Care Home: Maycroft Residential Home

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well All staff are involved at mealtimes to assist those living in the home as necessary. Observations showed that staff are kind and polite when dealing with those living there. People are treated with dignity and respect. People living in the home looked well dressed and cared for and the home has a friendly atmosphere. Staff were enthusiastic and had a good knowledge of those living in the home. What has improved since the last inspection? There were seven requirements and three recommendations after the last key inspection 22nd June 2007, which have now been met.Care plans now have sufficient detail to enable staff to care for people living in the home. Health risk assessments are completed and they include the reason for and current level of risk. Storage keys for medication are kept by the person administering medication and not left unattended. Adequate numbers of staff are provided to meet the needs of people living in the home. Two references and a recent photograph are obtained for all employees. Staff have received training in dementia. There are still four who require training but this is in hand. Hot water temperatures are checked, recorded and where necessary action taken. Fire drills are recorded and the details are available. Pre-admission assessments contain more detail on health and social care needs so that staff know how to meet the needs of those they care for. A record of social activities is being made, and the staff are trying to create new ways to ensure people living in the home have something of interest to look forward to or take part in. Residents allowance records are completed in line with the homes policies and procedures. What the care home could do better: The manager should make notes at interview and keep these on staff files to provide evidence of areas discussed. Where there has been a change in the plan of care the information needs to be clear and detailed to ensure staff are able to provide the necessary care. Complete and accurate records must be kept of all medication received, administered, or not administered, together with a reason why the medicine was not given, in order to demonstrate that residents receive the medicines prescribed for them. CARE HOMES FOR OLDER PEOPLE Maycroft Residential Home 73 High Street Meldreth, Royston Hertfordshire SG8 6LB Lead Inspector Alison Hilton Unannounced Inspection 6th June 2008 07:30 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 DS0000047648.V366009.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. DS0000047648.V366009.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maycroft Residential Home Address 73 High Street Meldreth, Royston Hertfordshire SG8 6LB 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) 01763 260217 01763 260217 manager.maycroft@aermid.com www.aermid.com Aermid Health Care Limited Joan Ogden Care Home 25 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (24), Old age, not falling within any other of places category (25) DS0000047648.V366009.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user under the age of 65 with a diagnosis dementia may be admitted 22nd June 2007 Date of last inspection Brief Description of the Service: Maycroft is situated in the High Street in Meldreth, and within walking distance of the village amenities. The home is on 2 floors, with a passenger lift to the upper floor. The residents have a variety of sitting and dining areas, and sufficient space to move around the home. All rooms are single occupancy and there are currently no en-suite facilities. There are extensive gardens where service users can sit or walk, weather permitting and access has been improved, allowing more service users to enjoy the gardens if they choose. The home offers care to a maximum of 25 older people and older people with dementia. The cost of a placement is between £550 and £595 per week, with extra charges for hairdressing, chiropody and toiletries. A copy of the inspection report is kept with the signing in book. DS0000047648.V366009.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 star. This means the people who use this service experience good quality outcomes. We, the Commission for Social Care Inspection (CSCI) carried out a key unannounced inspection of Maycroft on Friday 6th June 2008 at 07:30 hrs using the Commission’s methodology described below. This report makes judgements about the service based on the evidence we have gathered. Staff (including night staff), people who live at the home and the deputy manager were spoken to. An Annual Quality Assurance Assessment (AQAA) was completed and returned to the Commission prior to this inspection. Surveys were sent to care workers, relatives and people living in the home. Seven out of twelve staff surveys were returned. Seven out of twelve relative’s surveys were returned and seven from people living in the home. Information they provided will be in the body of the report. A number of records were seen, together with three staff personnel files and two files of people living in the home. There were twenty-two people living in the home on the day of inspection and three beds were vacant. The deputy manager was present for most of the inspection. What the service does well: What has improved since the last inspection? There were seven requirements and three recommendations after the last key inspection 22nd June 2007, which have now been met. DS0000047648.V366009.R01.S.doc Version 5.2 Page 6 Care plans now have sufficient detail to enable staff to care for people living in the home. Health risk assessments are completed and they include the reason for and current level of risk. Storage keys for medication are kept by the person administering medication and not left unattended. Adequate numbers of staff are provided to meet the needs of people living in the home. Two references and a recent photograph are obtained for all employees. Staff have received training in dementia. There are still four who require training but this is in hand. Hot water temperatures are checked, recorded and where necessary action taken. Fire drills are recorded and the details are available. Pre-admission assessments contain more detail on health and social care needs so that staff know how to meet the needs of those they care for. A record of social activities is being made, and the staff are trying to create new ways to ensure people living in the home have something of interest to look forward to or take part in. Residents allowance records are completed in line with the homes policies and procedures. What they could do better: The manager should make notes at interview and keep these on staff files to provide evidence of areas discussed. Where there has been a change in the plan of care the information needs to be clear and detailed to ensure staff are able to provide the necessary care. Complete and accurate records must be kept of all medication received, administered, or not administered, together with a reason why the medicine was not given, in order to demonstrate that residents receive the medicines prescribed for them. DS0000047648.V366009.