Care Home: Marmion Nursing Home

What the care home does well Prospective residents are fully assessed prior to admission assuring that the home can meet their needs. The residents each have a contract which stipulates the terms and conditions of their residency. Following admission comprehensive care plans and risk assessments are developed. The health and personal care needs of the residents are clearly identified and monitored. A local GP completed a comment card and all was positive about the care provided at the Home. The residents are enabled to take appropriate risks and are encouraged to discuss any concerns with nominated key staff. The residents (where able) plan their activities together with the staff and individual lifestyles and routines are respected. Complaints and Protection of Vulnerable Adults concerns are addressed appropriately. The residents are protected by safe staff recruitment procedures and supported by a well-trained and supervised staff team. The facilities in the Home are domestic in style and afford the residents with a comfortable, homely environment. The staff were very helpful and constructive throughout the inspection. Comment cards sent directly to the Commission were very positive. Quotes taken from those are detailed below: `Carers do very well for me, I am very happy here` `I have freedom in the home and can make all my own decisions` `Staff always speak nicely to me, they help me shower. The food is good I have put weight on whilst I have been in here` `The carers always listen to me and never let me down`. `I can trust the staff` `I have a private room which I love, I enjoy my drinks and food` `We are delighted with every aspect of care, the staff are very professional, a happy place to visit`, my father is well looked after` `All staff are excellent and the residents always receive the best care`. No negative comments were received. What has improved since the last inspection? What the care home could do better: The home continues to meet the National Minimum Standards. CARE HOME ADULTS 18-65 Marmion Nursing Home Stretton Street Glascote Tamworth Staffordshire B77 2BH Lead Inspector Mrs Sue Mullin Key Unannounced Inspection 14 March 2007 11:00 Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 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 Marmion Nursing Home DS0000022350.V326772.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 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. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Marmion Nursing Home Address Stretton Street Glascote Tamworth Staffordshire B77 2BH 01827 67953 n/a 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) Grangemoor Care Homes Christopher Homer Care Home 24 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (24) of places Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16 February 2006 Brief Description of the Service: Marmion care home with nursing accommodates residents suffering from with mental health disorders from the age of 18 years and over. The home caters for 24 service users in total. The home is built on two levels accessed by a passenger lift and has communal areas, two lounges and a dining room. There are two bathrooms and a walk in shower facility and five separate toilets throughout the home. Five single rooms have en suite facilities. The home is situated less than one mile from the centre of Tamworth and has a bus stop 400 yards away. Weekly fees are £480 up to £613 Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 14th March 2007 and determined the core elements of the key inspection using the National Minimum Standards as reference. The methodologies used incorporated assessment of the pre-inspection questionnaire, completed by the care manager prior to the inspection and comments cards completed by relatives and other health professionals. During the inspection process, records required for registration were scrutinized and discussions were held with all disciplines of staff on duty. The care manager for the home has been in post now for some time and was present on the day of the inspection and was very helpful and actively involved throughout the visit. A sample tour of the home was undertaken. The home was very clean with no malodours evident. No relatives visited during the inspection but the inspector met several of the residents and spoke at length to them. Most of the residents actively sought out a meeting with the inspector and much of the inspection was spent with direct input from the residents themselves. The overall impression of the care of the residents was excellent. All were dressed appropriately and attention was paid to personal hygiene requirements. Observations were made of staff and resident interaction, eye contact was maintained and there was a real feel of respect and affection. The home continues to provide an excellent standard of care to all residents in the home. Commitment to residents to improve their lifestyle is high on the agenda. What the service does well: Prospective residents are fully assessed prior to admission assuring that the home can meet their needs. The residents each have a contract which stipulates the terms and conditions of their residency. Following admission comprehensive care plans and risk assessments are developed. The health and personal care needs of the residents are clearly identified and monitored. A local GP completed a comment card and all was positive about the care provided at the Home. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 6 The residents are enabled to take appropriate risks and are encouraged to discuss any concerns with nominated key staff. The residents (where able) plan their activities together with the staff and individual lifestyles and routines are respected. Complaints and Protection of Vulnerable Adults concerns are addressed appropriately. The residents are protected by safe staff recruitment procedures and supported by a well-trained and supervised staff team. The facilities in the Home are domestic in style and afford the residents with a comfortable, homely environment. The staff were very helpful and constructive throughout the inspection. Comment cards sent directly to the Commission were very positive. Quotes taken from those are detailed below: ‘Carers do very well for me, I am very happy here’ ‘I have freedom in the home and can make all my own decisions’ ‘Staff always speak nicely to me, they help me shower. The food is good I have put weight on whilst I have been in here’ ‘The carers always listen to me and never let me down’. ‘I can trust the staff’ ‘I have a private room which I love, I enjoy my drinks and food’ ‘We are delighted with every aspect of care, the staff are very professional, a happy place to visit’, my father is well looked after’ ‘All staff are excellent and the residents always receive the best care’. No negative comments were received. What has improved since the last inspection? What they could do better: The home continues to meet the National Minimum Standards. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 7 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. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 8 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 Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents/ relatives are provided with information contained in the Statement of Purpose and the Service Users Guide. Prospective residents are fully assessed prior to admission guaranteeing that the home can meet their needs. EVIDENCE: The homes Statement of Purpose has recently been amended and provides up to date information relating to the service and provisions available at the home. Information contained within this document was in compliance to Schedule 1, of the Care Homes Regulations. The homes admission procedure incorporated a very thorough pre admission assessment, to establish whether the home would have the capacity to meet the individual’s identified care and social needs. Information derived from the pre admission assessment provided the foundation for the development of a care plan and a risk assessment. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 10 Discussions with the staff confirmed that prospective service users were able to visit the home prior to admission, having the opportunity to view the premises and meet the staff team. Discussions with the care staff identified that there were no service users within residence with any specific cultural needs. Service users are able to continue to practice their religious faith and one resident receives regular contact with a member of his faith. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning and risk assessment is comprehensive and covers all areas of the residents’ lives. The residents are enabled to take appropriate risks and have opportunity to discuss any on-going concerns with staff. EVIDENCE: Care planning and risk assessment continue to be high priority. Regular reviews are held for each resident, which includes the resident, their relatives, the key worker and the Local Authority. Care plans are reviewed and amended as and when needed. Staff are diligent in completing detailed assessment of risk; every outing and activity is risk assessed. Any limitations or restrictions to a resident’s rights are justified within the risk assessment process. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 12 Care plans were randomly selected for examination, information contained in them was detailed, relating to the specific care, physical and social needs of the individual service user, providing information with regards to the degree of support and assistance required to enable the individual to live a fulfilled lifestyle. The examination of care plans and discussions with the care manager confirmed, that the plan of care was reviewed on a monthly basis to reflect the changing needs of the individual service user. Records were maintained of all healthcare professional intervention, service users had access to relevant healthcare services for routine health screening. All service users were registered with a General Practitioner. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents plan their activities together with the staff and individual lifestyles are respected. EVIDENCE: Individual social requirements/needs are developed for each resident. Appropriate levels of care staff are available during the daytime, which meets the various outings and activities. All residents are encouraged and supported to maintain family and other significant relationships. Some residents have locks on their bedroom door (but most are at present unable to utilise individual keys, or do not wish to have their own key). Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 14 Menus are devised together with the residents are well balanced. All residents spoken to stated the food was very good and plentiful. Care staff involved in food preparation have received food and hygiene training. The kitchen was inspected and all standards relating to meals and hygiene were fully met. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of the residents are clearly identified and monitored EVIDENCE: Personal care needs are clearly identified within the care records. Where possible the residents are encouraged to be independent and take responsibility for their own personal hygiene. The residents are enabled to have flexible lives and this is planned into their activity plans. The present resident group is a mixed gender and the staff team assist them appropriately. A key worker system is in place. Each resident is registered with a local general practitioner and dentist. The residents receive psychology support where required. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures within the Home safeguard the residents and staff. EVIDENCE: Some of the resident’s behaviour can be challenging and staff deal with this behaviour by in intervention techniques, with an emphasis on diversion and distraction and behavioural management plans in place, if required. Behaviours are monitored and evaluated. The staff have access to the appropriate Protection of Vulnerable Adults procedures and have received training. This training is being strengthened and is ongoing. Criminal Records Bureau and Protection of Vulnerable Adults checks are made for all staff. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The facilities in the Home are domestic in style and afford the residents with a comfortable, homely environment EVIDENCE: The Home is furnished and managed as a domestic family home. The residents have access to all areas of the house, including participation in the domestic chores (where able) and their views sought on the day-to-day running of the home. Accommodation is provided on two floors and communal facilities include a domestic setting of two lounges, a dining room, kitchen, laundry, bathrooms and a newly constructed walk in shower room. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 18 Several of the residents are heavy smokers and the smoking lounge is decorated regularly. The garden area is well maintained and the residents are looking forward to the summer when they have regular BBQ’s. The home was clean throughout and there is also car parking at the front of the home. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected by safe staff recruitment procedures and supported by a well-trained and supervised staff team. EVIDENCE: 75 of the current staff team have achieved NVQ 2 or above. The Home provides a good ratio of care staff on all daytime shifts and at night there are no ‘sleeping’ night staff. All staff on duty are alert and ready to meet individual needs. There had been no new staff employed since the last inspection however the homes recruitment procedures are robust. Criminal Records Bureau and Protection of Vulnerable Adults checks are made for all staff. The manager ensures that all new staff completes an induction with an experienced member of staff prior to starting work. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 20 Staffing records were examined and identified that all staff had undergone numerous and required mandatory training courses. 8 care staff have first aid training. Records seen evidence that the care staff receive regular support and two monthly supervision. There were sufficient staffing levels to support the resident’s needs and staffing rotas were completed well in advance. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and his staff demonstrate a real commitment to maintaining the high standards in the Home. EVIDENCE: The pre-inspection questionnaire completed prior to this visit indicated that the Home and Health and Safety equipment are maintained appropriately. A random selection of the Health and Safety records was seen, including fire safety and testing of emergency lighting. These were all in order. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 22 There was a positive emphasis focused on providing a high standard of care and a service that was diverse in meeting the specific needs of the individual service user. A senior member of staff informed the Inspector that the management team were supportive, and regular formal supervision sessions were undertaken to ensure that staff were provided with the necessary support and training to undertake their respective roles and responsibilities. The home have regular staff and residents meetings and these are recorded. The care staff were observed throughout the course of the inspection to interact and communicate with both the service users and the staff group in a respectful and professional manner. The care manager is to commence his RMA management course later on this year. Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 3 2 3 3 4 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 3 3 X X 3 X Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Marmion Nursing Home DS0000022350.V326772.R01.S.doc Version 5.2 Page 26 - 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!