Care Home: Mellor Nook

What the care home does well On our arrival the home was warm, clean, comfortable and fresh smelling. We were made very welcome and residents appeared content and "at home" saying that they loved living there. We checked the care files for two residents and could see that each person had been fully assessed before they came to live at the home to make sure that their needs could be met. Having identified residents` care needs staff had written detailed care plans, so that it was clear what help each person needed and what their preferences and usual routines were. Residents had seen their GP`s, chiropodists and opticians and one person was being seen by the district nurse. We saw staff helping one resident to move, using equipment appropriately and safely. Residents said staff were "lovely" and we noticed a good rapport between those working at the home and those living there. Since the last inspection an activities organiser had been appointed and residents told us they played Scrabble, dominoes and draughts, took part in quizzes and practiced gentle exercises. Some residents enjoyed doing crosswords or jigsaws and one resident had watched the Olympics over the summer with interest. It was reported that a new minibus had been bought and residents were enjoying trips out each week. On the day we visited it was one resident`s birthday and residents told us there would be a party that afternoon for her and they would have party food, wine and a cake. The complaints procedure was displayed in the home. One visitor told us that they had complained about some matters when their relative was first admitted to the home and the issues had all been resolved. Staff said they received training that was relevant to the job they were doing. The deputy manager was undertaking training in dementia care, which she was finding useful and other staff were undertaking National Vocational Qualification (NVQ) level 3 training. Of 12 carers, 9 had successfully completed NVQ level 2. This qualification is obtained following training in providing personal care. This meant that staff had a good basic knowledge of the care they needed to provide. Staff and residents felt there were enough staff on duty to meet peoples` needs. We looked at the duty rota for the week commencing 27/10/08 and this showed that at least 2 and often 3 carers were on duty during the day. The owners/managers of the home were also on duty or on call and in addition there were extra ancillary staff such as a housekeeper, cook and the activities organiser. Systems were in place for residents to give feedback about the home. Occasional residents` meetings were held and an annual resident satisfaction survey was carried out. The owners analysed the comments received and used them to continue to improve the service. It was reported that the arrangements for dealing with residents` money were unchanged and residents were encouraged to manage their own money where possible to maintain their independence. Records showed that the building and equipment were regularly checked and serviced to ensure the environment was safe for residents and staff. What the care home could do better: One resident was being seen by the district nurse who had put a care plan in place to deal with a medical condition they had. Staff need to make sure they fully follow any plan put in place by another health care professional, as a small part of this plan was not being acted on. Medicines were in the main managed well but it was noted that the cupboard in which they were kept was not locked. Medicines must always be stored in a locked cupboard. The instructions for one resident`s medicines were handwritten by a staff member. If staff handwrite instructions in this way, the record should be checked and countersigned by a second member of staff to make sure there are no errors. Although we said at our last inspection that there should be liquid soap and paper towels provided for staff to wash their hands these were still not in place. The owner had bought the dispensers but not yet put them up in the toilet areas. Staff should be provided with liquid soap as bar soap provides a greater risk of bacteria. Staff personnel files were looked at. As part of the recruitment process staff had beenasked to provide an employment history but there was no space on the application form for them to put the dates of their former employment. This meant it was not always clear how far back the employment history went. Employment histories should be as detailed as possible so the employer can satisfy themself that the candidate is suitable to work in the home and has a reliable track record. The owners had arranged for a health and safety inspection to be undertaken by an independent company. This was carried out in June 2006. Some of the recommendations made had not yet been addressed. The owner should make sure that these suggestions are dealt with to ensure the continuing safety of residents and staff. One of the owners needs to undertake the Registered Managers Award as at the present date none of the joint owners have achieved this qualification. Although the owners have many years of experience between them someone does need to have completed the award to fully meet the National Minimum Standards. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Mellor Nook 133/135 Moorend Road Mellor Stockport Cheshire SK6 5NQ three star excellent service The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Fiona Bryan Date: 2 2 1 1 2 0 0 8 Information about the care home Name of care home: Address: Mellor Nook 133/135 Moorend Road Mellor Stockport Cheshire SK6 5NQ 0161-4274293 01614270843 manager@mellornook.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs. Jean Mary Critchlow,Mr John Robert Critchlow,Mr James William Critchlow care home 15 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 15 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 15 Date of last inspection Brief description of the care home The home was built in the 18th Century and is laid out in its original cottage style. People living at the home have the use of and share a lounge that has a number of original features, including an inglenook fireplace. There is also a small lounge/ reception area as you walk into the home where some people like to sit throughout the day. Window seating and ceiling beams retain the cottage feel and, with the addition of Care Homes for Older People Page 2 of 9 Brief description of the care home fixtures and fittings, which are in keeping with the age of the property, service users are provided with a warm and inviting environment. The home offers 11 single bedrooms, nine of which have en-suite facilities, and two double rooms, one of which has an en-suite facility. All bedrooms are tastefully furnished and, like other parts of the home, reflect the age and character of the building. Mellor Nook is situated some considerable way from any shops and community life; therefore most people living there are from the local area and prefer a quieter lifestyle. Fees for accommodation and care at the home vary between 326 and 450 pounds per week. A service user guide is displayed in each room and is also available on the homes website: www.mellornook.co.uk Care Homes for Older People Page 3 of 9 What we found: This random inspection