Care Home: The Minstrels Residential Home

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What the care home does well The Minstrels residential care home provides good quality, person centred care to the people who live there. Feedback from the people that we spoke to was very good. One person said `It`s really lovely here.` Another said `yes I`m very happy, I get well looked after.` The staff team are dedicated to providing the residents care in a dignified and caring manner. The new manager has introduced many new procedures and is planning a refurbishment of the communal areas to make the place feel more homely. Staff are well trained and supported by the management team. Residents complemented the food and said they are involved in planning menus. They also said that there is plenty of choice and the food is always served nice and hot. There is a variety of suitable social activities and stimulation available. The activity coordinator ensures that everyone in the home receives stimulation, even if this is by way of a one to one chat for those residents that prefer to stay in their rooms. What has improved since the last inspection? A lot of work has been done to review peoples individual care plans. The manager told us that this is still in the early stages. However a lot of progress has been made and residents and their representatives are fully involved. A key working system has been introduced so that residents get more focused support. A quality assurance system has been introduced and residents are asked their views through surveys and residents meetings. Recruitment procedures are more thorough and new systems for logging and monitoring complaints has been introduced. What the care home could do better: The manager said that he has more plans to improve the service and has done a lot in a very short time. Only one recommendation has been made which is that staff need to record or show evidence that the residents mental capacity has been considered when reviewing their care. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Minstrels Residential Home 88 Sleaford Road Boston Lincs PE21 8EY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Jessop     Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: The Minstrels Residential Home 88 Sleaford Road Boston Lincs PE21 8EY 01205359797 01205358515 sandra.copeland@the-minstrels.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Minstrels Healthcare Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 47 Number of places (if applicable): Under 65 Over 65 47 old age, not falling within any other category Additional conditions: 0 The maximum number of people who can be accommodated is 47. The registered person may provide the following category of service only:- Care home only - Code PC To people 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 Date of last inspection Brief description of the care home The Minstrels Residential Home provides personal care for up to 47 people. The home is located in extensive grounds, which also accommodates the Minstrels Nursing Home and sheltered accommodation flats. The home is set in large landscaped gardens with car parking facilities. The complex is in a residential area close to the amenities of Boston Town centre. It is also on a bus route. Accommodation is provided in a mixture of single and double occupancy bedrooms with many having en suite facilities. There is a lift serving accommodation on the first floor. The Minstrels is owned by Retirement Care Homes for Older People Page 4 of 23 Brief description of the care home Villages Ltd. A copy of the Service user Guide and Statement of Purpose can be obtained from the manager. The fees at the time of the inspection ranged from £351 to £499 a week. Extras are for hairdressing, chiropody, toiletires, newspapers and magazines. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and formed part of a key inspection, focusing on key standards, which have the potential to affect the health and welfare of people who use the service. Throughout this report the terms we and us refers to The Commission for Social Care Inspection (CSCI). The visit lasted approximately five hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned that Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting the standards and their plans to improve aspects of the service. Care Homes for Older People Page 6 of 23 The main method used to carry out our inspection is called case tracking, this includes following the care of a sample of three people through their care records and assessing their care. We spoke to five people and saw the bedrooms of those who said we could. We also spoke with two staff. The acting manager was present throughout the inspection and feedback was also provided to the Regional Manager. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service has a robust admission procedure. Admissions are not made to the home until they are satisfied that peoples needs can be met. Evidence: The manager carries out a comprehensive needs assessment prior to people being accepted for accommodation. Information is gained from external sources such as social services, health services and relatives or other representatives. We saw that people are formally notified by the manager that the service is able to meet their individual needs. This service does not provide intermediate care. Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are provided with good quality care that is given in a sensitive and dignified manner. Evidence: Care planning systems have been reviewed since the last inspection. Each resident has a person centred care plan which describes in detail their health and social care needs. A key working system has been introduced, this means that residents get a named worker who provides a more person centred service. We looked at the care plans for three people. The plans contained an admission assessment, medical background and a care plan for their health care needs including their nutritional needs, mental health and continence needs. There was also a moving and handling assessment. Personal preferences were recorded in relation to the persons day to day care needs such as what time the person likes to go to bed and what they like to wear. Risk assessments had been completed and provided detailed information about how the risk is to be minimised or eliminated and what equipment should be used. Although some care plans reflected choice, we saw that assessments on mental capacity had not been Care Homes for Older People Page 11 of 23 Evidence: completed. The manager has planned some training on this so that staff can implement this practise in the day to day care planning process. The people who we spoke to said that they are satisfied with the care they receive. One person said yes, we are very well looked after, Another person said I get the care that I need and the staff are very gentle and kind. People who we spoke to also said that they have access to health care services as required. On the day of the inspection the community chiropodist was visiting the home. GPs, district nurses, dentists and other health care services regularly visit people and staff said that communication between health care services and staff working at the home is good. We looked at the medication records for three residents. Where residents are able to administer their own medication, a risk assessment is completed to ensure that this can be done safely. Staff who administer medication are fully trained and have ongoing competence assessments. A thorough medication audit is carried out by the pharmacist on a regular basis and medication is stored in accordance with the homes medication procedures. We observed kind and caring interactions by staff. One carer was observed trying to persuade a resident to come to the dining room for lunch, she had a gentle approach and gave constant reassurance and compliments to the resident. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are provided with suitable stimulation which meets their individual needs and preferences. The meals are nutritious and provide people with plenty of choice. Evidence: The service employs a full time activity co-ordinator who arranges a suitable programme of activities. There is a notice board in the hallway which advertises whats happening in the coming weeks. On the day of the inspection residents were having a sing along. Each resident has an individual activity programme, the residents life history and any past interests the person may have and participation is recorded. People who may not wish to participate in group activities or social events are offered some one to one time with the activity co-ordinator. Activities organised included quizzes, bingo, music and movement, dominoes and outings. A regular religious service is also held in the home. A hairdresser visits the home once a week. People were very complementary about the food, saying the food is very nice and Its very tasty and hot, a great choice available. On the day of the inspection the lunch time menu was fish and chips. The fish was available in several varieties such as Care Homes for Older People Page 13 of 23 Evidence: battered fish, fish fingers, fish cakes and steamed fish. This was served with chips or mash potato. Two desserts were on offer. The menu is displayed in the dining room. People who may have swallowing difficulties were provided with soft diets which was served in a presentable way. The dinner tables were nicely laid out with condiments available and the manager stated that the food is locally sourced. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The robust complaints procedure ensures that residents concerns and views are listened to. Evidence: The service has received three complaints since the previous inspection in 2007. All have been fully resolved within a reasonable timescale. The manager has a new system for recording all complaints however none have been received since the new manager started in post. All residents spoken to were aware of how to make a complaint. The home has a copy of the guidelines for dealing with a suspicion of abuse. All staff spoken to were aware of this procedure as they said they had received training and have a copy of the national and local procedures for safeguarding adults. There has been one adult safeguarding investigation carried out following an allegation of financial abuse. This continues to be investigated however action was taken immediately to protect the people who live in the home. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Minstrels provides a comfortable, clean and safe environment to the residents who live there. Evidence: The home has been extended since the last inspection and provides a further nine bedrooms. There is a large lounge and dining room and a smaller, quiet lounge where people can sit with their visitors. The main lounge has a large TV for residents to watch television programmes or films. Residents are encouraged to bring in personal belongings and their own pieces of furniture. There is a variety of equipment around the home which is regularly maintained. One resident said the lounge is like an institution, I prefer to stay in my bedroom. The manager said that a refurbishment is being planned and the communal areas will be made more homely. The home was very clean and tidy throughout. No unpleasant odours were detected. Staff observed good infection control procedures. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a committed, well trained staff team who continually update their skills and knowledge in order to provide a safe service to the people who live in the home. Evidence: Feedback about the staff team was good. One resident said we have some very kind staff here who are very nice to me. Everyone that we spoke to said that their needs are met by the staffing levels. People said that they didnt have to wait for long periods of time if they requested assistance. The deputy manager has worked in the home many years and is very dedicated to her role, she works closely with the residents and has a very good understanding of their needs. She said I really enjoy working here, the residents are great and i dont mind doing any job in the home to support the staff team. Staff spoken to said that they receive regular training and felt confident about providing safe care. We observed two care staff lifting people from armchairs into wheelchairs and this was done using the appropriate equipment in a safe way. All training is locally commissioned and ongoing supervision is carried out. We looked at the recruitment files of two staff. Records were clear and all references had been vetted. Criminal record Disclosures had been obtained prior to starting Care Homes for Older People Page 17 of 23 Evidence: employment. The service has an in house NVQ assessor. This enables staff to complete an National Vocational Qualification internally. The Annual Quality Assurance Assessment states that seven staff have completed an NVQ qualification. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and people are able to voice their opinions in various ways in order to feel involved in the future plans for the home. Evidence: A new manager has been in post since November 2008, he has experience of managing services for vulnerable people. He has implemented many new policies and procedures and has a rolling programme of refurbishment planned. He stated that he plans to register with CSCI in the near future. The residents and staff said that they are adapting to the new management structure. One resident said we need to know more about it really, Im a bit confused about who owns the care home now. A quality assurance system is being implemented where residents are asked their views. People who stay at the home on respite will also be sent a survey following their visit. Residents meetings are held every three months and staff meetings take place every two months or as and when required. Senior managers from Retirement Care Homes for Older People Page 19 of 23 Evidence: Villages visit the home on a regular basis to carry out quality audits. Medication audits are also carried out regularly by the pharmacist which ensures that policies and procedures are being followed. The administrator keeps detailed accounts of residents personal monies that are securely stored in the home and auditing is carried out regularly. Residents who can manage their own finances have access to lockable facilities in their bedrooms. The company has comprehensive health and safety polices and procedures which are available to staff and are reviewed. Equipment is regularly tested to ensure the safety of people using it. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Staff need to record/show evidence that the residents mental capacity has been considered when reviewing their care. This will ensure that their choices and rights are reflected in their care plan. Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!