Care Home: Martins House

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What the care home does well Information about the home is provided to prospective residents and their families. They are also invited to visit and view the home so that they are able to make an informed choice whether to use the home or not. Individual`s needs are assessed to ensure that the home is able to meet the identified needs prior to admission. Care plans and information about residents are now held electronically on computers. Care plans were `person centred` and comprehensive and provided up-to-date information about how the needs of individuals were being met. A programme of weekly activities is planned, displayed in the dinning room and residents are reminded of activities taking place on a daily basis. Residents said that they are able to chose whether to participate in the activities provided on the day or not. The environment is homely, comfortable, airy and bright. The home is reasonably well maintained. There is a rolling programme of redecoration and renewal of furniture and furnishings. There is a good professional relationship between the staff, residents and relatives and other professionals. Residents spoken to said that the food was good and that they are provided with choices in the menu and alternatives. Feedback from residents and relatives was positive. One resident said that `this is the best home, staff are fantastic. I have lived here for 3 years`. Another said ` I find the care and support to be very good. Staff are kind, caring and helpful and there are enough activities provided for us. I have no concerns`. There is a competent staff team who are knowledgeable about the needs of residents. Staff received training appropriate to the work they are to perform, formal supervision and support from the management team. In relation to equality and diversity, the manager has stated in the AQAA that the `Statement of Purpose` lays down what is expected from the service and how it incorporates and promotes race, gender identity, disability, sexual orientation, age, religion and belief into what they do. The home also promotes understanding of rights, equality and diversity through staff training. The home`s policies and procedures are all written to incorporate, promote and uphold the strands of diversity. The home subcribes to Care Aware Advocacy Service for the residents and maintain links with Age Concern. What has improved since the last inspection? All the requirements and recommendations made in the last inspection report have been complied with. Information about the residents including their care plans are now held electronically in `CAREDOCS` system. A number of bedrooms and other areas of the home have been redecorated, recarpeted and furnished. What the care home could do better: The home should carry out a risk assessment for each resident who use an electric reclining chairs so that risks can be identified, minimised and managed. A deep clean of the main kitchen equipment should be carried out on a regular basis so as to maintain a clean and safe environment where food is prepared and cooked. The management must ensure that information held electronically are kept secure and safe and that records made earlier in care plans by a member of staff can not be changed or altered by others. Key inspection report Care homes for older people Name: Address: Martins House Jessop Road Stevenage Hertfordshire SG1 5LL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Bijayraj Ramkhelawon     Date: 2 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Martins House Jessop Road Stevenage Hertfordshire SG1 5LL 01438351056 01438741528 manager@martinshouse.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Chauncy Housing Association Limited care home 63 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Martins House is owned and managed by Chauncy Housing Association. Martins House is registered to provide residential support to 63 elderly service users. The home is a purpose built three storey setting in a residential area of Stevenage. There is a parade of shops nearby and the town centre is about a mile away. Accomodation is provided in single rooms, although there are facilities to offer shared facilities if requested. All rooms have en-suite toilet and washing facilities and there are a number of assisted bathrooms throughout the home. On the ground floor there are two sitting rooms, conservatory, activities room and a large open planned dining room. The main kitchen and food storage area is adjacent to the dining room. There are additional small domestic style kitchens on each floor. There is a unit housing eleven frailer service users on the first floor. The floors are linked by two passenger lifts. The home also provides a hair-dressing facility. Care Homes for Older People Page 4 of 23 Over 65 11 63 0 0 2 4 1 0 2 0 0 8 Brief description of the care home The current fees charged range from £437.78 to £558.34 per week. Up to date Statement of Purpose and Service Users Guide and a copy of the lastest inspection report can be obtained from the care home on request. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out on the 21st December 2009 and took one whole day. It included talking to people using the service, visitors and staff, examining care plans, staff files, staff training records, fire safety procedures, maintenance records, all other records and documents and a tour of the premises. The home has completed an Annual Quality Assurance Assessment (AQAA) and information from this assessment has been reflected in this report. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? All the requirements and recommendations made in the last inspection report have been complied with. Information about the residents including their care plans are now held electronically in CAREDOCS system. A number of bedrooms and other areas of the home have been redecorated, recarpeted and furnished. Care Homes for Older People Page 7 of 23 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information about the home to assist them in making a decision whether to use the care home or not. They know that their needs would be assessed before moving into the home. Evidence: Information about the home including the Statement of Purpose and Service Users Guide was available to prospective and current residents. A copy of each document is available at the front entrance of the care home. Residents said that they were invited to visit and view the home before an offer of placement was made. An assessment of needs for each individual was carried out prior to admission and residents spoken to said that they were able to visit and view the home before making a decision whether to move in or not. As stated in the Annual Quality Assurance Assessment (AQAA) the manager will within Care Homes for Older People Page 10 of 23 Evidence: the next twelve months provide information to the residents in additional formats including tapes and pictures and in different languages. Care Homes for Older People Page 11 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their identified needs would be met appropriately. Evidence: Six care plans were examined. These were found to be person centred and provided information about the individual in the form of a profile, about the rights of individuals, assessment of needs (complaints understanding, dementia, emotional needs, abuse, general health, mobility, dressing, personal care, bathing, appetite, continence, night checks, environment, communication, medication, hobbies). All these information including the daily records are held electronically in computers in CAREDOCS system. Risk assessments in relation to health care and personal care needs including mobility were maintained. However, risk assessment for residents who use electric reclining chairs were not carried out to ensure that possible risks are