Care Home: Mayfair Residential Home The

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What the care home does well The service provides a good level of care in comfortable surroundings. People`s care needs are well assessed and health care professionals said they had a good relationship with the home. Medication is handled safely. People have a wide range of interesting activities offered to them in line with their interests. Visitors are welcomed and the food is of a high quality. One person said: `The food is brilliant, I had seconds today . It is always good and there is always plenty.` The home handles complaints well and people are protected from harm. Staff are well recruited, and well trained. They are on duty in sufficient numbers to make sure people get the right care. The acting manager is well respected by staff who said she was easy to approach and fair. One person living at the home said; `She`s a hero.` People are protected by the health and safety policies and procedures in the home. What has improved since the last inspection? Medication handling has improved to keep people safe from errors of administration. Staff training has improved so that staff now all have foundation training, and training in abuse awareness, to ensure people are kept safe. What the care home could do better: The dining room carpet must be replaced as soon as possible to provide a more pleasant environment for people to eat in. Other areas of the home need to be redecorated, however, this has already been identified by the manager and a plan is in place to make sure this happens. Written care plans should be improved to give more detail of the care needed for each individual. The home must begin to survey people to find out what people think about the service so that the manager can plan improvements based on comments received. The new manager must be registered with CQC as soon as possible. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Mayfair Residential Home The 42 The Esplanade South Cliffe Scarborough North Yorkshire YO11 2AY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Karen Ritson     Date: 2 3 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Mayfair Residential Home The 42 The Esplanade South Cliffe Scarborough North Yorkshire YO11 2AY 01723360053 01723379084 mayfair@enqs.fsnet.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Fay E Crawforth care home 22 Number of places (if applicable): Under 65 Over 65 4 22 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 The Mayfair is a care home providing personal care and accommodation for 22 older people. Mrs. Fay Crawforth is the registered manager and the proprietor. The home does not provide nursing care. Should such care be required on a short-term basis then it will be provided by the community health care services. The Mayfair is a five storey Victorian terraced property located on the south side of Scarborough with good access to the main town centre and all the amenities including the public transport network. Ample on-street parking is available. There are fourteen single bedrooms twelve of which have en-suite facilities. There are also four double rooms and each of these has en-suite facilities. Care Homes for Older People Page 4 of 24 Brief description of the care home A passenger lift is available to all floors. The home does not have gardens however the home overlooks the south bay and public gardens and walkways. Additional charges are made for hairdressing, chiropody, toiletries, papers and magazines. Information about the services provided are made available in the homes Statement of Purpose, Service Users Guide and through published inspection reports available from the home. Care Homes for Older People Page 5 of 24 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection for this service took twelve hours. This includes time spent gathering information, examining documentation before and after a site visit. It also includes the time taken to write the report. The site visit took place on 23rd June 2009 between 9:30 and 13:30. Information was gathered from the following: 1. A visit to the home. 2. Speaking with people living at the home. 3. Speaking with staff. 4. Case tracking three people on the day of the site visit. 5. Looking at information provided by the manager after the site visit. 6. Notifications sent to the commission from the home since the last inspection. 7. Examining policies, procedures Care Homes for Older People Page 6 of 24 and records kept at the home. 8. Examining information regarding the home on the file kept by CQC. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations -but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? 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 set out 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 24 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 24 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 have the information they need to make a decision about admission. Their needs are well assessed so that staff know what care is required. Evidence: Each person has an assessment before admission. This includes all areas of required care, and risk assessments where needed. Each person has a personal history so that staff can get to know each person, what their interests are and what they have done in their lives. Assessments form the basis of the care plan and there is a capability profile for each person. This ensures that peoples need are understood as a whole and that care can be planned based on this. Specialist assessments are included when necessary to ensure each persons needs are understood and that individual needs can be met. The home has a number of people living there who have a reasonable level of independence and the home is clear in its service user guide and statement of purpose about the scope of care it intends to provide. Those people whose needs are Care Homes for Older People Page 10 of 24 Evidence: considered too complex for the home are not offered a place. Care Homes for Older People Page 11 of 24 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. Care plans need more detail to give direction for holistic care, though evidence from health care professionals shows people do receive such care. People are treated with dignity and with regard to privacy. Safe handling of medicines protects them. Evidence: Each person has a plan of care based on the assessement. Not all care plans were up to date, and the deputy manager was in the process of drawing up new care plans for everyone. Most care plans were not sufficiently detailed to give a clear idea of each person as a whole, what care was required and what could be managed independantly or with help from someone other than a member of staff. The care plans were reviewed every month but there was no evidence that the reviews had found their way into updated care plans. All health care professional notes were kept separately and it was easy to see what treatment and advice had been given. Daily notes were kept, but were basic and only recorded once each day and night. These did not give a clear idea of how each person had spent their day or what mood they had been in for example. Some entries were along the lines of no problems or fine. This is not sufficient to Care Homes for Older People Page 12 of 24 Evidence: build a picture of each person particulalry if something happens which requires staff to look back over notes to see any pattern emerging. Behaviour charts and other specialist monitoring tools are used when necessary and this helps to give a clearer picture of how difficulties are managed. Health care professionals said that the home worked well with them. One person said that staff were always very friendly and take on board what is suggested. This person said the level of care in her opinion was very good and that people seemed happy and well looked after. Throughout the day staff were observed speaking to people with kindness and care. The home has a privacy and dignity policy and staff said this was covered in their induction. Medication is well handled according to policy and procedure. Staff with responsibility for medication have all had training in the safe handling of medications. This ensures people are protected from medication