Care Home: Mountbatten Lodge

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What the care home does well People living at, working or visiting Mountbatten told us "we are looked after very well," " regular entertainers visit the home," "we work very well together" and "all areas of the home are kept clean". There are two activity co-ordinators which take on the organising of activities that meet the residents needs. Staff told us that Mountbatten Lodge benefits from a committed and stable management team who provide a consistent approach to the running of the home. As part of the provider` quality assessment process an annual forum is held with residents, their relatives and staff to examine outcomes for people living in the home and if improvements need to be made to ensure the best possible care is provided at all times. What has improved since the last inspection? The number of activity hours has been increased which has enabled a "best friends cafe" to open which provides a communal meeting space for residents and their families to enjoy. We were told by the staff this has been a very positive move for the home and is very popular with the residents and their families. The activity coordinator provide a small mobile shop for the residents to buy toiletries etc and request for items to be purchased on their behalf. There has been an increase in the number of staff who have achieved an NVQ award and also the number of assessors within the home, which provides greater flexibility for staff to work towards the award. What the care home could do better: The newly redecorated and refurbished lounge on the ground floor is unfortunately extremely dark and is not very welcoming, especially if your eyesight is failing. Consideration should be given to make it brighter and more welcoming. Information contained within the care plans should be consistent to ensure staff are clear on what the person is able to do for themselves to ensure they maintain their independence as much as possible. We found that information at the front of the care plan conflicted with information contained later on within the same person`s care plan. Staff should also remember to sign and date any additional information to provide a good audit trail and review process. Where a person has been identified as having challenging needs a plan should be put in place so staff provide a consistent approach in managing the behaviour. Key inspection report Care homes for older people Name: Address: Mountbatten Lodge Old Crabtree Lane Hemel Hempstead Hertfordshire HP2 4EX     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: Alison Butler     Date: 0 9 0 3 2 0 1 0 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 21 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 21 Information about the care home Name of care home: Address: Mountbatten Lodge Old Crabtree Lane Hemel Hempstead Hertfordshire HP2 4EX 01442244188 01442282546 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.quantumcare.co.uk Quantum Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Mountbatten Lodge is situated in the Jarman Park Area of Hemel Hempstead, close to the town centre with its local shops and facilities and adjacent to a large supermarket and leisure park. Mountbatten Lodge is a purpose built home for up to sixty older people. The home is on two floors and divided into four individual units with single ensuite bedrooms, a lounge, dining room and assisted bath and shower rooms. Two units cater for people with dementia and these are on the ground floor with access to an enclosed garden area. Parking is available. For information on the up to date fees for the home contact should be made with the manager. Information about the home and the service it offers is contained in the Statement of Purpose and the Service User Care Homes for Older People Page 4 of 21 Over 65 60 60 60 0 0 0 1 4 0 4 2 0 0 9 Brief description of the care home Guide. A copy of these and the most recent inspection report are available in the home Care Homes for Older People Page 5 of 21 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 last inspection of this service took place on 14 April 2009. This unannounced inspection was carried out by one inspector representing the Care Quality Commission. However, for the purpose of this report this will be shown as we. The inspection started early morning and provided us with the opportunity to observe staff interacting with residents and the daily routines. We conducted a tour of the home, examined personnel and care records. Comments we have received either through responses to our surveys we sent out prior to the inspection, or during the inspection have been included throughout this report. Information received by us was reviewed and this included the Annual Quality Assurance Assessment (AQAA). This is a self assessment document and focuses on how the home meets the outcomes for the residents and also provides some statistical data. Care Homes for Older People Page 6 of 21 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 7 of 21 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 8 of 21 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Mountbatten Lodge can be assured that they have their needs fully assessed prior to admission and are given the information to make an informed choice. Evidence: The manager provides prospective residents with a copy of the statement of purpose and service user guide to provide them with the appropriate information to make an informed choice. People we spoke to about coming to live at the home confirmed that whilst they had not visited the home personally their families had done so on their behalf. We examined the files of newly admitted residents and found that these contained appropriate detailed information to evidence that they were able to meet the needs of the person. Positive comments we received included they are wonderful, my needs are met, Staff cant do enough. Care Homes for Older People Page 9 of 21 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. People who live at Mountbatten can be assured that their health and personal care needs are met and they can expect to be treated with dignity and respect. Evidence: The residents all informed us that their care and health care needs were being met. The manager of the home has built up a good relationship with the GP who provides the residents with good health care and related support that they require, including access to appropriate health and community care services. Although some care plans contained detailed information on how residents needs are to be met, some showed information that conflicted. We saw in one record a summary sheet at the front which provides an overview of the care required (although it is not to be used in isolation) it stated that they are able to do their upper body but the main part of the care plan stated they need help with all aspects of personal care. We looked at the review process and again some were regularly reviewed whilst another had not been reviewed since December 2009. The AQAA states that detailed person centred care plans are in place. However, care needs to be given to ensure that all care plans appropriately detail what the resident is able to do for themselves Care Homes for Older People Page 10 of 21 Evidence: and then what support staff need to carry out in order for all their health and care needs to be fully met. Most plans we looked at relevant health visits were recorded also providing information on any follow appointments were necessary. Care staff record in the daily notes what care and support they have provided, the care team managers record on an additional form which they use to provide handover information to the next shift, and this provides an overview of highlighted issues. These are then transferred into the individual care records to be used when they review people on a monthly basis. Observation of the staff showed that they were kind, caring and encouraged residents to be as independent as possible. Comments received included the staff