took place on Saturday 22nd November 2008. Staff at the home did not know this visit was going to take place. At the last key inspection the overall quality rating for this home was judged as excellent so we did this inspection to satisfy ourselves that nothing had changed and that residents were still happy with the care they were receiving. We looked briefly at all the key standards. These are the standards we feel are especially important in ensuring that residents health, safety and quality of life are promoted and protected. We observed some care practices and spoke with residents, visitors, the manager and other staff that worked at the home. We looked in detail at the care provided to 2 residents, looking at their experience of the home from their admission to the present day. A small selection of staff and care records were looked at, including care plans, medicine records, staff duty rotas and training records. We found that in general staff were continuing to follow the homes policies and procedures and that the home was running well. What the care home does well: On our arrival the home was warm, clean, comfortable and fresh smelling. We were made very welcome and residents appeared content and at home saying that they loved living there. We checked the care files for two residents and could see that each person had been fully assessed before they came to live at the home to make sure that their needs could be met. Having identified residents care needs staff had written detailed care plans, so that it was clear what help each person needed and what their preferences and usual routines were. Residents had seen their GPs, chiropodists and opticians and one person was being seen by the district nurse. We saw staff helping one resident to move, using equipment appropriately and safely. Residents said staff were lovely and we noticed a good rapport between those working at the home and those living there. Since the last inspection an activities organiser had been appointed and residents told us they played Scrabble, dominoes and draughts, took part in quizzes and practiced gentle exercises. Some residents enjoyed doing crosswords or jigsaws and one resident had watched the Olympics over the summer with interest. It was reported that a new minibus had been bought and residents were enjoying trips out each week. Care Homes for Older People Page 4 of 9 On the day we visited it was one residents birthday and residents told us there would be a party that afternoon for her and they would have party food, wine and a cake. The complaints procedure was displayed in the home. One visitor told us that they had complained about some matters when their relative was first admitted to the home and the issues had all been resolved. Staff said they received training that was relevant to the job they were doing. The deputy manager was undertaking training in dementia care, which she was finding useful and other staff were undertaking National Vocational Qualification (NVQ) level 3 training. Of 12 carers, 9 had successfully completed NVQ level 2. This qualification is obtained following training in providing personal care. This meant that staff had a good basic knowledge of the care they needed to provide. Staff and residents felt there were enough staff on duty to meet peoples needs. We looked at the duty rota for the week commencing 27/10/08 and this showed that at least 2 and often 3 carers were on duty during the day. The owners/managers of the home were also on duty or on call and in addition there were extra ancillary staff such as a housekeeper, cook and the activities organiser. Systems were in place for residents to give feedback about the home. Occasional residents meetings were held and an annual resident satisfaction survey was carried out. The owners analysed the comments received and used them to continue to improve the service. It was reported that the arrangements for dealing with residents money were unchanged and residents were encouraged to manage their own money where possible to maintain their independence. Records showed that the building and equipment were regularly checked and serviced to ensure the environment was safe for residents and staff. What they could do better: One resident was being seen by the district nurse who had put a care plan in place to deal with a medical condition they had. Staff need to make sure they fully follow any plan put in place by another health care professional, as a small part of this plan was not being acted on. Medicines were in the main managed well but it was noted that the cupboard in which they were kept was not locked. Medicines must always be stored in a locked cupboard. The instructions for one residents medicines were handwritten by a staff member. If staff handwrite instructions in this way, the record should be checked and countersigned by a second member of staff to make sure there are no errors. Although we said at our last inspection that there should be liquid soap and paper towels provided for staff to wash their hands these were still not in place. The owner had bought the dispensers but not yet put them up in the toilet areas. Staff should be provided with liquid soap as bar soap provides a greater risk of bacteria. Staff personnel files were looked at. As part of the recruitment process staff had been Care Homes for Older People Page 5 of 9 asked to provide an employment history but there was no space on the application form for them to put the dates of their former employment. This meant it was not always clear how far back the employment history went. Employment histories should be as detailed as possible so the employer can satisfy themself that the candidate is suitable to work in the home and has a reliable track record. The owners had arranged for a health and safety inspection to be undertaken by an independent company. This was carried out in June 2006. Some of the recommendations made had not yet been addressed. The owner should make sure that these suggestions are dealt with to ensure the continuing safety of residents and staff. One of the owners needs to undertake the Registered Managers Award as at the present date none of the joint owners have achieved this qualification. Although the owners have many years of experience between them someone does need to have completed the award to fully meet the National Minimum Standards. 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 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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 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 Staff should make sure that advice from other health care professionals is fully carried out so residents health care needs are met. Where staff handwrite instructions for medicines, these should be checked and countersigned by a second member of staff to reduce the risk of errors being made. Medicines kept in the home should always be kept in a locked cupboard so they are securely stored. There should be room on their application forms for new staff to put in the dates of their previous employment, so a good employment history is obtained and can be validated. One of the owners should undertake the Registered Managers Award. 2 9 3 4 9 29 5 31 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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