Care Home: Mont Calm Residential Home

What the care home does well It is evident through us talking to members of staff that the emotional health of the residents is of a high priority to the home and that staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life in accordance to their plan of care. Staff demonstrate their commitment to achieving best outcomes for residents. Staff stated they expressed job satisfaction and confidence in the management of the home. Residents who spoke to us confirmed in their own words that they receive a good quality of care from staff who are courteous, respectful, communicate well, are experienced and deliver care in a individualised and professional manner. Many comment cards received about the home reflected a very positive experience of the home and further evidenced that the home works towards providing a high level of care. One comment card referred to staffing within the home. What has improved since the last inspection? It was evident through the inspection process that the home is taking steps to improve the standards of care. The management of the home has been faced with various challenges since the previous inspection. Shortfalls identified at the previous inspection have been actioned and the manager has evidenced her capability to improve standards within the home to provide better outcomes and quality of care for the residents. What the care home could do better: Several recommendations were made with regard to service improvement. A request was made to review staffing to ensure all parts of the home are covered by sufficient staff to meet the needs of the residents at busy times. Key inspection report Care homes for older people Name: Address: Mont Calm Residential Home 72-74 Bower Mount Road Maidstone Kent ME16 8AT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Robert Pettiford     Date: 1 1 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Mont Calm Residential Home 72-74 Bower Mount Road Maidstone Kent ME16 8AT 01622752117 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: sam.reeves@montcalm.org.uk MGL Healthcare Ltd care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 39 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - DE Date of last inspection Brief description of the care home Mont Calm Residential Home is registered to provide personal care and accommodation for 39 older people with Dementia. The home is owned by MGL Healthcare Ltd. A family run business by Mr John Lisis, Mr Michael Lisis and Mrs Lisette Lisis. Having one other home nearby in Maidstone and another in Canterbury. The home consists of three properties directly next door to each other, (70,72 & 74 Bower Mount Road). Mont Calm has twenty-four single rooms, twelve of which have en-suite facilities and seven double bedrooms, three of which have en-suite facilities. There are shaft lifts in the houses and a staff call system. There is a large rear garden Care Homes for Older People Page 4 of 25 39 Over 65 0 Brief description of the care home and ample parking to the front of the building. The homes current fees range are according to assessment. Information on the Homes services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place at 6:50AM on 11th August 2009 We agreed and explained the inspection process with the manager. The focus of the inspection was to assess the home in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Older Persons. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. We used a varied method of gathering evidence to complete this inspection, pre inspection information such as the previous report and discussion and correspondence with the registered provider/manager was used in the planning process. This was to support us to explore any issues of concern and verify practise and service provision. The home had completed an annual quality assurance assessment questionnaire Care Homes for Older People Page 6 of 25 (AQAA). This provided us with information relating to What the home considers it does well, What we could do better, What has improved within the last 12 months and plans for improvement. The judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Commission to be able to make an informed decision about outcome areas. Further information can be found on the Commissions website with regards to information on KLORAs and AQAAs. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre-admission assessments, rotas, and training records. In addition an environmental tour took place. We identified a sample of residents for case tracking (a review of the level of care and support needed, and if it is being provided in a way that treats them with respect and dignity). Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident can be confident that their needs will be assessed prior to moving in to the home and they have the opportunity for visits prior to committing to living at the home. Intermediate care is not provided Evidence: Records held showed that residents have an assessment, which identifies their individual needs prior to or on admission to the home. The residents, their families and health provide the information / social care professionals. This is then reflected into the care plans and these are developed in agreement with the individual where possible. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the home meet the needs of the individual. Before agreeing admission the service carefully considers the needs assessment for each individual prospective person and Care Homes for Older People Page 10 of 25 Evidence: the capacity of the home to meet their needs. The assessment process recognises cultural needs and the importance of promoting equality and diversity rather than just meeting needs in a reactive manner. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from detailed care plans and are supported by staff that treat them with dignity and respect. They can feel confident that their healthcare needs will be met and that the recording and administration of medication meets with current guidance. Evidence: We viewed and discussed with the manager the care records relating to several residents at Mont Calm. In the care plans viewed there were guidelines in respect to support needed. The home undertakes regular reviews. Formal reviews involving significant professionals and relatives where possible are also undertaken. Risk assessments are in place. Evidence was available that residents were involved in drawing up personal care plans where this is possible in the documentation and that they are consulted in reviewing and amending such care plans as their capacity allows. The care planning system was of a good standard. The manager continues to use a more person centred planning approach to care plans, which has a socially lead model as its base. Care Homes for Older People Page 12 of 25 Evidence: The care plan is used as a working tool and is understood by all staff. It is written in clear language and can be used in an emergency by people who are not familiar with its content. We viewed a sample of care records and specific health care records relating to several residents. Records viewed confirmed residents had access to a range of health care inputs as and when required and as part of regular health checks. The home benefits from two medication rooms. The inspector viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets, and the protocols for the administration of PRN as Required Medication. MAR sheets were seen to be completed correctly and medication was stored appropriately. The manager confirmed that all staff that dispense medication have received appropriate training. It is evident through talking to members of staff at Mont Calm that the emotional health of the residents is of a high priority to the home and that staff are pro active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life from interactions witnessed. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Current residents enjoy a good lifestyle, which meets with their expectations. Relatives are actively encouraged to maintain contact with their relatives. The residents benefit from appetising meals and a balanced diet offered at the home. Evidence: The residents spoken with confirmed they were happy with the lifestyle at Mont Calm and found the level of activities about right. The home benefits from a activities co ordinator who works 18 hours each per week. A new co ordinator is being recruited to provide additional activities within the home. Staff normally arrange activities in the afternoon records are kept of what the activity is. A wide range of the activities is organised. Residents and staff confirm that Christmas parties and birthdays celebrations are also celebrated. Family and friends feel welcome and know they can visit the home at any time. Staff always make time to talk to visitors and share information with the agreement of the resident. The design of the home provides seating areas within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. Evidence was seen that residents can bring in personal items for their rooms and staff confirm this was encouraged. The AQAA states One day a person Care Homes for Older People Page 14 of 25 Evidence: using the service said they would like to go to the pub so we asked who else would like to go and went. We ask service users in meetings what activities they would like to have who they would like to come and when they would like to have them. Based on what has been asked of us we have a new larger tv on the wall and an activities board. The residents spoken with said the food was of good quality and that they had a choice. Three full meals plus snacks were available every day with drinks readily available. Evidence was seen that the residents were offered a choice at every meal and that it was well balanced and nutritious. The inspector viewed the menus, which offered a selection of fruit and vegetables on a daily basis. Specialist diets could be provided when advised by health care professionals or residents, including any cultural food needs. The general feeling amongst residents was that the food was good. The AQAA states Menus have changed to ensure there are favourites of everybody on there. The home has a five star rating from the Foods Standards Agency, thus exceeding the required standards with regard to food hygiene and safety. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are aware of their rights with regard to making a complaint and to whom to complain.Residents are protected from the risk of abuse by the homes Adult Protection policy and procedures. Evidence: A copy of the Homes complaints procedures was seen and evidenced at the previous inspection and it was confirmed by the manager that it includes all the information outlined in the Standards. We enquired if the service had changed or if there had been any amendments. The manager stated that no changes had been made. Residents spoken with felt confident that they are listened to and concerns are taken seriously. It was evidenced at the last inspection that the home was not meeting the standard with regard to the protection of residents. Evidence suggests otherwise during this inspection. The homes Policy for the Protection of Residents and staff Whistle blowing procedure was discussed. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Staff have been provided with training in abuse on evidence collected during the inspection. The training records are comprehensive and show detailed records of training. Evidence was provided that staff have been checked with the Criminal Records bureau. The manager confirmed that all staff have been through the required Care Homes for Older People Page 16 of 25 Evidence: recruitment checks prior to appointment, which includes checking the POVA (Protection of Vulnerable Adults) register. No complaints or safeguarding adults alerts have been made since the last inspection. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well maintained environment which provides a homely warm atmosphere with safe access to comfortable indoor and outdoor communal areas Residents can feel confident that the home is kept clean and that policies and practices ensure that hygiene is maintained. Evidence: The home is set in well maintained gardens. It was apparent that the individual and collective needs are being met in a comfortable environment. The standard of internal decoration and fixtures and fittings are well maintained and of a good quality. The home benefits from a wide selection of communal areas thus affording residents space should they so wish desire. The home was found to be clean. Ancillary staff are employed in sufficient numbers to ensure that standards relating to food hygiene are fully met. During the inspection it was noted that the home does have a washing machine with a sluice facility to ensure that hygiene standards are met to meet the needs of residents. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care, social and emotional needs are promoted by caring staff they are trained to the required level to ensure residents safety and welfare. Evidence: The ratios of care staff to residents is determined according to the assessed needs of residents. Following discussions with staff, residents reviewing the rota and observations sufficient staff were on duty during day. However the home was requested to review its staffing arrangements within the more dependant part of the home who have greater needs. Support for staff if they are busy should be available and the need monitored. The home employs ancillary staff who work as cleaners, cooks, gardener maintenance staff. Thus allowing care staff the time to meet the needs of residents. From documentary evidence seen the standard of staff training was good with the majority of staff completing basic courses. The home has achieved the required level of staff being a minimum 50 percent achieving a NVQ (National Vocational Qualification) Level 2 or above care qualification. Shortfalls were noted at the last inspection with regard to staff training in abuse. This has been addressed. The manager had included within the homes action plan that all staff will complete basic core training. This has now been achieved The manager has completed a training Care Homes for Older People Page 19 of 25 Evidence: needs analysis and a up to date training matrix which clearly identify levels of training for each member of staff. The manager confirmed that the home has a development programme for all new staff, which meets Sector Skills councils workforce training targets and ensures staff fulfill the aims of the home and meet the changing needs of residents. The recruitment files were reviewed at the inspection last year and were seen to include all the information as required under schedule 2 of the Care Home Regulations 2001 on information given. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well run home with an experienced manager in post and is operated in their best interests and their views and opinions are important. Residents can feel confident that the management of the home take risks to their health and safety seriously and have robust systems in place to protect residents. Evidence: The current Registered Manager who is also a Director of the provider company is intending to de register and support the Deputy Manager to register. The Deputy Manager stated that she has the required qualifications and experience to register with the Commission as Registered Manager and will be applying to the Commission to be registered. The management of the home has been faced with various challenges since the previous inspection. Shortfalls identified at the previous inspection have been actioned and the manager has evidenced her capability to improve standards within the home Care Homes for Older People Page 21 of 25 Evidence: to provide better outcomes and quality of care for the residents. The AQAA states sends surveys sent to relatives and residents so they have the chance to express any issues they may have or just give any ideas and this can then be done confidentially. Staff have started to carry out regular keyworker meetings so they can get the views from the residents they keywork for and by being a keyworker a relationship can be formed and this would then hopefully give the resident more opportunity to feel comfortable to air any views. The home has an open door policy and makes themselves available to all people who use the service. Reviews are held regularly with the residents so that everyone involved in a persons care can ensure that they are happy with everything. The manager confirmed that the home does undertake quality assurance by means of asking residents to complete questionnaires. The views of other stakeholders are also sought. The residents spoken with confirmed a great deal of satisfaction living within the home and felt confident that their views and opinions were valued by both staff and management. The registered provider of the home does visit the home but does complete what is known as a Regulation 26 visit (Statutory documented visits by the provider to monitor standards within the home). This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required National Minimum Standards. The home has a full range of policies and procedures to promote and protect residents health and safety. Staff consistently follows these. There is full and clearly written recording of all safety checks and there is no evidence of a failure to comply with other legislation. There is a understanding of risk assessment and this is taken into account in all aspects of the running of the home, the environmental risk assessment had been updated. The home was requested to seek the advice of the fire officer to determine any risks with regard to the present arrangements for exiting the building. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 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 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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!