Care Home: Marston Court

Similar services:

• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well All prospective service users and their representatives are provided with a copy of the home`s Statement of Purpose, Service Users Guide, home`s brochure and a copy of the last inspection report. Oxfordshire Social Services have a block contract with the home for twenty two of the thirty nine beds. Copies of the Care Management needs assessment is provided to the home with Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 6supporting information from health and social care professionals as appropriate. The manager then undertakes a pre- admission assessment to ensure that the home is able to meet the prospective service user`s needs. All prospective service users and their representatives are encouraged to visit the home, stay for a while to meet the staff team and other service users, before making a decision to move in on a trial period. All service users are admitted for a trial period of four to six weeks, before a decision is made to make Marston Court their permanent home. Several service users have attended the day centre in the home or have previously stayed for short periods. Surveys completed by four service users confirmed that they had received enough information about the home before they moved in to be able to decide if it was the right place for them and had received a contract/ terms and conditions. Care plans are now draw up from the pre- admission assessment and agreed and signed by the service user and/or representative as appropriate. The care leader and service user review the care plan on a regular basis and record any changes. The healthcare needs of the service users are met by several GP practices and a range of healthcare professionals are available as necessary. The manager expressed her satisfaction of the service provided and said that she had a good working relationship with the visiting GPs and healthcare professionals. Comments received from a District Nurse, who visits the home on a regular basis included ` staff report any potential problems (such as red areas, possible urine infections etc) early enough to make a difference`, `The skin care in now very good with regular applications of prescribed creams/moisturisers etc.`, `There is no residual smell whenever I visit (of urine or anything else)`, ` Drinks appear to be freely available for residents with glasses and jugs of squash/water etc on the tables and in the ( bed) rooms in hot weather` , ` The atmosphere there is very pleasant, staff morale appears good and our patients appear happy to be there`. The inspector spent time with service users in each of the units. Service users able to express an opinion said that they liked living in the home, said that staff were `very caring`, `kind` and always thoughtful`. Staff were observed to interact with service users in a respectful and professional manner. Staff were observed addressing service users by their preferred term of address and in discussion with members of staff, they were clear about the need to respect service users privacy and dignity. During the inspection it was noted that all service users were appropriately dressed and well groomed. Attention had been given to ensuring that service users had dentures, spectacles and hearingaids in place. The inspector gained the impression that there was a good rapport between service users and the staff team. Service users confirmed that the routines in the home are flexible, such as being able to choose how to spend their day, when to go to bed and when to get up in the morning. The day`s menu was displayed and service users confirmed that they are offered a choice of meals and this is recorded. Menus seen evidenced that service users are offered a varied, wholesome and nutritious diet. The meal served was hot, tasty and served attractively. Staff were observed to be assisting service users in a discreet and dignified manner. The home has a training and staff development programme in place. All staff complete mandatory training and are encouraged to undertake ongoing training. Staff spoken to were positive about the training opportunities provided and felt that this gave staff confidence in carrying out their duties and assisted with promotion opportunities within the organisation. Staff spoken to said that they enjoyed working in the home and felt valued by the manager. Communication systems in the home appear to be well organised, with staff handovers taking place at the beginning of each shift. Staff meetings take place and staff feel that morale in the home is good. What has improved since the last inspection? Since the last inspection all care planning documentation has been reviewed and developed. Care plans are now draw up from the pre- admission assessment and agreed and signed by the service user and/or representative as appropriate. All service files include falls, moving and handling, pressure sore and fire risk assessments. These were well documented and up to date. Healthcare professionals, such as the falls specialist, are involved with risk assessments as necessary. Medication such as eye drops, that have a short life span are now dated when opened. The home records all complaints whether received verbally or in writing. Written references received without a company stamp are now followed up by telephone. All hazardous substances are now locked away securely. The manager undertakes regular audits within the home, these include health and safety, medication, accidents/ falls and care planning. What the care home could do better: Recruitment of staff must include obtaining two written references. One must be from the