recording practice must be consistent to ensure that information recorded on people using the service one to one care documentation is detailed, accurate and up to date. Consideration should be given to review the process in place on how the one to one care documentation is monitored daily by the trained nurses. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: Mallard House Dunthorne Way Grange Farm Milton Keynes Buckinghamshire MK8 0DZ The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Joan Browne Date: 2 5 1 1 2 0 0 8 Information about the care home Name of care home: Address: Mallard House Dunthorne Way Grange Farm Milton Keynes Buckinghamshire MK8 0DZ 01908520022 01908524532 rufaro@pjcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Rufaro Mandipira Type of registration: Number of places registered: P J Care Ltd care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia 53 Over 65 0 Conditions of registration: The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) The maximum number of service users to be accommodated is 53. Date of last inspection Brief description of the care home Mallard House is a purpose built 53 bedded nursing home which provides care and accommodation for adults over 18 years of age with cognitive impairment and acquired brain injury. The home is registered and the owner is an established provider of care in Buckinghamshire. The home is situated in a residential area and is conveniently Care Homes for Adults (18-65 years) Page 2 of 8 located for the centre of Milton Keynes. The home has its own transport, which facilitates access to the community for residents. The accommodation has all single rooms with en-suite facilities (shower, hand basin and WC). Support from a range of health professionals has been established within the local healthcare service. A landscaped garden is accessible to all residents. Care Homes for Adults (18-65 years) Page 3 of 8 What we found: A routine random inspection was undertaken on 25 November 2008. We found that the home continues to provide a good level of care to people using the service. As a result of this visit one requirement and two recommendations have been made. We have summarised our findings under the main outcome areas that were assessed. Individual needs and choices: We looked at two care plans for two people using the service. The plans examined were well written and had been subject to regular reviewing with accompanying risk assessments such as, moving and handling, fall, waterlow (tissue viability) and nutritional in place. We noted that staff were providing one to one care to these two individuals between the hours of 08:00 am and 20:00 pm. The documentation relating to the one to one care provided was examined and gaps in the detailing of information were noted. It was evident that staffs recording practice was not consistent. A requirement is made to ensure that there is an improvement in staffs recording practice. Consideration should be given to review the practice in place for checking if staff were completing the one to one documentation sheets appropriately. We were told that the registered nurses were responsible for ensuring that they are completed. However, from the evidence seen there were shortfalls in the monitoring process. People who were spoken to were complimentary about the care provision. Complaints and protection: The complaints folder was examined and the chronology showed that since the last key inspection the home had received eight complaints. We saw evidence that the manager had responded to all the complainants in writing within a reasonable timescale. There was a clear audit trail of the outcomes of the complaints that were investigated. In July 2008 the home made three safeguarding referrals to the local Social Services safeguarding of vulnerable adults team. A summary of the outcome of these investigations were recorded in the safeguarding folder. We noted that individuals full names were recorded. To comply with confidentiality and the data protection act the home should consider using individuals initials rather than their full names. There was a recent safeguarding referral which the Commission was made aware of. The outcome of the investigation was not recorded in the complaints and protection folder. The manager explained that she was waiting to receive the outcome of the investigation in writing from the safeguarding team. Staff spoken to said that they had undertaken updated training in the safeguarding of vulnerable adults. They were knowledgeable on the appropriate action that should be taken if they witnessed or suspected that a person using the service was being abused. The staffing roster was examined. We were told that on Oakley unit the home aims to provide two registered nurses and seven carers on the morning and afternoon shifts daily. This number is reduced to one registered nurse and three carers at night time. We noted in the four weekly rota that was examined there were two occasions when the level of staffing was not maintained. Each unit has an allocated clinical manager who provides hands on support five days a week as and when required. On Brunel unit the roster reflected that the level of staffing over the four week period that was looked at was satisfactorily maintained. The staffing numbers were one registered nurse and Care Homes for Adults (18-65 years) Page 4 of 8 five carers on the morning and afternoon shifts. This number was reduced to one registered nurse and two carers at night. We saw evidence that on some days the units were supported by two or three activity persons. This is to ensure that people are supported with social activities or rehabilitation treatment outside and inside the home. On most Fridays it was noted that there were between three and four activity persons on Brunel unit to accommodate social activities outside of the unit. We were told by the manager that the level of staffing provided was adequate to meet individuals diverse needs and a regular review of peoples dependency levels are undertaken to ensure that there are sufficient staff to meet their assessed needs. When required staffing hours are increased in consultation with care managers. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 6 of 8 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 12 Staffs practice must be consistent when detailing information on the provision of care given to people who are in receipt of one to one care. This is to ensure that records relating to the care provided is accurate and up to date. 28/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Consideration should be given to review the practice in place for monitoring the one to one care documentation sheets. To comply with confidentiality and the data protection act consideration should be given to use peoples initials rather than their full names when recording information in the complaints and protection summary folder. 2 23 Care Homes for Adults (18-65 years) Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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