identified, minimised and managed. Residents and relatives spoken to said that staff were caring, supportive and helpful. They also said that they were being well looked after and that they felt Care Homes for Older People Page 12 of 23 Evidence: that their needs were being met in a professional way. The manager said that the home is in the process of changing to a new supplier for all its medicines. The records for the administration and management of medicines were kept in good order. The medicine record charts showed that medicines were given as prescribed and unused medication was returned to the supplying pharmacy. A monthly audit of the system including the ordering, storage, administration and disposal of medicines was carried out. Care Homes for Older People Page 13 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can benefit from the opportunities to participate in activities provided for them that are appropriate to their needs. Evidence: A dedicated day care activity co-ordinator plans the activities for residents on a weekly basis and books entertainers for special occasions throughout the year. A programme is displayed on the main notice boards and in each unit. Residents said they were reminded about the activities on a daily basis. Those spoken to confirmed that they have a variety of activities provided for them and that they go out on trips about 3 to 4 times a year. Although the home does not have a minibus, staff are able to hire a coach from the local Council as and when required. Lunch was served unhurriedly. Choices were provided on the menu and residents were complimentary of the food, activities and the staff team. However, they said that some fresh fruits would be nice and the kitchen staff confirmed that fresh fruits were not provided as relatives brought these in during their visits. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their concerns would be listened to and acted upon and that they would be safeguarded from abuse, neglect and harm. Evidence: The home has written policies on Complaints, Safeguarding Adults and Whistle Blowing which staff said they were aware of. The complaints procedure is also included in the Service Users Guide. Fifteen complaints have been received in the last twelve months. Eight were upheld, three were neither proven or disproved and three were not upheld. One complaint was pending. The home also received eleven compliments during the same period. The majority were from residents raising their concerns and these were dealt with in accordance with the homes complaints procedure. Staff spoken to said that they have received training in Safeguarding Adults, and the home follows the Hertfordshire County Council Procedure for Safeguarding Adults. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are cared for in an environment that is homely, comfortable and safe. Evidence: The home was kept clean, fresh and pleasant. Residents spoken to said that the home is comfortable, bright and homely. They also said that they were happy with their bedrooms and that they are able to bring their personal possessions and belongings. There is a programme of redecoration and some units including numerous bedrooms have been redecorated and recarpeted. The quiet room has new lighting, curtains and artwork. Staff spoken to said that they had undertaken training in infection control. Protective clothing, gloves and hand washing facilities were provided. As stated in the AQAA, the registered manager will within the next twelve months continue with the rolling programme to redecorate and renew carpets and furniture within the home. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service do benefit from the care and support they receive from a competent and qualified staff team and that they feel protected by the homes recruitment policies and procedures. Evidence: Residents and staff spoken to felt that, generally, there were always enough staff on duty and praised the care they received. The interaction between staff, residents and visitors was professional and staff were knowledgeable about the needs of individuals and provided support in a sensitive and professional manner. Six staff files were examined and these were found to have all the necessary documents including two written references for each employee and the Criminal Records Bureau (CRB) checks were carried out before an offer of employment was made so that residents are safe and protected. New staff undergo a programme of induction and staff are provided with training relevant to their work. Staff spoken to confirmed that they received formal supervision on a regular basis. They also said that they received support from senior members of staff and the management team was approachable and helpful. Staff are encouraged to undertake NVQ training and at present, there are 45 care staff in post of whom 14 have completed the NVQ Level 2 and 5 have completed the Level Care Homes for Older People Page 17 of 23 Evidence: 3. Currently, 11 care staff are undertaking the NVQ Level 2 and another 9 at Level 3. As stated in the AQAA, staff turnover has been higher than normally experienced mainly due to immigration issues which management has dealt with satisfactorily with the support of the local immigration officer. The plans for the next twelve months are that a formal exit interview will be held for each staff leaving the care home; an induction pack for the agency staff will be provided and the recruitment system will be reviewed. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their health, safety and welfare are protected by the safe practices in place and the support they receive from an experienced staff team. Evidence: People using the service spoken to have commented positively on the good practices and quality of care and support they received. Staff, residents and relatives spoken to said that the manager was approachable and supportive. The home carries out its quality assurance on the service provision by seeking the views of people using the service, their relatives and other interested parties. However, other members of staff were able to change or alter information in the care plans and daily records that are held electronically. This system must be reviewed so that information is kept secure and safe. Care Homes for Older People Page 19 of 23 Evidence: The kitchen has not had a deep clean for several years and is planned for January 2010. The records of the temperatures of the fridges and freezers were not maintained on a daily basis. Records of fire alarm checks and fire drills were maintained on a regular basis. Records were available for inspection and maintained in accordance with legislation to ensure that the safety of people in the home is promoted. Other records examined were up to date and were held securely. Staff spoken to were aware that people using the service can access their records and information held about them in accordance with the Data Protection Act 1998. There were policies and procedures to ensure that the health, safety and welfare of residents and staff are promoted and protected. A valid insurance certificate was displayed and expires in May 2010. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 37 17 Daily records for residents held electronically must be kept secure and safe. So that changes in recording cannot be made by others. 12/02/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 8 Risk assessment for residents who use electric reclining chairs should be carried out so that possible risks are identified, minimised and managed. Fresh fruits should be provided for residents to compliment their dietary needs. A deep clean of the kitchen equipments should be done on a regular basis. Records of the temperature of the refrigerators and freezers should be kept up to date. 2 3 4 15 38 38 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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