last/ most recent employer. Entries made in the daily comments sheet, within service users files, should be fuller in description to allow for a full picture on the care that has been given and validate care plans. It is recommended that service users` care plans reflect their special interests and hobbies and how these are going to be met. Consideration should be given to including health and social care professionals, GPs and other stakeholders in the annual quality assurance questionnaires in order to gain a more rounded view of the service being provided by the home. Make available the results of quality assurance surveys available to service users, relatives and other interested parties. This should include the collated findings and action to be taken. CARE HOMES FOR OLDER PEOPLE Marston Court Marston Road Oxford Oxfordshire OX1 1ND Lead Inspector Marie Carvell Unannounced Inspection 30th April 2008 10:00 X10015.doc Version 1.40 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 Marston Court DS0000013159.V361015.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 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. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Marston Court Address Marston Road Oxford Oxfordshire OX1 1ND 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) 01865 241526 01865 722290 manager.marstoncourt@osjctoxon.co.uk www.oxfordshire.gov.uk The Orders Of St John Care Trust Mrs Theresa Jean Whitford Care Home 39 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (3), Dementia - over 65 years of of places age (20), Learning disability over 65 years of age (3), Old age, not falling within any other category (39), Physical disability over 65 years of age (20) Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 39. 8th October 2007 Date of last inspection Brief Description of the Service: Marston Court is a care home providing personal care and accommodation for 39 older people and Day care facilities for 10 from the local community. The care home is managed by The Orders of St John Care Trust who are responsible for many care homes throughout the county of Oxfordshire. Marston Court is located in a residential area of Oxford approximately a mile from the city centre. Local shops, churches, pubs and other amenities are accessible to service users. Marston Court is a two storey building served by a lift. All rooms are single with shared bathroom facilities. The care home is divided into four wings, each having a lounge and dining area. The grounds are shared with the county office of The Orders of St John Care Trust providing some lawn and a secluded patio area with a water feature. Prices range from £495.00 - £680.00 per week. Items not covered within the fees include hairdressing, podiatry, newspapers and magazines, toiletries and contributions to some outings and activities. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10:00 and was in the service until 18:00. It was a thorough look at how well the service is doing. It took into account detailed information provided by the registered manager in August 2007, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to surveys that the Commission had sent out. Four service users, two relatives and a healthcare professional responded to surveys sent out. In addition comments were received from a GP, who provides out of hours medical care to the home. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standards of the service. The inspector toured the building, examined records including case tracking five service user files, met with service users individually and as a group. The inspector also spent time with the manager, care and ancillary staff. In addition the inspector spent time observing how care was being delivered to service users and joined service users, in one unit for lunch. At the last inspection carried out October 2007, four statutory requirements and six good practice recommendations were made; these are referred to in the body of the report. Feedback was given to the manager throughout the inspection. What the service does well: All prospective service users and their representatives are provided with a copy of the home’s Statement of Purpose, Service Users Guide, home’s brochure and a copy of the last inspection report. Oxfordshire Social Services have a block contract with the home for twenty two of the thirty nine beds. Copies of the Care Management needs assessment is provided to the home with Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 6 supporting information from health and social care professionals as appropriate. The manager then undertakes a pre- admission assessment to ensure that the home is able to meet the prospective service user’s needs. All prospective service users and their representatives are encouraged to visit the home, stay for a while to meet the staff team and other service users, before making a decision to move in on a trial period. All service users are admitted for a trial period of four to six weeks, before a decision is made to make Marston Court their permanent home. Several service users have attended the day centre in the home or have previously stayed for short periods. Surveys completed by four service users confirmed that they had received enough information about the home before they moved in to be able to decide if it was the right place for them and had received a contract/ terms and conditions. Care plans are now draw up from the pre- admission assessment and agreed and signed by the service user and/or representative as appropriate. The care leader and service user review the care plan on a regular basis and record any changes. The healthcare needs of the service users