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000047648.V366009.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 DS0000047648.V366009.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): 1,3,5,6 Quality in this outcome area is good. People who may want to live in the home have enough information to know what the home can provide so they can make a decision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s pre-admission assessments have been altered to ensure they include enough information on health and social care needs to adequately guide staff members. People living in the home said they or a relative had visited the home before they came and they were given enough information to make a decision about coming to live here. One person said, “ my daughter came to see it (the home) and I moved here to be close to her.” One relative said “the home provides a family atmosphere”. DS0000047648.V366009.R01.S.doc Version 5.2 Page 10 Staff surveys showed that 5 out of seven felt they usually received enough information about a persons needs to be able to look after them. DS0000047648.V366009.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. The health and social care needs of people in the home are documented, ensuring they can and are being met This judgement has been made using available evidence including a visit to this service. EVIDENCE: The identified needs of each resident are reflected in their care plan, including details of how these needs are to be met and the action required by staff, although there are areas where further detail would be useful. On discussing this with the deputy manager, she said further improvements to the care plans are being made, including a larger format so that more information can be included. There was evidence that the care plan for someone who was discharged from hospital had been reviewed at that time and changes made according to need. On another file the care plan had been reviewed but where the information had changed there needed to be more explanation of how the changes impacted on the care the staff had to provide. DS0000047648.V366009.R01.S.doc Version 5.2 Page 12 Each resident has a comprehensive health care risk assessment including Nutritional Risk, Waterlow scores (this measures the risk of a person getting a pressure area) with the reason for or indication of current risk level. There were details of GP, District Nurse and Community Psychiatric Nurse (CPN) visits. Both files seen for people living in the home had risk assessments completed. One comment from the relatives surveys returned was that the care given to her relative is “done well” and another commented, “the level of care is excellent in particular where health issues are concerned”. Staff surveys showed that “ we work well to show all service users that we care”, and “ we have a good team”. Residents surveys showed that 5 out of 7 felt they always received good care and support and 2 usually felt this. People looked well dressed and cared for. Keys for the medication trolley are not left unattended and the staff member administering medication that day had them with them to ensure the safe storage of medication. Where medications are no longer being used this should be written on the medication administration record (MAR) sheet so that it will not be given in error. For one person living in the home one medication should have been administered three times a day for four days. The MAR sheet showed that on two days the medication had been given four times. The deputy manager said she would look into it. Two people had been given their medication from the blister pack but this had not been recorded on the MAR sheet. One person should have eye ointment at night but there was no record this had been done for two nights in May. The controlled drugs record was seen and those checked were correct. DS0000047648.V366009.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 good. The staff provide activities to ensure that those living in the home have things to do both inside and out in the garden. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided in the AQAA showed that the manager was trying to employ an activities co-ordinator. Information from the surveys showed that “Residents tell me they are bored”; “outings would keep the residents in touch with the outside world” and “there is a lack of stimulation”. People living in the home said they had had their nails painted by staff and had bingo. The TV and CD player were used at different times during the inspection but were not overwhelming. Staff said they sat and chatted when they could and it was nice to see that staff are encouraged to eat their meal with people in the home. One person living in the home has started to call the bingo numbers. Another person said he goes to his room and paints pictures. A record of the social and recreational activities that take place in the home are now recorded in the diary. These included gardening, painting, bingo, nail painting, karaoke, PAT dog and sing-a-longs with outside entertainers. The DS0000047648.V366009.R01.S.doc Version 5.2 Page 14 deputy manager said that she is intending to get old-fashioned items so that people can touch them, have discussions about them or explain what they were for. She said the home is organising a summer fete and those living in the home will be encouraged to join in. One person spoken to said he was looking forward to it and would be selling some paintings. Staff and people living in the home have been raising money to purchase a minibus so that they can enjoy trips out. The target amount has nearly been reached. Resident surveys showed that 3 people felt there were sometimes appropriate activities available; 2 felt there usually were and one felt there always was. The meals are freshly cooked each day and there is always a choice. The cook said she did not always cook what was on the menu as it depended on the weather and her knowledge of peoples likes and dislikes. She was aware of those with special diets and how to provide extra calories for those who needed to gain weight. One person said there was not a great deal of choice but he thought the meals were “moderate”. Another said, “ I choose what I want. I have no grumbles about the food”. The surveys showed that 3 people usually like the meals and 4 always do. Breakfast was provided in the dining area, on easy chairs in the lounge or in a person’s bedroom. Everyone was given a choice and those spoken to said they were enjoying their breakfast. Those who got up early (there were 14 up and dressed when we arrived) had had a drink and some said they had already had breakfast. It was seen that they were asked if they wanted fresh fruit when those who got up later were offered something to eat. On the day of inspection lunch was fish cakes or macaroni cheese with chips, spaghetti hoops, pasta salad or mash. For dessert there was rice pudding, fruit or yoghurt. During the day the cook had also made fresh doughnuts for the residents. DS0000047648.V366009.