errors. Care Homes for Older People Page 13 of 24 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 can live their lives the way they choose and they have a range of activities available. visitors are welcomed. The food is well varied and of a good quality. Evidence: People have their interests assessed and a variety of activities is on offer throughout the week to cater for individual tastes. Activities include aromatherapy, exercises, quizzes, quoits, daily newspapers, entertainment from external sources on a regular basis, where someone visits to sing and play instruments. People at the home can join in with percussion. Individuals are assisted to go out for walks to the rose gardens nearby and some go out for walks into town independently or on trips out with friends. Two people have an interest in painting and attend an art class, there is also a regular sherry social and film club. These arrangements ensure people have a wide range of activities they enjoy. One person said she took a lively interest in what was going on in the home and that there were a number of interesting people to talk to and to go on short walks with. She said there was often something happening in the afternoon and that people could join in, she said you never get bored here. The home has a visiting policy and people are encouraged to visit at any reasonable Care Homes for Older People Page 14 of 24 Evidence: time. The menus are on an eight week programme which changes to take account of the seasons. People can choose from a wide range of options at breakfast including cooked breakfast, cereal, porridge and toast. Lunch is a three course meal and tea is usually a lighter option, with supper later and drinks offered throughout the day. Specialist diets can be catered for if necessary. One person needs liquidised foods and another needs a high calorie diet. Food is sourced locally where possible and the home has a weekly supermarket delivery. The home has a dedicated cook and assistant who make sure menus are interesting and varied through taking suggestions from people living at the home. Care Homes for Older People Page 15 of 24 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 have their complaints listened to and acted upon. They are protected from abuse. Evidence: The home has a complaints policy and procedure. Staff said they had received training in listening to people and taking their concerns seriously and feeding back any points for action. The manager said there had been no formal complaints since the last inspection. The policy is on display at the entrance to the home so that people are made aware of their right to complain. The address for the new CQC needs to be amended on this policy. Staff have all received abuse awareness training and staff said they were aware of what to do to protect people from abuse and how to report anything suspicious. All staff receive CRB and POVA first checks which ensures the people living at the home are protected from those who are not suitable to work with vulnerable adults. Care Homes for Older People Page 16 of 24 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 who use the service live in a safe, reasonably maintained and comfortable environment. Evidence: The manager and deputy have plans to upgrade the decoration in some areas of the home. Bathrooms are to be refitted, the dining room is to have a new carpet and will be redecorated, and individual rooms are being redecorated as they become vacant. The home smells fresh in all communal areas, however, some individual rooms had an odour problem. The manager said the cleaner tried hard to keep on top of this but it was difficult with some individuals due to the nature of their care needs. The dining rooms carpet is in a poor state and is very stained, this is to be changed as a priority. Otherwise the home is maintained reasonably well and is a comfortable place for people to live. The laundry is suitable for the needs of those living at the home. One person commented that the laundry was not a problem, that it was rare for clothes to go missing and that the clothes came back in a good state. Care Homes for Older People Page 17 of 24 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 benefit from well recruited and trained staff, in sufficient numbers to provide a good service. Evidence: The home is registered for 22 and has 17 residents at present. There are two waking night staff and two on duty during the day, one of whom is always a senior carer. The home employs a cleaner who occassionally works as a carer and separate catering staff. Staff said this worked well and that they did not feel rushed and on the day of inspection staff were observed chatting to people and generally finding time to attend to their needs. Staff are well recruited and have a Protection of Vulnerable Adult check and Criminal Records Bureau check before commencing work. Staff training has improved. All staff receive induction training to skills for care guidelines and have foundation training which is regularly updated. Staff now have infection control training as a separate area rather than only including this in induction. Staff said they felt confident they knew what care was needed and how to offer the correct care. This ensures peoples needs can be met. Care Homes for Older People Page 18 of 24 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. The views and preferences of people do not adequately influence practice. People are protected by the health and safety procedures of the home. Evidence: Alison Parker has day to day control of the home. At the moment she is the deputy manager. Fay Crawforth is the registered manager. Alison intends to register with the CQC as soon as possible and has plans to begin a management qualification this year. Staff said that Alison was supportive and easy to approach and that she did a good job of managing the home. One member of staff said I can go to Alison with anything that is bothering me and shell listen. One person living at the home said she was very good with staff and kind to residents. Shes a real hero, she said. The manager has not yet commenced a quality assurance system and plans to do this. She carries out some internal audits but has not surveyed people formally and does not have an annual plan for improvement based on feedback. The AQAA for the home Care Homes for Older People Page 19 of 24 Evidence: was not returned promptly and was forwarded after the inspection. A small number of personal allowances are kept and these are all kept separately in wallets with each transaction recorded. Records were checked against money held and all was correct. The home has an up to date fire risk assessment, and evidence was seen for gas safety, and compliance with the environmental health department. The fire risk assessment highlighted a number of areas which needed attention so that the home could be safe. A number of these have been completed and the others are planned to comply with guidelines on the risk assessment. This ensures people are kept safe. Care Homes for Older People Page 20 of 24 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 24 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 19 23 The carpet in the dining room must be changed as soon as possible, to provide a pleasant environment for people to dine in. 30/09/2009 2 33 24 the manager must ensure that a quality assurance system is put in place, to ensure that practice is influenced by the opinions of those who use the service and to provide a framework for improvement of care. 31/08/2009 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 7 Care plans should be developed to include the way in which all care needs are to be met to give a holistic view of each person adn their needs. The individual rooms of people must be kept as free from odour as possible to provide a pleasant environment for Page 22 of 24 2 19 Care Homes for Older People people to live in. 3 31 The manager is reminded of the necessity to register the new manager with CQC. The new manager must have a qualification in care and management to NVQ level 4 or equivalent. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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. 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