Care Home: Mitchell House

What the care home does well Mitchell House provides a comfortable and kind atmosphere in which to live. Residents are well care for and say that staff are very kind and considerate and their privacy and dignity is respected at all times. The home carries out thorough assessments prior to residents moving in and this includes finding out about social interests, hobbies as well as health and personal needs. Residents` health needs are properly met by the home and by visiting community health professionals.Recreational and social activities are a major focus of the home and are frequent and varied, designed to ensure that all residents have opportunities to participate and enjoy the programme. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents are encouraged and supported to exercise choice and control over their lives as far as possible. Meals are wholesome and nutritious; the menu includes opportunities for choice. The complaints and quality assurance procedures reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home and grounds are well maintained and residents are encouraged to personalise their rooms with small items of furniture and personal effects. What has improved since the last inspection? The home has made significant improvements in many areas, including arrangements for recreational and social activities, staff management and training, care documentation and the overall condition of the premises. What the care home could do better: This report contains no requirements for improvement; the National Minimum Standards are met. Recommendations have been made for aspects of record keeping to be further improved, to ensure all necessary information is available to guide staff in their work. CARE HOMES FOR OLDER PEOPLE Mitchell House Mitchell House 2 Mitchell Road Canford Heath Poole Dorset BH17 8US Lead Inspector Gloria Ashwell Unannounced Inspection 11th February 2009 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mitchell House Address Mitchell House 2 Mitchell Road Canford Heath Poole Dorset BH17 8US 01202 681446 01202 852248 manager.mitchellhouse@careuk.com 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) Care UK Community Partnerships Ltd Post vacant Care Home 50 Category(ies) of Dementia (50) registration, with number of places Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Dementia- Code DE The maximum number of service users who can be accommodated is 50. 19th August 2008 Date of last inspection Brief Description of the Service: Mitchell House is a care home accommodating a maximum of 49 older people. Residents admitted for permanent care have dementia; the home has beds available for respite care which may be used to accommodate people with other diagnoses. The home comprises one building on the ground floor, divided into 5 bungalows each containing bedrooms, a kitchenette, communal areas and hygiene facilities. All bedrooms are for single occupancy and have wash-basins but do not have en-suite toilets. The home is located at Canford Heath and public transport operates close to the home. The fee range quoted in the service user guide at the time of inspection was £400 to £500 per person per week. Up to date fee information may be obtained from the service. Mitchell House DS0000067219.V374235.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 stars. This means the people who use this service experience good quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. This inspection was carried out by two inspectors, accompanied during part of the inspection by an expert-by-experience provided by the support organisation Help the Aged. Throughout the report the term we is used, to show that the report is the view of the Commission for Social Care Inspection. This inspection was unannounced; the inspectors arrived at 10:00 on 11 February 2009, toured the premises and spoke to residents, staff, observed staff interaction with residents and the carrying out of routine tasks and together with the acting manager discussed and examined documents regarding care provision and management of the home. The duration of the inspection, being the combined total of hours both CSCI inspectors spent in the care home, was 10 hours. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: Mitchell House provides a comfortable and kind atmosphere in which to live. Residents are well care for and say that staff are very kind and considerate and their privacy and dignity is respected at all times. The home carries out thorough assessments prior to residents moving in and this includes finding out about social interests, hobbies as well as health and personal needs. Residents’ health needs are properly met by the home and by visiting community health professionals. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 6 Recreational and social activities are a major focus of the home and are frequent and varied, designed to ensure that all residents have opportunities to participate and enjoy the programme. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents are encouraged and supported to exercise choice and control over their lives as far as possible. Meals are wholesome and nutritious; the menu includes opportunities for choice. The complaints and quality assurance procedures reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home and grounds are well maintained and residents are encouraged to personalise their rooms with small items of furniture and personal effects. 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. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so Standard 6 does not apply and was not assessed) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure enables prospective residents to make informed decisions about moving to the home and ensures that only residents whose needs can be met by the home are offered places there. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. EVIDENCE: All new admissions are carefully planned to minimise distress to the new resident and to ensure that staff have available all relevant information in order that they can properly meet each persons needs. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 9 The records of two residents admitted since the last inspection included comprehensive and clear details of pre-admission assessment carried out by the acting manager while visiting the prospective residents at their previous addresses. In advance of making the decision to enter the home prospective residents or their representatives visited the home to view the premises and meet residents and staff. Following pre-admission assessment of each prospective residents needs and circumstances the home writes to them confirming the agreement and ability to provide accommodation and care. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of residents are met by suitably trained staff; doctors and other professionals visit as necessary and residents receive the medicines they have been prescribed. Care is planned to promote the individuality of each resident and to provide staff with sufficient information to enable the needs of each person to be competently and sensitively met. Prescribed medication is properly managed promoting the good health and well being of residents. Residents are treated with respect and their privacy and dignity are promoted at all times. EVIDENCE: Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 11 The care records of 7 people who live at the home were examined and found to contain risk assessments forming the basis for care plans and daily records describing the care of each person. There was evidence that individual residents or their representatives had been involved in the development and review of planned care provision. In general, the care plans and associated records were clear and comprehensive but some areas for improvement were identified. One resident has diabetes but the care plan did not fully describe this circumstance and thereby failed to provide guidance to staff on the condition e.g. specific precautions including the likely indications of health deterioration and the action to be taken in such event. Another resident has an indwelling urinary catheter but the care plan did not provide staff with sufficient information and guidance on management. Medicine handling is carried out by staff trained in this work. Residents wishing to do so can manage their own medicines in accordance with a risk assessment process and some of the currently accommodated residents manage their own inhalers. Medication records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. To promote good practice it is recommended handwritten dosage and administration instructions be signed and dated by the writer, and countersigned and dated by a person who has checked each entry for accuracy. Residents spoken to during the inspection said they are treated with respect and their privacy and throughout the inspection there was extensive evidence of good relationships between staff and residents. For example, we spoke with the relatives of residents who said “This home has transformed since the new manager came. The staffs morale has been lifted. Its great” and “The staff are lovely, X is very well looked after”. There was evidence of provision of good standards of care, by well motivated, kind and competent staff. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities to engage in social and recreational activities and are encouraged and supported to pass the time according to individual preference. A choice of menu is provided and meals are nutritional and appetising. EVIDENCE: Since the last inspection the home has developed the provision of recreational and social activities as a major focus; there is a weekly programme of activities including seasonal events and celebrations, visiting entertainers and local excursions and during recent weeks ‘themed evenings’ have taken place in the home, including a ‘pub night ‘ and a ‘Scottish night’, and a ‘Valentines night’ is planned. Throughout our visit there were well-attended attended activities taking place; during the morning a musical entertainment, and in the afternoon Bingo. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 13 A resident, assisted by a staff member, was pushing shop trolley containing confectionary, toiletries etc. about home, and clearly enjoyed this regular activity. The home has commenced publication of a newsletter, providing information about the ongoing development of the service, staff changes and articles of general interest. Visitors can attend at any time and those spoken to during the inspection said they are always made to feel welcome and placed at ease by the staff and all said they were particularly impressed by the cheerful friendliness of the staff. Residents believe they are shown respect and properly treated; comments made during the inspection included “They are like our friends”. Meals provide good nutrition and are liked by residents. Most residents take their meals in the dining rooms, others receive them in their bedrooms. Residents said they have plenty to eat and the quality of meal provision is good. Staff were seen seated next to residents while unhurriedly assisting them to eat and drink. Dining tables were nicely set and lunch attractively served with good menu choices. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A system is in place to deal with any complaints that might be made by residents. The home’s adult protection policy and ongoing staff training demonstrates the homes commitment to understanding abuse and of protecting residents. EVIDENCE: Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home has a complaints policy and procedure. Since the last inspection no written complaints have been received and there have been no allegations or investigations regarding the safeguarding of vulnerable adults. All staff receive training on the safeguarding of vulnerable persons and the home has a written policy and procedure for the protection of vulnerable adults. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, clean, well equipped and suited to the needs of residents. EVIDENCE: The home is well maintained both inside and out. The gardens are attractive, safe and easily accessible for residents. There is a continuous programme of repair, renewal and refurbishment to ensure the premises and furnishings remain comfortable, well maintained and safe. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 16 The building complies with the requirements of the local fire service and environmental health department. All areas of the home were clean and there were no unpleasant odours. There are bathrooms equipped for the use of persons requiring assistance. The laundry room is equipped with equipment compliant with hygiene requirements, including a sluice cycle washing machine. Adequate supplies of clean linen were seen to be available. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are kind, suitably trained and experienced and residents are confident they are in safe hands. EVIDENCE: The home is at all times in the charge of an experienced person and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. The records of 2 recently employed staff members were examined and found to contain all essential information including written references and evidence of Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 18 identity. Criminal Records Bureau (CRB) disclosures are obtained for all staff in advance of employment. The home has developed and implemented a comprehensive induction process for all staff, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities. Clear records of staff training, supervision and appraisal are kept, indicating that staff receive training appropriate to their needs. The provider organisation requires all staff to undertake and as necessary update training in core subjects including fire safety, moving and handling, food hygiene and emergency aid. To ensure competency, staff are encouraged and supported to receive training in additional subjects relevant to the care they provide e.g. understanding dementia, end of life, nutrition and wound care. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the training provision. Residents and visiting relatives spoken with during the inspection indicated satisfaction with all aspects of service the home provides. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and the care and contentment of residents is at the heart of the daily management and running of the home. EVIDENCE: The home is at present in the charge of an acting manager who demonstrated efficiency and competency throughout the inspection. She is soon to apply for registration. The home and the provider organisation have good systems for internal audit quality assurance monitoring to ensure the maintenance of good standards in Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 20 all aspects. Periodic surveys are carried out; during a recent survey of ‘Customer Care’ standards the home scored highly, indicating that residents and their representatives are satisfied with the staff. With the exception of safekeeping small amounts of money for some residents, the home does not manage the finances of residents. Residents who are unable to undertake this responsibility personally have nominated relatives, friends or other representatives to do this on their behalf. There are good processes for staff recruitment, induction and formal supervision. Records indicated that fire safety equipment is routinely checked and tested at the required frequencies and during the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. There is a regularly reviewed fire safety assessment and escape plan. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 22 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. Refer to Standard OP7 OP9 Good Practice Recommendations As necessary, care records should be expanded to include sufficiently detailed reference to diabetes and any other conditions relevant to particular residents. Handwritten dosage and administration instructions should be signed and dated by the writer, and countersigned and dated by a person who has checked each entry for accuracy. Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 23 Mitchell House DS0000067219.V374235.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Mitchell House DS0000067219.V374235.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. 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