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. People living in the home are protected from abuse by the training of staff and the homes policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA showed that there had been no complaints at the home. There have been no complaints received by the Commission at this time. There have been no occasions when safeguarding adult referrals were made and no safeguarding adult investigations. Further information showed a quality assurance programme in place to improve services Staff spoken to during the inspection said they had completed the statutory courses including Safeguarding (formerly known as Protection of Vulnerable Adults (PoVA)). Staff were not aware of the Mental Capacity Act, which will have an impact on them and the deputy manager said she would get more information on the Act. All staff have completed PoVA training. The resident surveys showed that 4 people knew who to speak to if they were unhappy, and one usually did. DS0000047648.V366009.R01.S.doc Version 5.2 Page 16 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, 20, 24,26 Quality in this outcome area is good. People benefit from a home that is clean and has a maintenance programme. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All areas of the home were clean and there were no unpleasant odours. There are several seating areas and two dining areas within the home. People sat where they wanted and moved about the room. The standard of decoration, furnishings and carpets is satisfactory. Comments from relatives included “provides an excellent standard of care whilst maintaining a homely atmosphere”. The garden is big and has several different areas within it. The staff said they are trying to get people interested in growing vegetables and flowers now that DS0000047648.V366009.R01.S.doc Version 5.2 Page 17 the better weather is here. Several people living in the home did say that there are plans to build an extension, but this did not appear to unsettle them when they spoke about it. People said they had their own rooms and had brought their own belongings such as photos and pictures. DS0000047648.V366009.R01.S.doc Version 5.2 Page 18 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. Checks are made on staff prior to their commencement of employment to ensure the safety of people living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection there were an adequate number of staff available to meet the needs of the people in the home. The rota was inspected and it showed there are five care staff on duty between 07:30 and 15:00; four between 15:00 and 22:00 and two waking night staff between 22:00 and 08:00. The deputy manager was on call as the manager was on a course. Records showed that all but four staff have received training in Dementia, and this was confirmed by care staff spoken to during the inspection. Arrangements have been made for the four remaining staff to receive the appropriate training. Three staff files were inspected and all the necessary criminal record bureau checks and PoVA checks were recorded, although there were some areas that needed clarification from the manager the day after the inspection. On two files it appeared that the references were not from the most recent employer. The manager said that she had asked about the last/current employer and this is who the references are from. One staff member had put a job history but DS0000047648.V366009.R01.S.doc Version 5.2 Page 19 omitted current employment by mistake. The manager said she confirmed that the employment status was correct with that employer. The other staff member had put down a referee who was difficult to contact and messages had been left and in the end the manager sought a reference from the same company but a different person within it. The manager said she does write notes at interview and it was discussed that these could provide good evidence that gaps in employment and any other issues had been checked. She agreed and intends to create a format to use at interview that will then be placed on file. New staff receive an induction but only when it is complete does it go in their file. The manager said that one of the newest staff members had some areas of the induction still to do and the other had only just finished and the induction had not been brought in for filing. The two newest staff did not have contracts on file. The manager said a new human resources manager was rewriting these at head office. DS0000047648.V366009.R01.S.doc Version 5.2 Page 20 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): 31,33,35,36,37,38 Quality in this outcome area is good. The home is being managed effectively to ensure those living there receive consistently high levels of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Hot water temperatures are checked and recorded so that they are maintained close to 43 degrees Centigrade to protect people in the home from scalding. There were some entries that showed the temperature of some sinks to be in excess of this but there was evidence that the plumber had been called and dealt with it. DS0000047648.V366009.R01.S.doc Version 5.2 Page 21 Records of fire drills were seen. The deputy manager said that night staff are part of the fire drills as most of them do some day shifts. Details of other checks were provided in the AQAA. The administrative records for residents’ allowance include the signature of a second staff for any money credited/debited. Staff surveys showed that only one person felt the manager met and supported them often, whilst two said they were met and supervised regularly and four staff said sometimes. The manager said that staff receive regular supervision and this was confirmed by staff during the inspection. The notes are locked away as they are confidential. The manager also said that after each shift there is a discussion and chat with each member of staff. The deputy manager said that the manager often does a night shift and sleeps in to ensure staff feel supported. Comments from relatives’ surveys included “ it is run by an extremely competent manager who leads by example”. DS0000047648.V366009.R01.S.doc Version 5.2 Page 22 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 X X X 3 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 X 3 X 3 3 3 3 DS0000047648.V366009.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP9 Regulation 17 (1) Schedule 3(i) Requirement Complete and accurate records must be kept of all medication received, administered, or not administered, together with a reason why the medicine was not given, in order to demonstrate that residents receive the medicines prescribed for them. Timescale for action 06/06/08 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 2 Refer to Standard OP7 OP29 Good Practice Recommendations Where there has been a change in the plan of care the information needs to be clear and detailed to ensure staff are able to provide the necessary care. Details of interview notes should be kept on the file so that evidence of matters discussed are available. DS0000047648.V366009.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 DS0000047648.V366009.R01.S.doc Version 5.2 Page 25 - 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!