Care Home: The Minstrels

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What the care home does well The Minstels provides good quality care in a homely and safe environment. Resident`s feedback was very positive. One said `I have been in the home eight years and I have been very happy.` Another said ` the staff are wonderful, they are very kind and caring.` Feedback from the visiting hairdresser was received. They said `the residents moral is boosted by the carer`s, they are always smiling, helpful and kind. Nothing is too much trouble for them.` The district nurse said `they deliver a family orientated, caring environment.` Staff said `I believe we provide a high standard of care in a well managed environment.` Staff are well trained and are supported by the Manager of the service. The food is home cooked and provides a well-balanced nutritious diet to meet individual needs and preferences. What has improved since the last inspection? Although this service has re-registered as it has been taken over by a new provider, there were concerns about fire safety following an inspection by the fire officer. Fire safety procedures are now satisfactory and a bran new fire system is being installed with the refurbishment of the home. What the care home could do better: All of the standards were met. Only one recommendation in relation to the monitoring of food and fluid intake has been made. CARE HOMES FOR OLDER PEOPLE The Minstrels Main Road Wrangle Boston Lincolnshire PE22 9AJ Lead Inspector Alison Jessop Unannounced Inspection 18th June 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Minstrels DS0000071388.V366609.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. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Minstrels Address Main Road Wrangle Boston Lincolnshire PE22 9AJ 01205 310178 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) Mr Deva Samat Keshwara Lilu Keshwara Mrs Caroline McDonnell Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is 16 This is a newly registered service. 2. Date of last inspection Brief Description of the Service: The Minstrels is currently registered to provide personal care only for up to 16 older people in 8 single bedrooms and 4 double bedrooms. It is set in its own attractive grounds and situated on the main road in the village of Wrangle, which is about 10 miles from the town of Boston. There are limited local shops and facilities a short walk away. The home offers a small car parking facility at the side of the home and there are garden areas at the front and side of the home however due to major development taking place this area is currently restricted. The home was pre-existing service, however it has been taken over by a new provider and has re-registered. A copy of the Service User Guide and Statement of Purpose can be obtained from the Manager of the home. Information about fees can also be obtained from the Manager along with a copy of the most recent CSCI inspection report. The Minstrels DS0000071388.V366609.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 unannounced inspection took place over one day by one Regulatory Inspector. The inspector spent a day at the home and spoke to six of residents and four staff. The Manager of the service was available throughout the inspection to answer any questions. Two residents were case tracked. This means we gained feedback from them, looked closely at their care plans, risk assessments and any other relevant documentation. We also looked at their medication and financial records. Feedback was gained from the staff group and we also gained feedback by sending questionnaires to the residents, staff, relatives and other health professionals that regularly visit the home. What the service does well: The Minstels provides good quality care in a homely and safe environment. Resident’s feedback was very positive. One said ‘I have been in the home eight years and I have been very happy.’ Another said ‘ the staff are wonderful, they are very kind and caring.’ Feedback from the visiting hairdresser was received. They said ‘the residents moral is boosted by the carer’s, they are always smiling, helpful and kind. Nothing is too much trouble for them.’ The district nurse said ‘they deliver a family orientated, caring environment.’ Staff said ‘I believe we provide a high standard of care in a well managed environment.’ Staff are well trained and are supported by the Manager of the service. The food is home cooked and provides a well-balanced nutritious diet to meet individual needs and preferences. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a thorough admission process, which ensures that individual needs can be met. EVIDENCE: All prospective residents are fully assessed before a decision is made about accepting the person into the home. The staff team said that they have adequate information about the person to be able to care for them. One member of staff said ‘when a new resident comes to the home, we are given information about that person. We are told how to work with the person and about their disability. We are not prejudice and take everything in our stride.’ This home does not provide Intermediate Care. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living at the home receive personalised care in a sensitive and dignified manner. EVIDENCE: Every resident has a detailed care plan that has been written with the resident and or family involvement. Individual preferences are recorded and how independence is encouraged. Each care plan contains assessments on all areas of health care. One resident had a pain assessment, which enables staff to recognise when the resident requires pain relief when they are unable to ask for it. The nurses and GP’s visit the home regularly and health care is closely monitored and recorded by staff. Staff are also trained to carry out observations such as blood pressure, temperatures and pulse. A chart has been set up for one resident who was being cared for in bed. This detailed any food and fluid intake and when the resident was re-positioned to prevent pressure sores. Some of the food and The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 10 fluid intake charts had not been fully completed and the amount of food and fluid taken was not recorded. Medication procedures in the home are adequately maintained. The Manager stated ‘I ensure that staff are fully competent before letting them administer medication, I observe them and provide regular, on-going monitoring.’ Staff confirmed that they have received comprehensive training in this area and felt confident about medication administration. All of the residents spoken to said that they are treated with dignity and respect. Staff observe a knock and wait policy when entering residents bedrooms. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The lifestyle experienced by the residents in the home meets the needs and expectations of the people who live there. Residents are provided with nutritious, home cooked food. EVIDENCE: The residents reported that there are some activities available. These include Bingo, dominoes, quizzes, entertainment and parties. One resident received a visit from the priest however other residents stated that the religious service, which used to be held at the home does not take place, as the vicar now has to cover several parishes. One resident said that she goes out for a walk to the local shop. One carer said ‘we would like to provide more things to stimulate the residents minds. Although Bingo and dominoes are played one or two times a week, I feel the residents needs just a little bit more than looking at the television.’ The Manager said ‘we have tried to introduce new activities by the residents were not very interested.’ The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 12 A resident said ‘we all wish the telephone wasn’t in the lounge as during the evening the TV gets turned down if someone is on the phone.’ This was relayed to the Manager who said that she would discuss the matter with the residents. Feedback about the food was very good. Meals are freshly prepared by the cook who has worked at the home for many years. One resident said ‘there are some foods I don’t like but I always have another alternative if I do not like what’s on the menu.’ The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 13 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use this service can be confident that their concerns and complaints will be listened to and acted upon. The residents are protected from harm and live in safe environment. EVIDENCE: All residents said that they would know how to make a complaint if they needed to. No formal complaints have been received in the last twelve months. There have been no safeguarding issues and staff spoken to said that they are fully aware of the procedures to follow should they be concerned about the safety or welfare of a resident. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Minstrels provides a comfortable, homely and clean environment to the residents. EVIDENCE: The home is currently undergoing redevelopment where the service will be extended and will provide more accommodation. As part of this the home will undergo a complete refurbishment. The residents said that they are enjoying watching the work being carried out and like watching the builders coming and going. One of the residents said ‘I am worried that some of its homeliness will be lost when it is extended.’ Each resident has a bedroom decorated to suit their individual needs and preferences. Also in lounge there are some of the resident’s own pieces of furniture and personal possessions such as family photos. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 15 The home was very clean throughout and staff work in accordance with infection control procedures. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff working at the home are well trained and are supported by the Manager of the service. This means that residents are well cared for, their needs are met and the staff work safely. EVIDENCE: Staff spoken to said that although at times they are very busy, they manage to meet people’s needs and provide good quality care. There only concern raised was that some of the residents needs are changing and some require more time. They are also concerned about the staffing levels in the future when there are more residents living at the home. One resident said ‘the staff are always busy but always come when I need them’ and ‘the staff are very good, the Manager is efficient and very professional.’ Staff receive regular training and their competence is assessed by the Manager. The staff complete the common induction standards and specialise training has been attended such as managing diabetes, managing epilepsy and dementia care. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 17 Staff recruitment procedures were looked at. All staff have been subject to criminal record disclosures. References have been received before staff work in the home, which protects residents from harm. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and is run in the best interests of the residents. EVIDENCE: The Manager of the home has completed her Registered Managers Award and is currently working to towards completing her NVQ assessor’s award. One carer said ‘we have got a good Manager who we can approach anytime we need to. She is a very good listener and gives us all the support we need.’ The residents are asked their views on a day-to-day basis about how the home is run and on a more formal basis once a year. The Manager stated that the surveys for this years quality audit are due to go out. Residents meetings are held on a six monthly basis. The relatives are also invited to the meetings. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 19 The financial records for the residents were looked at and were safely and satisfactorily maintained. Health and safety procedures are followed by staff and risk assessments are comprehensive and are used as a working tool in order to prevent risks. One residents risk assessment had been reviewed and as a result the rails on the bed were removed as it was felt that they were no longer safe. The service was inspected by the fire officer and many areas of the inspection failed to meet safe standards. Since then new smoke detectors have been fitted and other action taken to meet the requirements. A new fire system is being installed with the refurbishment of the home and the fire officer is due to re-inspect the home when this is completed. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 X 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations It is recommended that the amount of food and fluid is recorded on the intake charts, so that staff can ensure that adequate amounts are taken by residents who are at risk of dehydration and malnutrition. The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 The Minstrels DS0000071388.V366609.R01.S.doc Version 5.2 Page 23 - 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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