are met by several GP practices and a range of healthcare professionals are available as necessary. The manager expressed her satisfaction of the service provided and said that she had a good working relationship with the visiting GPs and healthcare professionals. Comments received from a District Nurse, who visits the home on a regular basis included ‘ staff report any potential problems (such as red areas, possible urine infections etc) early enough to make a difference’, ‘The skin care in now very good with regular applications of prescribed creams/moisturisers etc.’, ‘There is no residual smell whenever I visit (of urine or anything else)’, ‘ Drinks appear to be freely available for residents with glasses and jugs of squash/water etc on the tables and in the ( bed) rooms in hot weather’ , ‘ The atmosphere there is very pleasant, staff morale appears good and our patients appear happy to be there’. The inspector spent time with service users in each of the units. Service users able to express an opinion said that they liked living in the home, said that staff were ‘very caring’, ‘kind’ and always thoughtful’. Staff were observed to interact with service users in a respectful and professional manner. Staff were observed addressing service users by their preferred term of address and in discussion with members of staff, they were clear about the need to respect service users privacy and dignity. During the inspection it was noted that all service users were appropriately dressed and well groomed. Attention had been given to ensuring that service users had dentures, spectacles and hearing Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 7 aids in place. The inspector gained the impression that there was a good rapport between service users and the staff team. Service users confirmed that the routines in the home are flexible, such as being able to choose how to spend their day, when to go to bed and when to get up in the morning. The day’s menu was displayed and service users confirmed that they are offered a choice of meals and this is recorded. Menus seen evidenced that service users are offered a varied, wholesome and nutritious diet. The meal served was hot, tasty and served attractively. Staff were observed to be assisting service users in a discreet and dignified manner. The home has a training and staff development programme in place. All staff complete mandatory training and are encouraged to undertake ongoing training. Staff spoken to were positive about the training opportunities provided and felt that this gave staff confidence in carrying out their duties and assisted with promotion opportunities within the organisation. Staff spoken to said that they enjoyed working in the home and felt valued by the manager. Communication systems in the home appear to be well organised, with staff handovers taking place at the beginning of each shift. Staff meetings take place and staff feel that morale in the home is good. What has improved since the last inspection? Since the last inspection all care planning documentation has been reviewed and developed. Care plans are now draw up from the pre- admission assessment and agreed and signed by the service user and/or representative as appropriate. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 8 All service files include falls, moving and handling, pressure sore and fire risk assessments. These were well documented and up to date. Healthcare professionals, such as the falls specialist, are involved with risk assessments as necessary. Medication such as eye drops, that have a short life span are now dated when opened. The home records all complaints whether received verbally or in writing. Written references received without a company stamp are now followed up by telephone. All hazardous substances are now locked away securely. The manager undertakes regular audits within the home, these include health and safety, medication, accidents/ falls and care planning. What they could do better: Recruitment of staff must include obtaining two written references. One must be from the last/ most recent employer. Entries made in the daily comments sheet, within service users files, should be fuller in description to allow for a full picture on the care that has been given and validate care plans. It is recommended that service users’ care plans reflect their special interests and hobbies and how these are going to be met. Consideration should be given to including health and social care professionals, GPs and other stakeholders in the annual quality assurance questionnaires in order to gain a more rounded view of the service being provided by the home. Make available the results of quality assurance surveys available to service users, relatives and other interested parties. This should include the collated findings and action to be taken. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 9 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. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 10 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 Outcomes Statutory Requirements Identified During the Inspection Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards1, 2, 3 and 5. Standard 6 is not applicable, as the home does not provide intermediate care. Quality in this outcome area is excellent. Service users and their representatives are given information about the home and encouraged to visit in order to make an informed choice about moving into the home. Service users are fully assessed prior to admission to ensure that their needs can be effectively met by the home. All service users are able to move into the home for a trial period, before making a decision to stay permanently. All service users are provided with a contract or terms and conditions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 12 All prospective service users and their representatives are provided with a copy of the home’s Statement of Purpose, Service Users Guide, home’s brochure and a copy of the last inspection report. Oxfordshire Social Services have a block contract with the home for twenty two of the thirty nine beds. Copies of the Care Management needs assessment is provided to the home with supporting information from health and social care professionals as appropriate. The manager then undertakes a pre- admission assessment to ensure that the home is able to meet the prospective service user’s needs. All prospective service users and their representatives are encouraged to visit the home, stay for a while to meet the staff team and other service users, before making a decision to move in on a trial period. All service users are admitted for a trial period of four to six weeks, before a decision is made to make Marston Court their permanent home. Several service users have attended the day centre in the home or have previously stayed for short periods. Surveys completed by four service users confirmed that they had received enough information about the home before they moved in to be able to decide if it was the right place for them and had received a contract/ terms and conditions. Comments received from one relative included ‘my X has been a resident at Marston Court for approximately one and a half years. When X was initially moved in X was not in a very good state of mind following an operation. Since X has moved to Marston Court we, as a family have noticed a dramatic difference in X. We had reservations initially whether we had done the right thing by moving X out of X own home, but felt that we did not have much choice; however any reservations we had have certainly proven unfounded’. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. Standards 7,8 and 9 were subject to requirement at the last inspection. Standard 7 was also subject to a good practice recommendation. Quality in this outcome area is good. Care plans need to be further developed to include emotional and social care needs. Medication storage, administration and recording were seen to be well maintained. Service users feel that they are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 14 At the last inspection a requirement and good practice recommendation was made that all service users have a comprehensive care plan, drawn up from an assessment of need, to ensure that service users needs are fully met from the time of admission and that entries made in the daily comments sheet, should be fuller in description to allow for a full picture on the care that has been given. Since the last inspection all care planning documentation has been reviewed and developed. Care plans are now draw up from the pre- admission assessment and agreed and signed by the service user and/or representative as appropriate. The care leader and service user review the care plan on a regular basis record any changes. Although the information regarding health and personal care is well recorded, no information is recorded about the emotional and social care needs of the service user and how these are to be met. Information about social activities and hobbies are recorded by the activity organiser, however this needs to be incorporated into the care plan. The manager has agreed to address this using the OSJCT care planning documentation. Entries made in daily comments sheets are variable in content and the manager agreed to address this as a training need. Surveys completed by four service users confirmed that they ‘always’ received the care and support needed. Comments made by one service user included ‘staff are never to busy to give the support and help needed’. Comments received from relatives included ‘my X, is very happy at Marston Court. The staff are very caring, attending to X every need and the entertainment they organise is excellent. The (bed) room is always warm, well aired and cleaned regularly. My family are very happy with the care that Marston Court provides’, ‘I think a lot of X improvement is down to regular meals, medication and certainly the social contact. X thinks the world of the staff and is full of news of what X has been doing. The amount of photographs, which are taken, are brilliant, as X seems to like it as much as we do as a family as for the first time for many years we have pictures of X which actually show X happy and smiling naturally’, ‘Thanks to the staff at Marston Court we feel that when the time comes for X to leave us we can have some happier memories of X than we would have previously’. At the last inspection a requirement was made that where a risk is identified, a plan of action must be drawn up detailing how the risk is to reduced and detailed in the service users care plan. From examination of a sample of service user files, this requirement has been addressed. All service files include falls, moving and handling, pressure sore and fire risk assessments. These were well documented and up to date. Healthcare professionals, such as the falls specialist, are involved with risk assessments as necessary. The healthcare needs of the service users are met by several GP practices and a range of healthcare professionals are available as necessary. The manager expressed her satisfaction of the service provided and said that she had a good working relationship with the visiting GPs and healthcare professionals. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 15 Surveys completed by four service users confirmed that they ‘always’ received the medical support that they needed. Comments received from a relatives included ‘Whenever X has needed a GP they have always been called in a prompt manner and obviously now the staff are more familiar with X they can observe any signs of for instance a UTI (urinary tract infection) and act on it immediately so it does not become so much of a problem’. Comments received from an out of hours GP included that the manager and staff team were very competent and professional in their actions. The GP said that whenever he/she had been called out in an emergency, the necessary information and documentation was always available and staff were knowledgeable about the service user’s specific health needs and symptoms. Comments received from a District Nurse, who visits the home on a regular basis included ‘ staff report any potential problems (such as red areas, possible urine infections etc) early enough to make a difference’, ‘The skin care in now very good with regular applications of prescribed creams/moisturisers etc.’, ‘There is no residual smell whenever I visit (of urine or anything else)’, ‘ Drinks appear to be freely available for residents with glasses and jugs of squash/water etc on the tables and in the ( bed) rooms in hot weather’ , ‘ The atmosphere there is very pleasant, staff morale appears good and our patients appear happy to be there’. At the last inspection a requirement was made that all medication with a short life span is dated upon opening and that medication guidelines are followed when dealing with medication. Medication such as eye drops, that have a short life span are now dated when opened. All medication was seen to be appropriately stored. Medication administration records are well maintained and no obvious gaps in recordings were observed. All staff who administer medication have received appropriate training, this is updated on a regular basis. Currently none of the service users takes responsibility for the administration of their own medication. The Primary Care Trust undertakes regular medication audits. The inspector spent time with service users in each of the units. Service users able to express an opinion said that they liked living in the home, said that staff were ‘very caring’, ‘kind’ and always thoughtful’. Staff were observed to interact with service users in a respectful and professional manner. Staff were observed addressing service users by their preferred term of address and in discussion with members of staff, they were clear about the need to respect service users privacy and dignity. During the inspection it was noted that all service users were appropriately dressed and well groomed. Attention had Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 16 been given to ensuring that service users had dentures, spectacles and hearing aids in place. The inspector gained the impression that there was a good rapport between service users and the staff team. From discussion with the manager and observation, the inspector considers that the home is able to provide a service to meet the needs of individual service users of various religious, racial or cultural needs. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15. Quality in this outcome area is good. Service users are encouraged to make choices and to remain independent for as long as possible. There is a wide range of activities in place to meet the social needs of service users. Service users are provided with a varied, wholesome and nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are two enthusiastic, part time activity organisers in post, who are currently assisted by a volunteer for two afternoons per week. Information about weekly activities in displayed on notice boards throughout the home and there is a monthly activities schedule also displayed. All activities undertaken are recorded on a daily basis. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 18 Surveys completed by four service users confirmed that three felt that ‘usually’ there were activities arranged by the home that they could take part in and one service user felt that only ‘sometimes’ were activities arranged that they could take part in. Comments received from a service user included ‘ Not all activities are suitable, but this is to be expected’. Comments received from a healthcare professional included ‘ often when I visit I see evidence of various activities and all residents have the choice to join in if they so wish, books, jigsaws and puzzles are available and I do see them in use’, ‘ the hairdresser is very popular’. Many of the service users have friends and family who are able to visit on a regular basis. Service users are encouraged to maintain contact, as far as possible, with the local community. Service users said that their friends and relatives were always made welcome. Resident meetings are held every four months and are well attended. Religious ministers visit the home on a regular basis and arrangements can be made for service users to attend a local place of worship, if requested. Service users confirmed that the routines in the home are flexible, such as being able to choose how to spend their day, when to go to bed and when to get up in the morning. The inspector joined service users in one unit for the mid day meal. Tables were laid with napkins and condiments. The day’s menu was displayed and service users confirmed that they are offered a choice of meals and this is recorded. Menus seen evidenced that service users are offered a varied, wholesome and nutritious diet. The meal served was hot, tasty and served attractively. Staff were observed to be assisting service users in a discreet and dignified manner. Surveys completed by the four service users confirmed that they ‘ usually’ liked the meals served in the home. Comments received from service users included ‘meat could sometimes need to be cooked a little longer to be well done’, ‘not all meals entirely liked’. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. The home has a comprehensive complaints procedure in place. Policies and procedures are in place to protect service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a comprehensive complaints procedure in place. At the last inspection a good practice recommendation was made that all verbal complaints received by the home must be logged. Since the last inspection the home has received five complaints, all complaints were upheld and all but one resolved within twenty eight days. The home records all complaints whether received verbally or in writing. Complaints were seen to be appropriately recorded with action taken and outcomes recorded. Service users spoken to said that they would speak to a member of staff or the manager if they had any concerns and were aware of the home’s complaints procedure. Service users were confident that any concerns would be listened to, taken seriously and addressed. Since the last inspection in October 2007, the Commission has received information about one complaint, which was being addressed by the Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 20 organisation. It is understood that the complainant is now satisfied with the outcome of the initial complaint. All staff receive training in the home’s policies and procedures for protecting service users from abuse and the home’s whistle blowing policy, this was confirmed by staff on duty and training records. Training is provided during staff induction and then updated on a regular basis. The home has a copy of the Oxfordshire safeguarding Adults procedures. No safeguarding adult referrals or safeguarding adult investigations have taken place since the last inspection. No referrals have been made for inclusion on the POVA (Protection of Vulnerable Adults) list. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 19 and 26. Quality in this outcome area is good. The home provides safe, well maintained and comfortable accommodation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The location and layout of the home is suitable for its stated purpose. Service users expressed their satisfaction of being able to personalise their bedroom and the facilities within the home. All bedrooms are single occupancy and there are sufficient numbers of bathrooms and toilets throughout the home. Communal areas of the home have been made comfortable and have a homely feel. There is a programme of redecoration and refurbishment is in progress, Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 22 new floor covering is to be provided in the kitchen and hairdressing room. One of the two passenger lifts is currently out of action. This is being addressed. All areas of the home were seen to be clean, well maintained and free from unpleasant odours. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 23 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30. Standard 29 was subject to two good practice recommendations at the last inspection. Quality in this outcome area is good. Service users benefit from a low turnover of staff. Recruitment procedures are robust, but written references must be obtained before a new member of staff is appointed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From discussion with the manager, staff and examination of the duty rosters, staffing levels appear to be adequate to meet the needs of the service users. The home currently has two part time care assistant posts. Exit interviews are conducted, if possible. The inspector was advised that the four care leaders have achieved NVQ level III in Care and the trainee care leader is working towards the qualification. Twelve of the twenty four care assistants have achieved NVQ level II and the remaining care staff are either working towards NVQ level II or have applied to commence the course. One of the activity organisers is to commence an NVQ Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 24 in Care Activity and the senior cook has completed NVQ in Hospitality and Catering, the assistant cook is currently working towards this qualification. The home has a training and staff development programme in place. All staff complete mandatory training and are encouraged to undertake ongoing training. Staff spoken to were positive about the training opportunities provided and felt that this gave staff confidence in carrying out their duties and assisted with promotion opportunities within the organisation. At the last inspection two good practice recommendations were made, that any reference received without a company stamp is followed up with by telephone and that all CRBs (criminal record bureau) checks dated 2004 are repeated. No new members of staff have been recruited since the last inspection. Two members of staff are currently being recruited having been interviewed and upon receipt of police checks, will commence working in the home. Both personnel files consisted of an application form, evidence of a formal interview conducted by two senior members of staff, appropriate identification checks and evidence that police checks had been applied for. References had been applied for and those seen included a company stamp. However, one applicant had given an e-mail address only for a referee, with no address or other details. This had been accepted and a request for a reference had been made for a reference by e-mail. The manager was advised that this practice is unacceptable and all references must be requested in writing and received in writing. The manager has accepted this and stated that it was an oversight and that the applicant will be contacted to provide an address for the referee to be contacted, before a commencement date is agreed. The good practice recommendation to repeat all CRB checks dated 2004 has not been actioned as there is no legal requirement for this to be undertaken and Oxfordshire Social services do not require this in their contract agreement. Staff spoken to said that they enjoyed working in the home and felt valued by the manager. Communication systems in the home appear to be well organised, with staff handovers taking place at the beginning of each shift. Staff meetings take place and staff feel that morale in the home is good. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 25 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,36 and 38. Standard 38 was subject to a requirement and a good practice recommendation at the last inspection. Quality in this outcome area is good. Service users benefit from a well managed home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is experienced and well qualified having completed NVQ level IV in Health and Social Care and the Registered Managers Award. She has been the manager of Marston Court since 2002. The manager is supernumery to the Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 26 home’s staffing levels and is supported by an experienced, full time administrator. In discussion with service users and staff on duty all expressed the view that the home was well managed and run in the best interests of service users. At the last inspection, a good practice recommendation was made that consideration is given to including health and social care professionals, GPs and other stakeholders in the annual quality assurance questionnaires in order to gain a more rounded view of the service provided by the home. This has not yet been actioned. Quality assurance surveys are sent to service users each year. It is unclear as to how the information received is collated, action to be taken and made available to service users, relatives and other interested parties. Staff described the manager as being approachable, fair and consistent. Procedures are in place for dealing with service users monies and valuables kept in safekeeping. Financial records are well maintained and receipts are obtained for all expenditures made on behalf of the service users. All staff receive regular formal 1-1 supervision from either the manager or care leader every two months, who has received appropriate supervisory training. Records of supervision undertaken were seen to be well maintained, actions agreed, recorded and signed by both the supervisor and supervisee. Communication systems in the home appear to work well, regular meetings are held between the manager and housekeeping staff, catering staff, day care assistants and night care assistants. Minutes of meetings held since March 2008, were not available for inspection, although agendas were seen. Policies and procedures are in place and are reviewed on a regular basis. Reports written by a Cluster Manager, who is also a registered manager of a OSJCT home, completes a written report on behalf of the provider, following a monthly unannounced visit to the home, these were available for inspection. From April 2008, the home’s Operations Manager is to visit the home and a written report will be completed. The report for April 2008 was available. At the last inspection a requirement and a good practice recommendation was made that all hazardous substances are stored safely at all times and that the manager undertakes regular audits to ensure that staff are working to the home’s policies and procedures. All hazardous substances are now locked away securely and the manager undertakes regular audits within the home, these include health and safety, medication, accidents/ falls and care planning. A sample of records relating to health, safety, fire and welfare were examined and found to be up to date and well maintained. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 27 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 3 4 x 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 3 x 3 Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 29 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 OP29 Regulation 19 & Sch. 2 Timescale for action Recruitment of staff must include 31/05/08 obtaining two written references. One must be from the last/ most recent employer. Requirement 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 OP7 Good Practice Recommendations Entries made in the daily comments sheet, within service users files, should be fuller in description to allow for a full picture on the care that has been given and validate care plans. It is recommended that service users’ care plans reflect their special interests and hobbies and how these are going to be met. It is recommended that consideration be given to including health and social care professionals, GPs and other stakeholders in the annual quality assurance questionnaires in order to gain a more rounded view of the service being provided by the home. Make available the results of quality assurance surveys available to service DS0000013159.V361015.R01.S.doc Version 5.2 Page 30 2. 3. OP8 OP33 Marston Court users, relatives and other interested parties. This should include the collated findings and action to be taken. Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Marston Court DS0000013159.V361015.R01.S.doc Version 5.2 Page 32 - 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!