Care Home: Mountford House

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What the care home does well Service users and their representatives stated that Mountford House provides good quality care and accommodation. Residents made positive statements about the skills and caring qualities of the staff. Residents felt that they could follow their preferred routine and pattern of daily life. They reported that their health needs are monitored and appropriate professional advice and assistance is obtained when necessary. Staff record needs assessments for prospective residents and draw up care plans with the resident and their representatives. There were some good examples of detailed care planning. Residents can take part in a mix of organised group activities and individual activities with staff. Residents felt their visitors were welcomed to the home. Residents and staff felt able to approach the registered manager with any concerns and issues. The home provides homely accessible accommodation mostly on one level. There is a pleasant accessible patio outside.There are a number of staff who have worked at the home for some years. Staff and residents have got to know each other well. Cornwall Care has a structured training programme and supports and encourages staff in their training and development so that residents and their representatives can have confidence in a well trained and supervised staff team. What has improved since the last inspection? The management structure has changed and now incorporates the Registered Manager, Deputy Manager and Four Case Coordinators. A part time activities coordinator has been employed. The overall cleanliness and appearance of the home has improved What the care home could do better: Care plans must be reviewed at monthly intervals. All staff must receive formal supervision at least 6 times per year. Staff should make a daily record of each resident`s wellbeing, activities and changing care needs, and any events, in order to fully protect their best interests. The provider needs to continue the refurbishment of woodwork and window frames at the rear and sides of the building to ensure that the home is maintained to a good standard. The outstanding areas include a lot of residents` rooms.The provision of a secure garden would greatly enhance the opportunities for residents to be safely outside the building in fine weather CARE HOMES FOR OLDER PEOPLE Mountford House Cyril Road Truro Cornwall TR1 3TB Lead Inspector Mike Dennis Unannounced Inspection 10:00 22nd July 2008 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 Mountford House DS0000009158.V366834.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. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mountford House Address Cyril Road Truro Cornwall TR1 3TB 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) 01872 274097 01872 223990 mountford.home@cornwallcare.org Cornwall Care Ltd Mrs Linda Marie Vokins Care Home 38 Category(ies) of Dementia (21), Mental disorder, excluding registration, with number learning disability or dementia (5), Old age, not of places falling within any other category (23), Physical disability (7) Mountford House DS0000009158.V366834.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 - Code PC to service users of either gender whose primary care needs on admssion to the home are within the following categories: Old age, not falling within any other category (Code OP) - maximum 23 places Dementia (Code DE) - maximum 21 places Physical disability (Code PD) - maximum 7 places Mental disorder, excluding learning disability or dementia (Code MD) maximum 5 places The maximum number of service users who can be accommodated is 38. 13th August 2007 2. Date of last inspection Brief Description of the Service: Mountford House is one of eighteen homes owned by Cornwall Care Ltd. It is registered to accommodate thirty-eight older people in need of personal care and who are over retirement age. The Registered Manager is Linda Vokins. Mountford House is a large purpose built care home situated just outside Truro. It is close to local facilities and has good transport links to the local town. Mountford House core services are: - The residential home provides long term care to service users who are in need of personal care and are over retirement age. Mountford House accommodation is essentially on one floor and consists of four wings. Each wing has a its own lounge, bedrooms and bathing facilities. All rooms have call bells. Meals are prepared in a well-equipped kitchen on the lower ground floor and served in a central dining room on the ground floor. All parts of the home are accessible to service users. A patio area at the front is accessible to all who use the home. There is limited parking. The provider gave the charges at July2008 as from £450 to £550. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a planned unannounced key inspection. The purpose of the inspection was to follow up the provider’s compliance with the requirements and recommendations set in the last inspection report dated 13th. August 2007, and to focus on the key national minimum standards as identified by the commission. We were was on the premises for approximately six hours. The methods used were discussion with the manager, staff, residents, and their relatives and visitors, inspection of records and documents, observation of the daily life of the home and inspection of the premises. We are grateful to the Registered Manager, staff and residents for their assistance in completing the inspection. What the service does well: Service users and their representatives stated that Mountford House provides good quality care and accommodation. Residents made positive statements about the skills and caring qualities of the staff. Residents felt that they could follow their preferred routine and pattern of daily life. They reported that their health needs are monitored and appropriate professional advice and assistance is obtained when necessary. Staff record needs assessments for prospective residents and draw up care plans with the resident and their representatives. There were some good examples of detailed care planning. Residents can take part in a mix of organised group activities and individual activities with staff. Residents felt their visitors were welcomed to the home. Residents and staff felt able to approach the registered manager with any concerns and issues. The home provides homely accessible accommodation mostly on one level. There is a pleasant accessible patio outside. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 6 There are a number of staff who have worked at the home for some years. Staff and residents have got to know each other well. Cornwall Care has a structured training programme and supports and encourages staff in their training and development so that residents and their representatives can have confidence in a well trained and supervised staff team. What has improved since the last inspection? What they could do better: Care plans must be reviewed at monthly intervals. All staff must receive formal supervision at least 6 times per year. Staff should make a daily record of each resident’s wellbeing, activities and changing care needs, and any events, in order to fully protect their best interests. The provider needs to continue the refurbishment of woodwork and window frames at the rear and sides of the building to ensure that the home is maintained to a good standard. The outstanding areas include a lot of residents’ rooms. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 7 The provision of a secure garden would greatly enhance the opportunities for residents to be safely outside the building in fine weather 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. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 8 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 Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 9 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): 1, 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s statement of purpose and service user guide documentation provide prospective people with details of what the home provides helping an informed decision about admission to the home. The manager assesses all people prior to admission to the home to ensure that the home will be able to meet their care needs. People may visit the home prior to admission. EVIDENCE: Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 10 Information is given to prospective residents by of a Statement of Purpose, Service users Guide and brochure. These documents have recently been revised to include the Independent Living facility now provided. Managers complete needs assessments for prospective residents and obtain assessments from the commissioning authority. Cornwall Care Ltd has a standard format for assessment and care planning which, when completed in sufficient detail, covers all the issues specified in the standard. The four residents’ records case tracked in detail contained written needs assessments. Commissioning information from health and adult social care was also on file as were contracts and statements of terms and conditions. Assessments stated who was present, providing evidence that the prospective resident and their family were involved in the assessment. A new service has commenced at this home, Independent Living for one service user. This area has it’s own dedicated staff team. An open visiting policy is operated. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 11 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning documentation has been considerably improved. The care plans evidence that the care needs of the residents are being met at all times. Medication is being administered correctly to residents. Staff are fully aware of the principles of respect, dignity and privacy in their delivery of care to the residents. EVIDENCE: All the residents case tracked had written care plans. Cornwall Care Ltd has a standard single format for assessment and care planning. Staff here also draw Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 12 up a ‘Care Profile’ - a summary of the care plan used as a working document. All care plans case tracked directed and informed care staff in detail in meeting the health, personal and social care needs of residents. These were good examples of individual care planning. The records did not however provide evidence of regular reviews. Each resident has a key worker. The Personal Routines and Preferences records detail residents’ lifestyle preferences and choices, their dietary preferences and needs, and their religious beliefs. The level of information in the records is variable. Care staff confirmed that they are involved in the care planning and reviewing residents’ care needs. All residents case tracked had a moving and handling assessment. Falls risk assessments are included as a small part of the moving and handling assessment. Where a resident is at risk of falling, the home completes a separate falls risk assessment to direct staff in reducing the risk and safeguarding the resident. Care staff do not complete a record every day for each resident. There has been some improvement in this area but gaps between entries in the running records still exist for certain residents. It is important that an adequate record of the residents’ wellbeing, activities undertaken, dietary intake, visitors, and other events is maintained. Staff keep separate records in respect of bathing, and other specific individual health and care needs. Residents are all registered with local GP practices. Residents and their representatives felt that their health care needs were well-monitored and prompt attention obtained when required. Resident records detailed medical contacts for each resident. The community nurses visit the home regularly. Residents were very positive about the kindness and caring qualities of the staff. They felt that their privacy and dignity were respected and had confidence in the staff when they were being assisted with care. Relatives and visitors expressed satisfaction with the standard of care provided and the caring qualities of the staff. The Registered Manager monitors staff attention to privacy and dignity by being present around the home and seeking feedback from residents and visitors. The home uses the Boots monitored dosage system. Cornwall Care has a corporate policy and procedure on the handling of medicines which includes guidance on the use of homely remedies. Medicines for the care home are stored in the deputy managers’ office. A locked trolley holds the medicines which are not suitable for including in the monitored dosage system cassettes. Replacement stocks of medicines and the monitored dosage system cassettes are stored in a locked metal cupboard which is secured to the wall. Controlled drugs are stored within this cupboard in a fixed locked container. The cupboard and trolley were tidy and well organised. There is a small medicines refrigerator and the temperature is checked daily. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 13 Signed consent forms for the administration of medicines were found on each resident’s file. Identified staff, who have completed training, have responsibility for the administration of medicines. The administration records in the care home were generally well maintained. Amendments to the records were appropriately referenced, dated and signed. A record of medicines returned to the pharmacist is kept as a duplicate book. The pharmacist had visited recently following the change to the monitored dosage system. A random audit of controlled drugs was undertaken and all was found to be satisfactory. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment of the social care needs of residents and the activities being provided at the home meets residents needs. Visitors to the home are welcomed and encouraged. During the course of the inspection the residents commented very favourably on the standard of the meals at the home. EVIDENCE: Residents felt that they had control over their daily lives and choices in their routines and patterns of daily living. The home provides some regular programmed activities including games, keep fit, hairdressing and manicure sessions. There are regular religious services and visits from a range of denominations. The home shares a people carrier with another home and Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 15 arranges regular outings. Residents discussed their interests and activities with us. Individual interests are recorded in resident admission information and care plans. The Registered Manager stated that staff look to promote active care, occupation and wellbeing. Residents are supported to continue their own preferred individual activities and interests. Records confirm this. Staff were engaged in various activities with residents during the inspection. An activities co-ordinator is now employed 3 times per week. A physiotherapist and Complimentary therapist is also employed There is a flexible visiting policy and residents choose where they meet their guests. Residents felt that their visitors were made welcome. Visitors confirmed that the home’s visiting arrangements suited them. Staff make them welcome and offer them a cup of tea. The Registered Manager stated that she does not act as appointee for any residents for their benefits or manage any savings. Residents’ finances are generally managed with informal assistance from relatives or through Power of Attorney arrangements. Residents can bring in possessions and furniture by agreement with the provider. This was clearly evidenced in some residents’ rooms. Cornwall Care Ltd has made available to residents the ‘Care Aware’ advocacy service. The home operates Cornwall Care Ltd’s ‘appetite for life’ initiative to ensure that a varied and appealing diet is provided to residents in a relaxed atmosphere. Breakfast is served flexibly according to individual preferences. The choices include cereal, toast, fruit, prunes, a cooked breakfast and drinks. There are two or three main choices each day at lunch, with further individual choices available. The home is currently providing diabetic diets, and liquidised diets to two people. Residents’ food and drink preferences are recorded. Residents made positive comments about the quality of food provided. They can choose to have their meals in their room or in the dining area. Lunch was a relaxed and sociable occasion with staff providing appropriate support. Residents enjoyed a glass of wine or a non-alcoholic drink with their choice of meal. Hot and cold drinks are served between meals. We took the opportunity to inspect the kitchen and speak with the cook. The kitchen was clean and in order and the cook, who has been in post for many years portrayed an enthusiasm and understanding for her work and residents needs. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure provided to the people in the service user guide. Adult protection policies and procedures have been reviewed and are deemed satisfactory , in line with the local council multy-agency procedures. EVIDENCE: Cornwall Care Ltd has a corporate complaints procedure which complies with the standard. Mountford House and the commission have not received any complaints since the last inspection. Residents told us that they had not needed to complain, but they were confident that the managers and staff were approachable and would deal with any issues raised. There is a complaints and compliments record. Cornwall Care Ltd has a corporate adult protection policy which includes how to comply with local multi-agency guidance. The manager has a copy of ‘No Secrets’, the Department of Health guidance, and a copy of the Cornwall multiagency adult protection guidance. The manager should ensure that staff are Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 17 aware of the multi-agency guidance. Cornwall Care Ltd provides training in adult protection at induction and during NVQ training. Those staff who have not attended the multi-agency ‘alerter’s’ training, should be considered for this course. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 18 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, clean, and hygienic environment, which is suited to its stated purpose. EVIDENCE: Mountford is a purpose built care home in a residential area close to Truro centre. The main entrance is accessed up a sloped path. There is a moderately sized car park in the rear. The main residential areas of the home are on a single level with the main kitchen, laundry and training rooms on a lower ground floor. There is a passenger lift between the floors. The home Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 19 accommodates residents with mobility difficulties and visual impairments; all areas of the home are accessible to residents. Cornwall Care Ltd has a programme of continuing maintenance. The front aspect of the home has been refurbished and is well presented. However, a significant amount of the woodwork and window frames to the rear and sides of the building remain in very poor condition. This is causing problems inside the window frames and sills in some rooms. The communal areas are comfortably furnished and generally decorated to a good standard. The communal areas are generally clean and homely. The dining room is a pleasant shared space with good quality furniture. There is a patio area accessible for residents at the front of the home with seating. The grassed areas to the rear and side have steeply sloping sides and are not accessible or safe for residents. Residents would benefit from the provision of a secure garden. There is a bathroom on each wing. Three have assisted baths; one has a level entry shower. The bathroom facilities were decorated to a good standard and were clean. There are toilets on each wing and these were clean and hygienic. The residents’ rooms are single and four have an en suite facility. Most residents’ rooms were decorated to a good or reasonable standard and were personalised. Some rooms are beginning to need redecoration. All rooms inspected had clean fresh bedding. Residents stated they were ‘happy’ with their accommodation and facilities. Some of the furnishings, both the fitted wardrobes and sink units, and freestanding furniture are showing their age. Odour control was acceptable. Staff reported that there is a maintenance book for logging jobs that need to be done and the general assistant completes these promptly. The laundry complies with the standard. There are two industrial grade washing machines and two tumbler dryers. Staff reported that the equipment was in good working order. Good practice guides are displayed on the wall and COSHH information was available in the office. Soiled laundry is moved to the laundry in sealed bags and there is a laundry chute from the main floor to the laundry. Hand washing facilities are situated around the home with liquid hand wash and disposable towels. There were also supplies of gloves and aprons throughout the home. One of the four sluicing areas has been generally improved to make it easier to keep clean. However, the original aged sluicing toilets and sluicing sinks remain. The wings lack modern enclosed sterilising sluices, which are safe and effective for cleaning the daily high number of commode bowls . Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels at Mountford are appropriate to meet the needs of the people. Recruitment procedures for new staff are satisfactory. Staff training is ongoing with a large amount of training recently undertaken and more planned. This is to the benefit of the people in the home and the staff. EVIDENCE: Residents commented that they felt staffing levels were sufficient. The roster for the care home detailed five care staff in the morning and four care staff in the afternoon, adequate general assistants and catering staff. In addition there is the manager, deputy manager, 4 care coordinators and an administrator At night there are 2 waking staff and a manager on call. This represents an improvement on staffing levels since the last inspection. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 21 The Independent Living Area for one person is staffed separately. Posts are advertised through the Job Centre and local press. Cornwall Care Ltd has standard corporate recruitment procedures. Two managers interview applicants using standard set questions. The records of a recently recruited member of staff showed that the required employment checks had been properly completed. Staff records for established staff contained the required documents and information. Staff receive a statement of terms and conditions of employment. Cornwall Care Ltd provides a structured corporate training programme for staff. Training records showed that staff had completed training, or were due to attend required training, in moving and handling, dementia care, food hygiene and health and safety. The provider was engaged in ensuring that all staff had up to date moving and handling. Recently appointed staff had begun their inductions. Staff were satisfied with the training they received to do their jobs. Approximately 90 of the staff are qualified to NVQ care level 2. The Cornwall Care Ltd training structure ensures that all new staff are registered promptly for their NVQ level 2. Staff training records were well ordered and up to date. Residents were positive about the skills, kindness and qualities of the staff team. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 22 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, 32,33, 34, 35, 36, 37, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management team at Mountford are experienced and competent in delivering positive outcomes to the people in the home. People spoken to during the course of the day expressed very positive comments on the standard of care that they are receiving at the home. Supervision of staff has not occurred at required time intervals. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 23 EVIDENCE: The Registered Manager is Linda Vokins and she was appointed approximately 2 years ago. She exceeds the experience requirement for Registered Manager and has an NVQ level 3 plus a Diploma in Management. A deputy and four care coordinators support the manager. There are clear lines of accountability from the manager through the care coordinators, who each have specific areas of responsibility, and supervise one of the wings and staff. Staff were positive about the support that they received from the manager. Cornwall Care Ltd has corporate policies for the management of service users’ monies and the home provides safekeeping for small amounts of money. Families and representatives pay in cash on behalf of the residents. Each resident has a record detailing payments in and out, and a running balance. Each resident’s balance is not held as an individual amount of cash – for 38 residents this would amount to a large sum for the home to hold. The cash is held in a specific bank account with a float available for daily transactions. A separate cash book details all payments in and out of the cash float. Proper dated receipts are retained for all transactions on behalf of residents in order to complete the audit trail. This involves, for example retaining a copy of the newspaper bill which details each individual resident’s expenditure. Cornwall Care Ltd has previously sought the views of residents and their representatives, and other stakeholders through questionnaires. The Registered Manager stated that the annual quality assurance survey this year has been completed. The staff records showed that all staff have not received regular supervision sessions, Staff generally receive annual appraisals. Each care coordinator is responsible for supervising the staff on an identified wing of the home or the night staff team. Cornwall Care Ltd has comprehensive policies for health and safety. A sample were checked against the original records and found to be accurate. Staff have attended required health and safety training. Staff reported that Cornwall Care Ltd promotes safe working and manages health and safety well. The records showed weekly tests of the fire alarm system and the emergency lighting and regular fire training for daytime staff. There is a written fire plan/procedure. The home’s fire risk assessment has been completed. Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 24 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 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 3 3 3 3 1 3 3 Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 25 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. 1 2 Standard OP7 OP36 Regulation 15 18 Requirement Care Plans must be reviewed at monthly intervals ALL staff to be supervised at least 6 times per year. Timescale for action 01/10/08 01/10/08 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. Refer to Standard OP7 Good Practice Recommendations Care staff should complete regular daily records for each service user. It is strongly recommended that the registered person must continue the programme of replacing the remaining windows and external woodwork. Residents would benefit from a safe and secure enclosed garden 2. OP19 3. OP20 Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 26 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 Mountford House DS0000009158.V366834.R01.S.doc Version 5.2 Page 27 - 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. 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