Care Home: Martin Hall Nursing Home

What the care home does well The home is comfortable, homely, clean and well-run and there is a happy atmosphere. The manager has an occupational therapy room for residents to do group activities. An activity organiser oversees the activities, which allows residents to take part in varied arts and craftwork, with the help of the other staff. There is well-documented evidence of the activities that people take part in. Staff are well-trained and provide care in a respectful manner. Residents and their families and visitors are happy with the care the people who live there receive. There was a good rapport between staff and residents. The atmosphere was relaxed, friendly and happy and residents were encouraged to have choice in their lives where possible. We did not make any requirements at this inspection visit. What has improved since the last inspection? The manager has worked on improving the care plans, which are clear, easy to read, comprehensive and consistent. What the care home could do better: Some of the decoration and carpets show wear and tear and are in need of replacement. The manager showed that this is in the business plan and refurbishment will be ongoing over the coming year. The manager has not yet commenced formal meetings with individual staff members. However, the manager has had appraisals with all staff, and has forms and plans in place to progress with this, with the help of senior staff. Two recommendations were made, as will be described in the main body of the report. CARE HOMES FOR OLDER PEOPLE Martin Hall Nursing Home The Old Hall Martin Lincs LN4 3QY Lead Inspector Vanessa Gent Unannounced Inspection 10th July 2008 14:00 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 Martin Hall Nursing Home DS0000002543.V368205.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. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Martin Hall Nursing Home Address The Old Hall Martin Lincs LN4 3QY 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) 01526 378251 01526 378250 lesley@martinhall.co.uk Peck & Packer (Care Homes) Limited Ms Lesley Susan Layton Care Home 40 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (39), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (40) Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide care for service users of both sexes whose primary needs fall within the following categories:Mental Disorder, excluding learning disability or dementia -over 65 years of age (MD(E)) (40). Dementia - over 65 years of age (DE(E)) (39) Dementia - (DE) (2) for service users aged between 60 years and 65 years The maximum number of service users in the home with nursing needs does not exceed 29 and the maximum number of service users with personal care needs only does not exceed 11. 6th July 2006 2. Date of last inspection Brief Description of the Service: Martin Hall is a privately run, two storey care home, with single storey extensions. It provides personal and nursing care for up to forty people of both sexes aged over 65 years, some of whom may have dementia or mental health needs. Respite care is available. It is situated on the High Street in the village of Martin, behind the doctor’s surgery. The local bus passes through the village every hour and runs between Boston and Lincoln; the nearest bus stop is just outside the home. Three miles away, in the village of Metheringham, there is a train station. Local amenities include a village shop and post office, the parish church, the village hall and a public house. The accommodation is made up of twenty-six single bedrooms, of which seventeen have ensuite toilets and washbasins, and seven double rooms, all of which are en-suite. Communally, there are several lounges; the smaller ones are suitable for residents who want to meet with their visitors in more private surroundings. There are two dining rooms, one used for people who need assistance with their food at mealtimes. Residents have communal use of six toilets, one upstairs and five downstairs, and two bathrooms. There is a passenger lift and two staircases for access to upstairs. The gardens at the rear of the property provide a secure, serene outdoor area for residents to sit in. Car parking is available for staff and visitors at the front of the home. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 5 The fees range from £384 to £485 and include toiletries and newspapers. Additional charges are made for chiropody, hairdressing, extra newspapers and magazines requested individually. Information about these costs as well as the day-to-day operation of the home can be found in the home’s statement of purpose and service user guide. These documents and a copy of the last inspection report are available to people who live there and those interested in coming to live at the home. On the day of the inspection thirty-four people were living at the home. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. An unannounced visit was made to the home as part of a key inspection. It started at 14.00 and lasted just under four hours. People who live at the home were asked what they prefer to be known as. They told us they like to be called residents. Before making our visit the manager completed and sent to us a questionnaire called the Annual Quality Assurance Assessment (AQAA), giving us information about the service, which contributed to the inspection process. Questionnaires we sent out were returned by two residents, eight relatives, four staff and two healthcare professionals. Information from these sources, as well as that which we hold about the service, was used to plan the visit and produce this report. The main method of inspection used is called ‘case-tracking’. This involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them and the staff and observation of care practices. Our visit to the home focused on whether key standards and requirements from previous inspections had been met and on how people feel about the quality of the service provided. The care received by three people was followed in detail to ensure the health, safety and welfare needs were fully met and that they were supported to maintain their dignity, autonomy and choice. Three staff members on duty and the administrator spoke with us. Residents, including those being case-tracked, communicated their experience of living at the home. Our ability to communicate verbally with people was limited so we used a range of observations of peoples daily life and care alongside discussions with people who visit and work at the home, using personal records, general house records and staff records to see if peoples overall needs were being met. From the questionnaires we received, all were very positive about the level and quality of care given. They told us that there are activities people can take part in, that staff always listen to what residents say and that the food is liked. Any comments we received will be mentioned in the main body of this report. A partial tour of the home was made and a sample of other records looked at. The manager was present throughout the visit. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 8 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 Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 9 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): 1 and 3 [Standard 6 N/A]. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information available for people is detailed enough to help them to decide if they want to move into the home. The managers assessment procedure ensures that the manager and staff can cater for all the new resident’s needs. EVIDENCE: The statement of purpose and service user guide, which give people information about the home, are up-to-date and readily available to them. This information, and being able to visit the home and see how it operates, helps people to make an appropriate decision about going to live at the home. Before people make a decision to move into the home, the manager or a senior staff member visits and assesses their needs, to make sure they can be cared for in the way they want and need. Records of assessment were available to confirm this and that residents have the chance to ask any questions and state their personal needs in advance of any move to the home. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 10 The manager does not provide an intermediate care service at the home. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and health needs are attended to by staff who understand their needs and preferences. They are cared for as valued individuals, and respected and treated with dignity by staff and the manager. EVIDENCE: As part of the visit to the home, we looked at the care plans of three people with varying needs. The progress on re-writing and developing the care plans has continued since the last inspection. All the care plans were neat, comprehensive, easy to read and understand. They contained all the information necessary to monitor individual’s needs and wishes and provide support in the way each person wanted and needed it to be. In the surveys returned to us, one person told us, “The care and attention given to all residents at Martin Hall is 100 .” Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 12 There were also lots of positive comments from relatives. They included; “The nursing and care my wife receives cannot be bettered.” “Communication between clients/staff/ management/relatives/friends more than adequate.” “My [relative] had to go to Lincoln County Hospital and the staff that went with him were extremely kind and helpful. All the staff are caring people” and “My [relative’s] illness demands full -time nursing care and Martin Hall provides this. I have no grounds for dissatisfaction – just the opposite.” Healthcare professionals told us, “Martin Hall staff are extremely reliable. In my experience, they seek appropriate medical advice, are reliable and competent to doing whatever medical observations/blood tests, blood pressures, that I may request” and “I Have found the nursing home to be thorough and liaise always and well between clients, their families and professionals involved when decisions about care are required, and that suggestions made/agreed are put into practice and monitored.” During our visit we saw that residents were treated with dignity and respect. The manager told us, and staff confirmed, that staff had completed studies in equality and diversity to help them respect the residents’ individuality the outcome of this training was evident in the way we saw sensitive support being given with staff taking time and moving at individuals own pace in order to meet need. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents enjoy the variety and quantity of activities provided. They are supported to make choices and decisions about their daily lives. They have a balanced, nutritious diet in quantities to suit the tastes and wishes of all the residents. EVIDENCE: The activity organiser has the use of a dedicated room for enabling the residents to do activities. He keeps clear, descriptive records of the activities offered to and engaged in by the residents. Activities were used to encourage people to be as independent as possible whilst giving sensitive support to make sure people could choose and take part in individual activities safely. Relatives made complementary comments about the way they feel when they visit. “[There’s a] cordial and welcoming nature of staff to visitors.” “Communication between clients/staff/ management/relatives/friends is more than adequate.” “Go ‘the extra mile’ to ensure relatives/friends who have difficulty visiting can attend – also provide a quiet environment whereby, on occasions, friends and relatives can dine together during visits.” Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 14 Relatives told us that people are able to make their own choices about their daily needs and they said that staff asked the residents what they wanted and helped them to make everyday decisions. One person told us, “They support people to live the life they choose as much as possible. It is an excellent service, with care, efficiency and helpfulness throughout.” Before making our visit people told us they liked the food. A relative said, “They keep him clean and well-fed.” “I have been there when the tea comes round and the staff spend time with each person to ensure they have a drink.” Another relative told us that [The] provision of food is one of the things the home does well. We saw that meals were planned and provided to meet the range of peoples needs and choices using menu plans and care plans to make sure all tastes could be met. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 15 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): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded by the home’s robust complaints policy, by dedicated and well-trained staff and a conscientious and well-respected manager. EVIDENCE: The manager showed us she has a system in place for recording and responding to concerns or complaints that she might receive. The manager told us that no complaints had been received directly by them since the previous inspection. People told us that they never had anything to complain about. Before making our visit to the home we received comments ranging from; “My wife is extremely well cared for” and “Never had any reason to complain” to “[the homel] does its job well” and “The nursing and care my wife receives cannot be bettered.” Relatives who visit regularly, often daily, told us they are perfectly happy with the excellent care given. Since our last inspection the manager has needed to take action to protect residents from abuse. She showed that she acted straight away and referred the information about concerns to Lincolnshires safeguarding adults team. The Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 16 manager and staff co-operated with the investigating authorities and acted appropriately to safeguard the residents at all times. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 17 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): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean, comfortable, hygienic and safe environment for the people who live there. EVIDENCE: Before we made our visit people told us, “The home is always clean and warm.” During our visit to the home we observed people moving around freely and with support, using communal and private spaces to take part in individual or group activities that people had chosen. We also saw that the home has a pleasant and secure garden where residents and their families can sit in good weather. The last Environmental Health Officer’s report in February 2008 was positive in its feedback. There were no issues to address. The last fire safety check was Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 18 done in November 2007. Any issues were addressed by the manager and maintenance team. Records showed that checks were kept by the maintenance person to ensure hygiene is safely maintained in the home. In the laundry, new machines had been installed to ensure and maintain the hygiene standards of the home. Staff told us that as soon as towels and flannels have been used, they are laundered and replaced with clean ones. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 19 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): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Enough staff are on duty at all times to care safely and appropriately for the residents. Staff are safely recruited, have the knowledge and skill to fulfil their roles, and are caring and supported in their work. EVIDENCE: We received many very positive comments about the staff at the home from residents, relatives and healthcare professionals. Relatives provided a range of comments from “I think the attention given to the residents is done with care and dedication. We cannot fault the care she has received” to “All the staff are very caring and I think that the skill and experience is obvious.” Health care professional told us, “The caring level provided by staff and management is excellent.” And “I think the care is excellent. I cannot think of any specific deficiencies.” Staff members commented “The care is of a very high standard. We are more of a family in respect of involving relatives and the way the residents are cared for. No home is perfect but we strive to give a good service and I feel it is one of the best homes I have worked for.” Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 20 The records of a recently recruited staff member showed that staff had been recruited and employed in the right way using proper checks to ensure the safe care of the residents. Staff told us that they feel they are well -trained. The training certificates in staff records we saw confirmed this. The manager told us that over 50 of care and 100 of catering staff have nationally-recognised qualifications. Two senior staff members told us they are the link for community liaison for incontinence issues and palliative care and they are supported to attend meetings. Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 21 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): 31, 32, 33, 35, 36, 28 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff keep the residents comfortable and safe. The home is run by an enthusiastic and competent team of manager and staff. EVIDENCE: The manager is a registered nurse with many years experience in the care of older people and management of a care home. Everyone we talked with spoke very highly of her. A healthcare professional told us, “In particular regard is the manager who is very professional, competent and reliable in all she is asked to do regarding medical tasks/treatment/ interaction with other professionals or client’s relatives.” A relative told us, “I visit daily. It is a first class, rural location with local staff. Management is available at all times.” Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 22 Answering in the survey of what is good about the home, one relative said, “Management’s obvious interest in clients, relatives and friends. Open door policy of communication between all parties and cares and ‘family’ environment.” Another said, “Nothing is too much trouble for the dedicated staff, which reflects on the efficiency of the manager. One relative told us they would like to have more meetings where they can discuss issues with staff and the manager. “Occasionally it may be appropriate to hold a formal relatives/friends meeting with staff and management to exchange thoughts and ideas.” The manager showed us she is planning to distribute questionnaires to monitor and take action to continue improving the service provided and that she would address this issue. People who live at the home need support to manage their finances. The home’s administrator showed how she manages and safeguards the residents’ personal allowances, the documents for which we saw to be all in order. The manager confirmed that staff do not yet have regular formal one-to-one meetings with the manager or senior staff but did show us that this is in the process of being set up and annual appraisals have already taken place. Martin Hall Nursing Home DS0000002543.V368205.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 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 2 X 3 Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. 1. Refer to Standard OP33 Good Practice Recommendations It is recommended that formal meetings are held for the representatives of residents who have limited communication so that thoughts and ideas can be exchanged with staff and management, to ensure that residents’ wishes are understood and shared. It is recommended that staff receive one-to-one supervision with the manager or a senior staff member at least six times a year to ensure they are supported fully in their work. 2. OP36 Martin Hall Nursing Home DS0000002543.V368205.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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 Martin Hall Nursing Home DS0000002543.V368205.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. 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