are always willing to help me, staff are wonderful and I love it here. The medication and storage were found to be well managed and all we saw were records well kept. There is a robust audit procedure in place for dealing with any errors in medication to ensure residents are kept as safe as possible. Care Homes for Older People Page 11 of 21 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. People who live at Mountbatten can be assured that they are offered various activities and recreational interests of their choice, and are encouraged to maintain links with families and the local community. Residents are provided with a balanced and wholesome diet. Evidence: The AQAA states that the Best friends cafe is used for various events and relatives are encouraged to use the cafe with residents. We saw that the best friends cafe is open 3 days a week between 10am and 2pm, when speaking with residents and staff we were told that this facility is very popular and reasonably busy. The manager has commenced work on the outside area near to the cafe to ensure that it can be used safely by both residents and visitors to the home. Some raised flowerbeds are being planted out and work is to be undertaken to ensure that the pond is safe. The staff hope that additional garden furniture will be purchased to make it a very pleasant area to relax and enjoy the outside area. On the afternoon of the inspection an exotic fruit tasting session was to be held which some residents said they were looking forward to. A cheese and wine evening was also being held that same night. Residents told us they were very happy with the activities provided at Mountbatten and feel that they are asked their views and they are listened to. Care Homes for Older People Page 12 of 21 Evidence: We observed the breakfast on the various units, and saw that it was very relaxed and unhurried with people coming in at various times through the morning. People were served fairly quickly. A choice was offered to people including a cooked breakfast option Comments about the food were generally good food is good, you always get plenty, I am able to come for breakfast when I am ready and not like my home cooking. Residents confirmed that they are able to access or ask for snacks and drinks throughout the day. Care Homes for Older People Page 13 of 21 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. People who live at Mountbatten can be assured that their views and any concerns they have will be listened to and acted upon. Robust policies and procedures are in place to protect them from abuse Evidence: There is a clear procedure in place for reporting of complaints.The compliments, concerns and complaints, folder was examined which showed a record of the action taken and the outcome. Residents spoken to felt confident in speaking out if they were unhappy or had any concerns and felt that they would be listened to and any would be action. All staff receive training in safeguarding during their induction which is then updated through ongoing training. The company ensure that the policies and procedures in regard to safeguarding are updated regularly to ensure they reflect current practise in the County. The manager has received training in Mental Capacity Act and Deprivation of Liberty and it is hoped that all staff will receive this training by the End of June 2010. Care Homes for Older People Page 14 of 21 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. People who live at Mountbatten can be assured that they live in a welcoming, warm, clean and well maintained environment that meets their needs. Evidence: A tour of the home was conducted and we saw cleaning staff working throughout the home. We found all areas to be clean and free from any mal odours. All areas to the home are accessible to wheelchair users. There is an on-going decoration programme to ensure the home is kept clean and pleasant. The ground floor lounges have been redecorated, although one lounge was very dark and this was made even darker as the new furniture was also dark. Consideration needs to be given to making this lounge look brighter, more welcoming and reduce the risk for those residents whose eyesight is failing. The manager has started work on the garden which will be accessible from the best friends cafe and it will provide a suitable seating area with raised beds and a view overlooking a pond. A check on hot water temperatures showed that one bathrooms hot water was above the recommended temperature range of 43-45 degrees. The housekeeper addressed this immediately by locking the bathroom door and putting a risk assessment in place. We were assured that this would be followed up with a visit from a plumber to have the temperature lowered to within safe limits. Policies and procedures are in place for the control of infection, and they follow the essential steps guidance and auditing. Care Homes for Older People Page 15 of 21 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. People who live at Mountbatten can be assured that a robust recruitment procedure is in place to keep them safe and there are sufficient competent staff on duty to meet their needs Evidence: An examination of four staff files showed that all the required information and checks had been carried out prior to them commencing their employment at the home. All staff receive an induction programme and there is an on-going training programme in place including achieving an NVQ qualification. On the day of the inspection the staffing levels were adequate throughout the home to ensure that the care and personal needs of the residents could be met at all times. Regular supervision of staff is carried out and feedback from staff was that they felt adequately supported in their roles to provide the residents with the best care possible. Care Homes for Older People Page 16 of 21 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. People who live at Mountbatten can be assured that the home is run in their best interests and that their health, safety and welfare is protected through a series of checks Evidence: The manager is waiting for criminal records bureau clearance so that they are able to apply to the Care Quality Commission to proceed with their registration. The staff confirmed there is an open door policy and that they feel able to go to any member of the management team if they have concerns or ideas for making the lives better for the people who live at the home. There are comprehensive policies and procedures in place to ensure staff are working and supporting residents safely. Quantum Care is accredited with the Investors in People Award this is a recognised national award that reflects an organisations commitment to staff and staff training. The manager completes a monthly accident and incidents audit which looks for any trends or additional support that may be required for individual residents. Equality and diversity issues are understood by staff and they are addressed within Care Homes for Older People Page 17 of 21 Evidence: the care plans, which appropriately describes how a residents needs and preferences are to be met. Fie safety records were checked and were well maintained. The manager completed the AQAA within the given timescales and it gave us the information required. The company have an Quality Assurance programme in place and an annual report is provided to residents, families and interested parties which gives an overview of the service and outcomes for the residents. The company have a policy and procedure in place for checking and auditing of all residents monies that is held in the home. The company employs a financial auditor who regularly visits the home and carries out an audit of the finances and a report is provided to the manager and the companys board members. Care Homes for Older People Page 18 of 21 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 19 of 21 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 20 of 21 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. 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