Care Home: Mulroy`s Seaview

What the care home does well Mulroy`s Seaview provides very good care to people living at the home. The admission process is excellent and the care needs assessment is very informative. People who live at the home said of their care, "I believe I am well cared for, if I have the slightest headache, they will check me over, they will give me a tablet or whatever else I need". Another person said, "The staff are very good and caring". Other people who live at the home said, "Very happy here, feel safe, couldn`t wish for any better staff and David (the proprietor/manager) is lovely and will do anything, fantastic"Surveys had been completed by health professional. They said that the service, "Provides an excellent to service to individuals with significant mental health problems. Work well within the recovery model". "Excellent environment, caring and motivated staff". The environment is warm and homely with a good amount of communal space. People living at the home were happy with the environment and said, "My room is beautiful, I couldn`t pick a better room". The meals continues to be amongst the really good things and people said, "Meals are beautiful, you always have a choice and you can make suggestions". There is also have a good range of activities and recreation, both on an individual basis as well as collectively. There is a very good staff team, with a range in skill mix and qualities. The staff continue to be very enthusiastic about working at the home and clearly have positive relationships with people living at the home and are good at supporting them to meet their needs. The structure of the staff team is well thought out and clearly of a level to fully meet people`s needs. Staff said, "Excellent management structure, full support given to all the staff". "Work at Mulroy Seaview with pride". Another detailed, "Good strong leadership, which filters down through the team, promoting a good ethos, encouraging individualised care and respect for people`s differences". What has improved since the last inspection? Some improvement has been made in respect of the care records with more dependency needs, this is continuing. The records to support good recruitment of staff have also improved. The policies and procedures have also been reviewed and fully updated. What the care home could do better: There is the need to continue to build upon the care assessments and evaluations for more dependant people living in the home and assessments need to be in place for risk such as use of bed rails. The staff-training programme needs to be more formalised and mandatory training must be carried out at the required intervals, with all staff being up to date with this training. There is also the need to ensure that new care staff who commence employment who do not have a National Vocational Qualification in Care, undertake the Skills for Care InductionSome additional measures will further strengthen the medication systems. Care is also needed to ensure that the weekly fire test in carried out . CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Mulroy`s Seaview 19-22 Newcommen Terrace Redcar TS10 1AU Lead Inspector Jackie Herring Key Unannounced Inspection 1st October 2008 09:30 X10029.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 Mulroy`s Seaview DS0000055582.V372631.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 and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mulroy`s Seaview Address 19-22 Newcommen Terrace Redcar TS10 1AU 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) 01642 493759 01642 756350 Mr David McArthur Mrs Kay McArthur Care Home 22 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (22) of places Mulroy`s Seaview DS0000055582.V372631.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 with Nursing To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Mental Disorder, excluding learning disability or dementia, Code MD maximum number of places 22 The maximum number of service users who can be accommodated is: 22 2nd October 2006 2. Date of last inspection Brief Description of the Service: Mulroys Seaview is a 22-bedded care home providing nursing care to older people and younger adults with mental health problems. The home is a converted property on the seafront at Redcar and close to the town centre, with a wide town centre facilities. All of the rooms are single bedrooms with ensuite facilities, although one room is substantial in size and is being used as a double with the approval of CSCI. The home provides accommodation across three floors, with the younger adults occupying the second floor. The weekly fee range from £490 - £800. Mulroy`s Seaview DS0000055582.V372631.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 two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirement to improve national consistency. Some regulations from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at risk or harm. In future if a requirement is repeated it is likely that enforcement action will be taken. This Key Inspection was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use the services, and that it does what the Care Standards regulations say it must. This inspection was conducted in two inspection days. During the inspection, a number of records were looked at, including records of people who use the service, along with staff recruitment and training records. A number of surveys from people who use the service as well as from staff and visiting professionals were received. Discussion also took place with the people living at Mulroy’s Seaview, the manager, deputy manager and staff. The manager has completed the Annual Quality Assurance Assessment (AQAA), the services self-assessment of how well they think they are meeting standards. This was received prior to the inspection and some of information has been reflected within the report to support the judgements made. The AQAA was well completed. What the service does well: Mulroy’s Seaview provides very good care to people living at the home. The admission process is excellent and the care needs assessment is very informative. People who live at the home said of their care, “I believe I am well cared for, if I have the slightest headache, they will check me over, they will give me a tablet or whatever else I need”. Another person said, “The staff are very good and caring”. Other people who live at the home said, “Very happy here, feel safe, couldn’t wish for any better staff and David (the proprietor/manager) is lovely and will do anything, fantastic”. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 6 Surveys had been completed by health professional. They said that the service, “Provides an excellent to service to individuals with significant mental health problems. Work well within the recovery model”. “Excellent environment, caring and motivated staff”. The environment is warm and homely with a good amount of communal space. People living at the home were happy with the environment and said, “My room is beautiful, I couldn’t pick a better room”. The meals continues to be amongst the really good things and people said, “Meals are beautiful, you always have a choice and you can make suggestions”. There is also have a good range of activities and recreation, both on an individual basis as well as collectively. There is a very good staff team, with a range in skill mix and qualities. The staff continue to be very enthusiastic about working at the home and clearly have positive relationships with people living at the home and are good at supporting them to meet their needs. The structure of the staff team is well thought out and clearly of a level to fully meet people’s needs. Staff said, “Excellent management structure, full support given to all the staff”. “Work at Mulroy Seaview with pride”. Another detailed, “Good strong leadership, which filters down through the team, promoting a good ethos, encouraging individualised care and respect for people’s differences”. What has improved since the last inspection? What they could do better: There is the need to continue to build upon the care assessments and evaluations for more dependant people living in the home and assessments need to be in place for risk such as use of bed rails. The staff-training programme needs to be more formalised and mandatory training must be carried out at the required intervals, with all staff being up to date with this training. There is also the need to ensure that new care staff who commence employment who do not have a National Vocational Qualification in Care, undertake the Skills for Care Induction. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 7 Some additional measures will further strengthen the medication systems. Care is also needed to ensure that the weekly fire test in carried out . 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. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 2 was looked at during this inspection. People who use the service experience excellent quality outcomes in this area. People have their needs assessed before they are admitted to the home ensuring their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA detailed the process for people being assessed and admitted to the home. It stated, “Resident choice of days/times to visit as part of integration programme, assessment prior to this and continuing”. The assessment Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 10 process was described a well planned and often took several months to ensure that the admission was appropriate for all concerned. Two records of people who live at the home were looked at. They contained comprehensive person centred assessment documentation. It was good to see detailed information provided by other health care professionals as part of this process. One person spoken to said that the process of admission was planned over several months and included numerous visits to the home. There was evidence of reviews contained within both files. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 7, 8, 9 and10 were looked at during this inspection. People who use the service experience good quality outcomes in this area. The homes assessment and care planning process ensures people’s needs are identified and met and are supported to be as independent as possible. Medication systems are in the main very good, some additional information would strengthen them further. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 12 The same two sets of records were looked at in more detail and a third was briefly looked at. These records were very detailed and person centred. There was clear evidence of a thorough assessment and supporting plans of care detailing the support to be provided. The individual history information was extremely detailed. A member of staff spoken to said, “The home provides a lot of personal and individual care”. People who live at Mulroy’s Seaview have a mix of needs, both older people and younger people with mental health needs and some people who also have physical dependency needs. It was identified that where people have increased dependency needs there should be supporting risk assessments in place, such as risk of falls; mobility and nutrition and also the need to risk assess the use of bed rails. It was recommended that a range of assessment tools should be looked at with a view to using the ones that would be most suitable to the people. There is the need to ensure that both sets of National Minimum Standards are looked at and the appropriate ones used for individual people. As such, some people who live at Mulroy’s Seaview need to have their care plans evaluated on a monthly basis rather than six monthly. The evaluations in the main were taking place at the required frequency and were extremely well written and informative. It was very clear from looking at the care files that people health and mental health needs are regularly reviewed. There was evidence of involvement by Community Psychiatric Nurses, people seeing their Consultant Psychiatrists, community dietician and attendance at review appointments and CPA’s. Surveys had been completed by health professional. They said that the service, “Provides an excellent to service to individuals with significant mental health problems. Work well within the recovery model”. “Excellent environment, caring and motivated staff”. The medication system was discussed with the qualified nurse who has a key role in managing this. It was confirmed that only qualified nurses are involved in the administration of medication. The records were well written with clear directions. It was recommended that when medication was received outside of the normal monthly medication, they needed to be recorded in the Medication Administration Records in the same way and needed to include quantities of medication received. Where items need to be handwritten on to the MAR sheet there is the need to ensure this is checked by a second person and there are two signatures. There is also the need to ensure that the medication fridge is kept locked. Currently none of the people living at Mulroy’s Seaview self medicate. There was some discussion about the management of leave medication; this is being looked at further. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 13 A member of staff spoken to said of what the service does well, “It is the person first rather than the illness, it is the relationships, they are all well cared for and loved”. One of the staff surveys detailed of what the service does well, “The person (resident) is at the centre. Holistic care is provided, individual needs and plans are established and regularly evaluated”. People who live at the home said of their care, “I believe I am well cared for, if I have the slightest headache, they will check me over, they will give me a tablet or whatever else I need”. Another person said, “The staff are very good and caring”. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 12, 13, 14 and 15 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People are treated with respect and their lifestyles are very much individualised with an appropriate range of social and recreational activities as well as the opportunities for personal development. Meals are provided to a good standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 15 There is daily planned activity for people who live at Mulroy’s Seaview. The AQAA stated, “Good activity programme of choice – individual and group, meaningful, provide opportunities to experience new places”. It also details that there is a recreation book and analysis of outings in a monthly report. It was recommended that it would be helpful to have social assessments available on individual files as well as records about what individuals have been involved in. It was clear that planned activities take place on a daily basis and that all people living at the home are involved at different times depending upon their individual needs. One member of staff said, “Activities included, both indoor and outdoor activities. Indoor, there is Sky TV available, newspapers are delivered, some people do cross-stitch and there is drawing and some games. Outdoor, go into Town a lot, shopping and go for an ice cream. Once or twice a week there is a planned hike”. People had also been to a day out to Ampleforth the day before the inspection and they had been to Whitby the week before. One person living at the home said, “Yes there are good activities, I get out and about, go to the beach, do crossstitch and tapestry and puzzle books”. Staff also said that there had been holiday to Berwick this year, which people enjoyed. Observations throughout the inspection also showed that there were plenty of books, DVD’s and music available. People also had their own personal TV’s etc within their rooms. It was also confirmed through discussion with staff that there were regular church visitors and that individual spiritual needs and preferences were met. There is also a small lounge available for people who wanted some quiet contemplation. People said that the meals were nice, with a good selection and that they could pick what they wanted. The inspector joined people for lunch, there was a very good selection, ranging from home made soup, jacket potatoes with a variety of fillings, salad or a light hot option, as well as other people having poached egg on toast. One person said, “Meals are beautiful, you always have a choice and you can make suggestions”. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 16 and 18 were looked at. People who use this service experience good quality outcomes in this area. People who use the service were confident their complaints would be listened to, taken seriously and acted upon. Adult protection procedures are in place, which helps to protect people that use the service from abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The AQAA detailed that there had been one complaint since the last inspection, which has been investigation and action taken. The home has a complaints procedure, which informs people who use the service and relatives of their right to complain, timescales for action and who to contact, which needed some slight amendment. The home keeps a record of complaints. The complaints records were looked at and contained evidence of the investigations that had taken place and the outcomes and responses were also recorded. People who use the service who were spoken to during the inspection said that they could approach staff and the manager in relation to any concerns that they may have. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 17 People living at the home completed ten surveys; they all indicated that they knew who to speak to in the event they had any concerns. One person living at the home said, “I can talk to any care helper”. Staff also confirmed that they knew what to do in the event someone had concerns. One of the staff surveys stated about concerns, “Have a complaints procedure which is covered in induction”. It was confirmed through discussion with people working at the home that they were aware of the complaints procedure and had also received training in respect of abuse and protection of vulnerable adults. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 19 and 26 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People who live at Mulroy’s Seaview benefit from a well-maintained, comfortable and homely environment in which to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 19 Mulroy’s Seaview continues to provide a warm and pleasant environment for people to live. On the first day of inspection the main lounge and dining areas on the ground floor were overcrowded and their functions were unclear. This was discussed and the manager confirmed that these areas did need to improve to make them more accommodating and homely. Some improvement had taken place on the second inspection day. The home in the main was observed to be clean with no malodours. One of the people living at the home said that they did not think their room was being cleaned as often as it should be. The manager who is in the process of recruiting additional staff acknowledged this. There continues to be space for quiet contemplations as well as areas with music and TV and games/activity areas. On the top floor there was a café area and also a small fully furbished kitchen in which supervised cookery sessions can take place. People spoke very positively about their individual bedrooms and said that they had been able to bring their own personal belongings and had been able to choose colours in their rooms. This was observed during the inspection. One person said, “ My room is beautiful, I couldn’t pick a better room”. A spacious yard continues to be available for use and contained table and chairs along with parasols. Murals had also been painted on some of the walls since last inspection. There is a sheltered facility within the yard for use by people who smoke, however this does not provide adequate protection when it is cold, windy or raining. Discussion took place with the manager and it was agreed that further protection would be looked at. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 27, 28, 29 and 30 People who use this service experience good quality outcomes in this area. The homes recruitment procedure is good, which helps to ensure that people are protected. Whilst staff are experienced and in sufficient numbers to meet the needs of people living at the home, there is the need for further development to induction and ongoing mandatory training. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Four staff files were looked at during this inspection. All had completed application forms, references and Criminal Records Bureau checks along with copies of certificates of training and qualifications. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 21 Staff training records were also looked at. This is an area that is in need of further development, particularly in relation to mandatory training. Discussion took place with the manager and deputy manager and it was agreed that a system needed to develop to ensure that staff were provided with and attended the required training. The AQAA detailed that 35 of staff were already qualified to NVQ level 2 and a further two staff are underway with this which will take them to 50 . One of the care workers spoken to said they had received in house client specific training such as; Epilepsy, Personality Disorder and Schizophrenia. A staff handbook had been developed which is really informative and give staff easy access to a number of policies and procedures. A duty rota is in place and skill mix of the staff team is specified with Registered Mental Nurses being on duty at all times and supported by care workers. There is substantial experience and skill within the staff team and they are clearly well able to meet the needs of the people living at the home. One staff member spoken to said, that there had been some difficulties with staffing over the past couple of months but that appropriate action was taken and the situation had now improved. It was also confirmed that additional staff were available whenever they were needed or arrangements would be put in place. An example recently was the need to increase observation during the night; until full recruitment could take place agency support was used. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 23 Standards: 31, 33, 35 and 38 were looked at during this inspection. People who use the service experience good quality outcomes in this area. The manager and management team continue to provide very good leadership to the staff team and continuously strives to improve standards within the home ensuring that people’s needs are well met. There is generally good service and maintenance arrangements are in place ensuring health and safety is promoted although attention was needed to fire checks and mandatory training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is owned and managed by a qualified nurse who has substantial years experience as both a nurse and a care home owner/manager. There is a very good management structure in place at Mulroy’s Seaview and staff have key areas of responsibilities as detailed previously in this report. One of the staff surveys contained the following statement, “Excellent management structure, full support given to all the staff”. People who live at the home said, “Very happy here, feel safe, couldn’t wish for any better staff and David (the proprietor/manager) is lovely and will do anything, fantastic”. People who work at the home said of what the service does well, “It provides a lot of personal and individual care, good experienced staff team with sound knowledge base”. “Every aspect of care provided is brilliant, the activities, it’s a nice house and the experience of the clinical staff”. One of the staff surveys contained the following comment, “Work at Mulroy Seaview with pride”. Another detailed, “Good strong leadership, which filters down through the team, promoting a good ethos, encouraging individualised care and respect for people’s differences”. The system for management of people personal allowances was not looked at on this occasion, as the inspector was satisfied at last inspection that the system was robust. It was also confirmed that people living at the home are regularly consulted about all aspects of life within the home. One of the staff surveys stated, “Residents have a significant voice in determining activities”. A sample of maintenance and health and safety records were looked at. In the main, these were in order but there is the need to ensure that in the absence Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 24 of the maintenance person that a system is in place to ensure that the weekly fire alarm checks are being carried out. Fire drills were also discussed and currently these are linked to staff meetings, it was recommended that these should happen at ad hoc times when people are not expecting them. It was also agreed that the fire training would also be strengthened with an increase in frequency. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 25 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 X 2 X 3 4 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 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 ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 4 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 4 32 X 33 3 34 X 35 3 36 X 37 X 38 3 Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? 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. Standard OP30 OP38 Regulation 13 Requirement The manager must ensure that there is a programme of ongoing mandatory training and a system for ensuring that all staff are up to date with this training. This will ensure that people have the health and safety knowledge needed ensuring that everyone is protected. New care staff that do not hold an NVQ must complete the Skills for Care Common Foundation Standards. Timescale for action 31/01/09 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 The assessments for older people continue to need more information and risk assessments such as nutritional, moving and handling and falls and these should be DS0000055582.V372631.R01.S.doc Version 5.2 Page 27 Mulroy`s Seaview evaluated on a monthly basis. Work should also continue in consulting with people about their individual assessments and plans of care and this should be recorded. When medication is received out with the monthly system, this should be fully recorded with the amounts received and date. Where it is necessary to handwrite items on the MAR sheet, there needs to be two signatures. 3. 4. OP19 OP38 The fridge should be kept locked when in use. Consideration should be given to increasing the level of protection to the smoking shelter in the yard. Arrangements should be in place for ensuring that the fire equipment is checked on a weekly basis. 2. OP9 Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. Mulroy`s Seaview DS0000055582.V372631.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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