Care Home: Millcroft

Similar services:

• Coopers Mill Ltd
• Bramley Avenue (73)
• Paradise Lodge
• Grangewood
• Upaya Ananda
• Newton Court (1-2)
• Kings Lane (32)
• Pemdale

What the care home does well Good interaction was observed between staff and residents during the inspection. Staff are knowledgeable and aware of the needs of the residents and encourage them to make choices about their lives and choose what they would like to do as far as possible. Training is provided for care staff and there is a rolling programme that staff are facilitated to attend. What has improved since the last inspection? Health Action Plans and Person Centred Plans have been formulated and implement for each person using the service The home provides additional relevant training to staff in order to support and meet the identified needs of individuals. A quality assurance system is now in place with records kept. CARE HOME ADULTS 18-65 Millcroft Royston Road Barkway Royston Hertfordshire SG8 8BU Lead Inspector Bijayraj Ramkhelawon Unannounced Inspection 24th June 2008 10:30 Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 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 Millcroft DS0000019469.V367054.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 Adults 18-65. 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. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Millcroft Address Royston Road Barkway Royston Hertfordshire SG8 8BU 01763 848306 01763 849440 millcroft@craegmoor.co.uk 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) Conquest Care Homes (Peterborough) Limited Mrs Katharine Ellen Tones Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Physical disability (2), of places Physical disability over 65 years of age (2) Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2006 Brief Description of the Service: Millcroft is a care home providing personal care and accommodation for 8 adults with a learning disability, one who may have associated physical disabilities and one who may be over the age of 65. The Home is owned by Conquest Care Homes (Peterborough) Limited, which is a subsidiary of Craegmoor Healthcare Limited. The home is located in the village of Barkway, which is situated in a rural area of Hertfordshire and it has its own means of transportation. The home was opened in 1998. Accommodation is offered on 2 floors. The ground floor comprises of a lounge, a quiet room, a dining room, a kitchen and 2 bedrooms (which are used to accommodate service users with mobility impairment as the home does not have a passenger lift) and one assisted bathroom with toilet. The first floor consists one lounge, 6 further bedrooms and 2 bathrooms with toilet. The entrance to the grounds is gated. There is ample parking facility to the front of the home and an extensive and well-maintained fenced garden at the rear with patio and lawn areas. Fees for the services range from £872.44 -£1,427.95 per week. Additional charges are made for newspapers, toiletries etc. (this was correct as at 24/06/08). Millcroft DS0000019469.V367054.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. This unannounced key inspection was carried out on the 24th of June 2008 and took one whole day. It included talking to staff, examining care plans, staff files, staff training records, complaints records, policies and procedures, fire safety procedures, maintenance records, all other records and documents and a tour of the premises. The registered manager has completed an Annual Quality Assurance Assessment (AQAA). Information taken from this self- assessment stated that the manager ensures that residents are supported in promoting their independence within their capacity and the organisation has introduced ‘My Voice’ a forum where clients can meet and speak about what they want from the company. In relation to equality and diversity the home adheres to the organisational policy and procedures incluidng its recruitment process and supporting the residents in their daily activities including attending the local Chapel. What the service does well: Good interaction was observed between staff and residents during the inspection. Staff are knowledgeable and aware of the needs of the residents and encourage them to make choices about their lives and choose what they would like to do as far as possible. Training is provided for care staff and there is a rolling programme that staff are facilitated to attend. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People choosing to use the service can be assured that information about the home would be available to them so that they could make an informed choice and that their assessed needs would be met. EVIDENCE: The service has an up-to-date ‘Statement of Purpose’ and ‘Service User’s Guide’ that provide information about the home and its services. Records examined and information gained from staff (people using the service have difficulty in communication) demonstrate that normally individuals admitted to the home are under a Care Management arrangement and have an assessment of needs carried out by their respective care manager from Adult Care Services, prior to admission to the home. Care plans examined and information gained from members of staff indicated that individuals were admitted to the home after an assessment of needs has been carried out. They also confirmed that prospective residents, their relatives/friends are always encouraged to visit and to “test drive” the home. If a placement is offered and accepted, the initial visits to the home is followed by a trial period to allow for staff to carry out a full assessment of needs. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6-10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be confident that their identified needs would be met appropriately and that they would be enabled to live the lifestyle they chose. EVIDENCE: Care plans examined showed that these were drawn up from a range of sources including individual’s assessment of needs, reports from Social Workers, input from family representatives, staff’s on going assessment during the trial period and contributions from other professional as appropriate. Care plans were detailed and comprehensive which reflected the identified needs of people using the service and how these needs were being met. Regular review of individual’s care needs was also carried out and details of their changing needs were reflected in their care plans. Staff spoken to confirmed that they supported the residents in making choices about their clothes they want to wear, food they would like to have and Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 10 activities they wish to do. Members of staff were observed to interact well with the residents and communicated with them in a manner that was appropriate to their level of understanding using a combination of verbal communication and gestures. Staff members spoken to demonstrated a good knowledge of the needs of individuals. Care practice observed appeared to empower and proactively encouraged people in participating in choosing and decision-making. Up to date risk assessments were in place covering a wide range of activities. Evidence gathered suggests that staff treated information given by people using the service and significant others in confidence. Records regarding the residents are compiled and stored in accordance with the organisation’s written procedures and the Data Protection Act 1998, and in their best interests. Information provided in the AQAA stated that within the next twelve months the manager would work towards improving the recording of daily activities and records. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be assured that they would have opportunities for personal development and enhanced their daily living skills where possible so that they are able to lead as near normal a life as possible. EVIDENCE: People using the service are encouraged to develop and maintain social, emotional, communication and independent living skills where appropriate. Information gained from staff and examination of care plans and menus indicates that people using the service and their relatives are consulted regarding residents’ culinary likes and dislikes. A weekly activity programme was devised for each individual as part of the care plan. The majority of the residents attend the day centre in Baldock and one person is supported by an ‘outreach’ support worker three times a week. Daily records of activities provided for each individual in the care home are Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 12 maintained. Personal details about the individual, their social history, health needs were reflected in each person’s care plan. The home has a vehicle that is used for transporting people for outdoor activities and appointments. A variety of social and recreational activities are facilitated to people using the service including leisure interests. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be confident that their personal and healthcare needs would be met appropriately. EVIDENCE: During the inspection residents were engaged in activities being provided at the care home. They appeared well dressed and groomed. Individuals received personal and healthcare support using the ‘person centred’ plan with support provided based upon identified needs including the rights of dignity, privacy, choices and respect. Members of staff were knowledgeable of the residents’ conditions, their likes and dislikes, and delivered care and support accordingly. Care plans examined show that people using the service are registered with a General Practitioner and they are able to see their doctor at the surgery. Healthcare needs were being met by healthcare professionals and a record of their visits was kept as part of the care plan. The administration and management of medicines were maintained in good order. However, where prescribed regular medicines have been changed to Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 14 PRN, these were not re-written by the prescriber. The records for ordering, administration, storage and disposal of medicines are kept in good order. All staff who administer medicines have undergone the safe administration and management of medicines training and those spoken to said that they have a good system in place to ensure that medicines are administered and managed safely. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be assured that their concerns and complaints would be listened to and acted upon and that they would be safeguarded from abuse, neglect and harm. EVIDENCE: The home has a complaints procedure which is also included in the ‘Service Users’ Guide and ‘Statement of Purpose’. The home maintains a record of complaints and nine has been received since (18/09/07) and dealt with in accordance with the home complaints procedure. The home has a copy of the Hertfordshire procedures on safeguarding adults. Staff spoken to confirmed that they are familiar with the procedures and staff records showed that they have received training on the safeguarding adults. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are cared for in an environment that is homely, comfortable and safe. EVIDENCE: The home was reasonably well maintained and furnished to provide a homely, comfortable and safe environment. All bedrooms viewed were painted in different colours and personal belongings displayed in their individual room. Generally, a good standard of cleanliness was evident throughout those areas viewed. Food items were appropriately stored in fridges and temperatures, recorded daily. The home has an infection control policy and procedures in place. Staff members spoken to are conversant with infection control procedures. However, the upstairs toilet was not provided with a toilet roll holder or a hand paper towel dispenser so as to control the spread of infection. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 17 In the AQAA the manager has stated that new dining room furniture and equipment would be purchased within the next twelve months. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32-36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service do benefit from the care and support they receive from a competent staff team and that they feel protected by the home’s recruitment policy and practices. EVIDENCE: Staff members have the necessary skills and they receive appropriate training to meet the varying needs of people using the service. Staff spoken with indicated that they have opportunities for relevant training and this gives them greater confidence to do their jobs. Staff were knowledgeable about the needs of individuals whom they were supporting and caring for. Currently, there are nine care staff in post of whom 2 have completed the NVQ Level 2 and one has completed Level 3. At present, one care staff is undertaking NVQ Level 3. Information gained from duty roster and staff members provides evidence that the day and night staffing levels remain adequate to meet the needs of current residents. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 19 The procedures for the recruitment of staff were found to be robust. The recruitment files for 6 members of staff were examined and these were found to be kept in good order with CRB checks carried out prior to an offer of employment was made. Staff spoken to confirmed that they received one to one formal supervision on a regular basis. Supervision records were maintained. Staff also confirmed that they received support from the management team and that senior members of staff were approachable and available for advice as and when needed. Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be assured that their health, safety and welfare are protected by the systems and practices in place and the support they receive from a dedicated staff team. EVIDENCE: The home is well managed and staff spoken to confirmed that the manager is approachable and they are able to raise any issues or concerns they may have. The effective implementation of a number of systems including assessment and admission process, care planning and review, consultation and communication, recruitment, induction, training, supervision and appraisal of staff ensures that the home operates in an efficient manner; this clearly Millcroft DS0000019469.V367054.R01.S.doc Version 5.2 Page 21 benefits people using the service and the staff teams. The home has a quality assurance system in place. All statutory records were available for inspection and maintained in accordance with legislation. Records inspected were up-to-date and accurate and were held securely. Staff spoken to were aware that people using the service can access their records and information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of people using the service and staff are promoted and protected. These records were accessible to all staff. All accidents and injuries are recorded in the accident book and RIDDOR forms have been completed where applicable. Regular checks on hot water temperatures and moving and handling equipment were recorded. Fire alarm checks were carried out on a regular basis along with fire drills. However, these fire drills did not include the night care staff (confirmation received subsequently from the manager stating that night staff have now attended the fire drill). A valid insurance certificate (expires on 04/04/09) was displayed in the manager’s office. Millcroft DS0000019469.V367054.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 Adults 18-65 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 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X 3 2 X Millcroft DS0000019469.V367054.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. Standard Regulation Requirement Timescale for action 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. 3. Refer to Standard YA20 YA30 YA42 Good Practice Recommendations Where prescribed regular medicines have been changed to PRN, these should be re-written by the prescriber. The upstairs toilet should be provided with a toilet roll holder and hand paper towel dispenser so as to control the spread of infection. All staff should receive fire drill on a regular basis including night staff. Millcroft DS0000019469.V367054.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 Millcroft DS0000019469.V367054.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!