Care Home: McNulty Court

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: McNulty Court 16 McNulty Court Dudley Northumberland NE23 7HX two star good service The quality rating for this care home is: 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: Alan Baxter Date: 2 2 1 0 2 0 0 8 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: McNulty Court 16 McNulty Court Dudley Northumberland NE23 7HX 01912500946 01912500946 vivienne.jeffrey@nhs.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Northumberland, Tyne & Wear NHS Trust Name of registered manager (if applicable) Miss Vivienne Josephine Susan Jeffrey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 0 care home 5 learning disability Additional conditions: The number of persons for whom residential accommodation with board and care is provided at any one time shall not exceed 5 men or women One Resident with dementia (DE), may be admitted, however no further admissions outside category LD to be admitted without consultation with CSCI. One person, LD over 65, may be admitted. Date of last inspection A bit about the care home McNulty Court is a purpose built home in Dudley that provides care and support for up to five people who have a learning disability. At the time of the inspection there were three ladies living at the home. Two of these ladies also have a physical disability. The home is set in its own grounds and offers lots of space for the residents. Dudley is on the outskirts of North Tyneside and is conveniently placed for good road links to all parts of the area; this enables the residents to enjoy a good range of social leisure and educational opportunities. Copies of the Homes Statement of Purpose and this Commissions inspection reports were available in the Home. The current scale of charges was between £1261 and £1495 per week. 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This is what the inspector found during this inspection. The Quality Rating of this service is 2 star. This means that people who live there enjoy a good service. How the inspection was carried out. Before the inspection, we looked at all the information we have received about the home. 2007. We looked at how the home has dealt with any complaints it has received. We looked at any changes to the way the home is being managed or run. We looked at the providers view of how well they care for the people who live there. We looked the views of the people who live there, of their relatives, and of the staff. The Visit: an unannounced visit was made to the home on 22nd November 2008. We talked to people who live in the home, relatives, staff, the manager and visitors. We checked to see how well their needs are being met. We checked that staff have been properly trained. We checked that the home is clean, safe and comfortable. We checked what things have improved since the last visit. What the care home does well Those people living in the home say that they are very happy in the home. One said, Its lovely here, and the staff are lovely. I have no complaints. Relatives spoken with were also very happy. They said, We cant speak highly enough of the care; The whole atmosphere of the home is one of warmth, peace and relaxation; and It gets better all the time. The home makes sure that it can meet all the needs of new residents before they come into the home. Staff then draw up a clear plan of how those needs are to be met. They use the views of the persons themselves, their relatives and other people involved in their care. People living in the home enjoy continuing improvements in their happiness and satisfaction. They are treated with respect and can make choices about how they spend their time. They can be as independent as possible, and can take reasonable risks. Family and other visitors are made very welcome. There is a healthy and varied diet, and people living there enjoy their meals. People living in the home know who to speak to if they have any concerns or worries. The building is pleasant and comfortable, with plenty of room. Staff really care for the people living there. The home is well managed. What has got better from the last inspection All assessments are now being signed and dated, so it is clear that they are kept up to date. Better training has been given about the safe handling of medicines, and some of the medication policies have been made clearer. The staff continue to look for new and different activities and experiences for the people in the home. The manager is arranging training on nutrition and meals, to make sure that the people living there have the best possible diet. The ways that staff must report any harm done to residents have been made clearer, and staff have had more training in this area. All staff have been given training on equality and diversity issues, to help them understand and meet all the needs of the people living in the home. The manager is improving the ways used to check how good the service is, including asking the people living there what they think. What the care home could do better Clearer records should be kept on the visits to the home by the homes line manager. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Alan Baxter St. Nicholas Building St. Nicholas Street Newcastle upon Tyne NE1 1NB 019 1233 3300 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 . Comprehensive assessments are carried out of the needs of each guest, so that the Trust is confident that it can meet those needs. Evidence: The home obtains assessments of the needs of any service user coming to the home. Examples included detailed assessments from the local refering authority, with additional specialist assessments from Community Nurses, Occupational Therapists and other specialists. The home also conducts a range of assessments, including health checks, skin integrity and nutritional assessments, personal strengths, needs and wishes assessments. This gives the home the information it needs to judge whether it can meet the persons needs. The home is careful to make clear where such information has come from, whether directly from the service user or from family or professionals. Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 . Service users receive care and support that is well planned and that takes into account their diverse needs whilst promoting their privacy and dignity. Evidence: The home uses the Care Programme Approach (CPA) to meet the needs of its service users. This a multi-disciplinary approach that includes input from all the professionals involved in the care of the people living in the home, as well as input from the people themselves. From this, an Individual service user support plan is drawn up. Further multi-disciplinary meetings take place every six months, to chart progress and make any amendments needed to the support plan. These meetings are well-minuted, and show evidence of significant and sustained improvements in the well-being and satisfaction of the people living in the home. Monthly house meetings are used to get the views of the people living there, who are encouraged to take their part in the running of the home. They are also asked how they wish to spend their day, and there are sufficient staff for them to go their seperate ways. The homes policy regarding risk taking is to accept that risks are a part of everyday life and cannot and should not be totally eradicated. So risk assessments seek to strike the appropriate balance between reasonable safety and maximum independence for the service users. Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 living in the home enjoy an good range of enjoyable and stimulating activities, are helped to make choices and be as independent as possible, and have a good choice of nutritious food. Evidence: Each person living in the home has an assessment of her leisure needs and wishes. There is a seperate timetable of activities for the more independent ladies, based on their assessed needs. One person is independent enough to plan her own activities, daily. Staff are continually trying to find out more each persons likes and dislikes, and thinking of new ways of providing stimulation. Current activities include needlework, rug-making, arts and crafts, DVDs and videos, and seasonal activities such as making Christmas cards. The conservatory is equipped with music and sensory equipment. Out of the home, the ladies enjoy line dancing, shopping, trips to the cinema and theatres (one lady had just been to London to see The Sound of Music musical). Both ladies spoken with said that they can do what they want during the day, in the evenings and at weekends. Staff support the ladies to use local shops and other amenities, such as libraries and museums. They also enjoy seperate short-break holidays, weekends away, and Evidence: activities-based weekends. All the people living in the home have support from their families, who are free to call in at any time. Any friends are also welcomed into the home. All the ladies have individual contracts. Staff explain whats in the contracts and tell them of their rights and responsibilities. The homes statement of purpose and service user guide are available to the ladies. These use pictures to help explain whats in the documents. One lady goes out and about of her own accord, and has her own front door key. Staff always knock on bedroom doors, give out mail unopened, and call the ladies by the names they wish to be called. The ladies may smoke and drink, if they so wish, and this is confirmed in their contracts. Menus cover a four week period, and are reviewed regularly, involving the ladies in this process. Individual choices are included in the menus. A cooked breakfast is available daily. Staff know the likes and dislikes of each lady, and will cook a seperate meal, if any lady chooses not to have the menu choice. Staff always try to make sure there is plenty of fruit and vegetables in the diet. Staff have been given guidance on the dealing with Diabetes from a general practitioner and a specialist nurse. No nutritional training has been given to staff, but the manager is looking at how this can be arranged. Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 . Service users are given personal care and support appropriate to their needs and choices, and their emotional and physical health needs are met. Evidence: Care plans and review minutes show that the people who live in the home are consulted about, and are included in, their personal care. Comments received from the ladies included Its lovely, here, and the staff are lovely, and, Staff treat us with respect. A relative spoke of the expert care and attention his relation receives in the home, and said that The entire ambiance of the home is of warmth, peace and relaxation. The people who live in the home have choices in every area of their day, including what to wear, when to get and go to bed, and what to eat. Physical and emotional health needs are fully assessed and are properly met. Specialist assessments are obtained, where required, and care plans are drawn up to follow such specialist advice. Clear, detailed records are kept of all visits to or from health professionals. Annual checks of eyes and teeth, and regular chiropody is arranged. None of the people who currently live in the home retain responsibility for taking their medicines. The home uses the monitored dosage system for medications, as this tends to reduce the likelihood of errors. Each lady has a record of her prescribed medicines, with the Evidence: names, purpose and any side effects of each noted. All staff have been booked onto a safe handling of medicines course. The Medication Administration Records (MAR) showed that systems for recording the administration of as and when required medicines is now clearer, with the MAR being initialed only when such a drug has actually been given (with a cross-reference to entries in the daily health care notes). Written permission for giving such drugs has now been obtained from each persons doctor. A new policy was in place for the recording of the administration of ointments and creams. Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 . The home manages any complaints positively and sensitively, and service users views are listened to and acted upon. There are acceptable systems for protecting service users from abuse and neglect. Evidence: The home has an appropriate complaints policy. It is available in a picture version, to make it more understandable to the people living in the home. The two ladies who spoke with the inspector both said that they had no complaints with either their care or the running of the home. No complaints have been received in the past year. A feedback book has been introduced, to record views and opinions that fall short of being complaints. All staff have received refresher training in the safeguarding of vulnerable adults in the past year. After detailed discussions with the staff group, the homes policy for reporting an allegation of abuse has been clarified and simplified, and is now displayed in the office in the form of a flowchart, including the contact details of the relevant contact agency (Social Services). 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 . Service users enjoy a pleasant, well equipped and safe environment, that is kept in a clean and hygienic state. Evidence: The building is purpose-built, spacious and well equipped. It is well furnished and pleasantly decorated, and is kept in good repair. The standard of hygiene is good. It was clarified that the home is responsible for carpet cleaning, not the persons living in the home. 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 . Service users benefit from having a competent, experienced and qualified staff team, who are recruited with care, and properly supervised. Evidence: Nine of the 14 care staff hold National Vocational Qualification (NVQ) level 2 in care. This exceeds the required 50 of care staff. Another 2 staff are studying for this qualification. The Commission has agreed with the Provider that staff recruitment and selection records are held at the organizations head office. Therefore, these records were not able to be accessed on this inspection. There is a staff training and development plan, drawn up from the needs identified in the annual audit of staff training needs. This includes mandatory training needs. Staff receive accredited mandatory training, then annual updates. Personal development training is addressed using the Trusts Knowledge ansd Skills Framework. Individual training plans are drawn up between the staff member and the manager. These are very thorough and identify specific training needs, with target dates for completion. All staff have received equality and diversity training in the past year. Staff receive formal supervision at least every two months, and often more often. There is annual staff appraisal. Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 . Service users benefit from a well-run organization, which includes quality assurance systems and good health and safety practices. Evidence: The current manager, Fiona Beattie, qualified as an RNMH nurse in 1993. She has senior and managerial experience in a range of hospital and community posts. She holds National Vocational Qualification level 4 in management. The home has an annual development plan in place. This covers areas such as refurbishment of the home, staffing levels, staff training needs and appraisals, and development of quality systems. The manager is currently organizing the required annual survey of the views of service users and their relatives, and will action any issues identified as needing improvement. Other quality systems in place include regular staff and service user meetings, visits by the homes line manager, health and safety audits, etc. There are systems in place for the maintenance and servicing of equipment, and for the checking and testing of safety systems such as fire panels and fire alarms. Staff fire drills are diaried, and carried out twice per year. There is a detailed and comprehensive policy on preventing infection. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 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 Helpline: 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 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. 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. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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