Inspection on 25/11/09 for Conewood Manor Nursing Home

This is the latest available inspection report for this service, carried out on 25th November 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Conewood Manor Nursing Home 60 Dunmow Road Bishops Stortford Hertfordshire CM23 5HL     The quality rating for this care home is:   one star adequate 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: Marian Byrne     Date: 2 5 1 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 20 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 20 Information about the care home Name of care home: Address: Conewood Manor Nursing Home 60 Dunmow Road Bishops Stortford Hertfordshire CM23 5HL 01279657933 01279657934 jackie@hollycaregroup.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Conewood Manor (Registration) Ltd care home 42 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 42 The registered person may provide the following categories of service only: Care Home with nursing - Code N 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 categories - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Conewood Manor Nursing Home is registered to provide nursing and personal care to 42 people. The home is situated within easy reach of Bishops Stortford town centre. The established accommodation is arranged over three floors accessed by stairs and a passenger lift. There is a communal dining room on the basement floor and a Care Homes for Older People Page 4 of 20 Over 65 0 42 42 0 1 7 0 9 2 0 0 8 Brief description of the care home communal lounge on each of the other floors. Bishop Stortford has excellent road, rail and air links and there is ample parking to the front of the home. Care Homes for Older People Page 5 of 20 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: one star adequate 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 inspection was carried out by two inspectors over one day. The manager was not present at the inspection. We spoke with the residents and staff. We looked at records pertaining to the care of the residents, the recruitment and the training of staff. We observed staff interact with the residents. We toured the premises. Prior to the inspection visit the manager returned the Annual Quality Assurance Assessment (AQAA) this is a legal document and must be completed and returned within defined timescales. It tells us about how the home has functioned in the previous year. We looked at all the relevant exchanges of information regarding the home since the last inspection. Care Homes for Older People Page 6 of 20 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 20 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 20 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. People who are admitted to this home can be sure that they will not be admitted unless the home can meet their needs. Evidence: All the people who are offered a place at this home have a full assessment prior to being admitted. They are given six weeks to settle in and decide if they like the home and if the home can meet their needs. The home re-assess all the residents after this period. The do this to ensure they are able to meet the needs of the resident and to give the resident an opportunity to reflect on their stay and make a more informed decision on whether the home meets their needs. Care Homes for Older People Page 9 of 20 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home can be sure that their health needs will be recognized and appropriate support offered in a manner that promoted independence and dignity. Evidence: All residents have a person centered care plan. By this we mean that the care plan is drawn up in a manner that reflects the individual needs of the resident. The resident (where possible) is involved in drawing up the care plan and the details of how their care is to be administered is set out clearly and written in a manner that is easy for staff to understand. Where difficulties are identified that are clear directions to staff on how to deal with the situation. We looked at the care plans of four people. Staff spoken with knew the care for people and appeared to know the residents very well. We saw that the residents health was promoted and that the residents has access to local health care professionals. We had concerns that there were not enough staff on duty to ensure all the residents on the top floor had their care delivered at times the residents choose. This is dealt with later in this report. We saw staff interact with the residents in a manner that promoted their dignity. All the residents we spoke with were complementary about the staff and spoke of their kindness and care. Care Homes for Older People Page 10 of 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some of the residents living in this home do not always have appropriate stimulation and cannot be sure that their food will always be served at an appropriate temperature. Evidence: The people we spoke with at this home assured us that they were encouraged and assisted in maintaining relationships that are important to them. They told us that visitors are welcomed to the home at all reasonable times. On the day of the inspection there was a constant stream of visitors to the home. We saw that the residents were not supplied with any materials that could offer them stimulation. The sitting rooms did not contain objects of comfort or stimulation. It is important that the residents are stimulated at all times and that they have a choice about reading material or other objects without having to rely on staff all the time. The promotion of independence is important as it allows the residents to have optimum mental and physical health. On the day of the inspection the lift was out of order and staff served the residents lunch in the sitting room. Staff had no way of keeping food hot on the journey from the kitchen to they place they chose to eat. While the day of the inspection was unusual in so far as the lift was not working, however, should residents decide to eat Care Homes for Older People Page 11 of 20 Evidence: in their rooms or in one of the sitting rooms the home has no heated trolley to keep the food at an appropriate temperature. On the day of the inspection we noted that there was an exercise class in progress when we arrived and the residents were seen to partake and seemed to enjoy it. Care Homes for Older People Page 12 of 20 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home can be sure that their complaints will be listened to and that they will be protected from abuse. Evidence: The home has a complaints procedure that is followed if a complaint is made. We spoke to staff regarding the safeguarding of the residents. We put a scenario to them on how to manage and incident should it happen. All the staff we spoke with knew the procedure to follow and were aware of their responsibilities under Safeguarding Adults procedures. Care Homes for Older People Page 13 of 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home may not have all their environmental needs met. Evidence: On the day of the site visit we noted that the home was clean, fresh and odour free. The communal areas had been decorated and the paint and soft furnishings were bright and clean. The floor covering in the communal areas was stained and shabby. We were told that it is due to be replaced early in the new year. The environment lacked items of stimulation for the residents. There were no objects that the residents could use to stimulate or entertain themselves. They were reliant on staff to offer stimulation. They are not always in a position to do this. The home needs to have objects of interest and comfort to offer stimulation to the residents. We spoke to senior management staff about this and they assured us that they would deal with it straight away. We were subsequently told that they have supplied objects of interest for the stimulation of the residents. Residents rooms were decorated to meet the needs and the taste of the residents. Care Homes for Older People Page 14 of 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not all of the people who live in this home can be sure that there are sufficient staff on duty to meet their needs. Evidence: We saw the staff on duty interact with the residents with kindness, care and affection. We were concerned that they wasnt sufficient staff on duty on the top floor to meet the needs of the residents. There were two staff on duty on the day of the inspection and this represented a typical days staffing. this is not sufficient as all or most of the residents need two carers to assist them in getting up dressed and having their personal care. While the two staff on duty are attending to an individual resident there is nobody to attend to the other residents if there is a problem. Staff were trained to deliver personal care and care for the residents generally. Staff said that they would go the manager if they had a problem and were confident that it would be dealt with. Care Homes for Older People Page 15 of 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home can be sure that in most areas it is run in their best interests. Evidence: The home has not had a prolonged period of stable management. The home manager was not present at the time of the inspection, however the staff were welcoming and were able to assist us with the records we needed. We were joined later by a senior manager from the provider organisation. Staff told us that they would go to the manager if they had a problem and were confident that the problem would be dealt with. We found that the staffing levels on the top floor not to be sufficient to meet the ongoing needs of the residents. There were two staff on duty and most of the residents needed two staff to assist them to get up this means that the other residents are left unattended. We were told that this would be addressed straightaway. We were later told that this had been addressed. The environment was lacking in objects that would offer stimulation to the residents, there was no reading material or objects to Care Homes for Older People Page 16 of 20 Evidence: touch or offer comfort or stimulation. The residents were reliant on staff for occupation. This is important as it promotes independence and offers stimulation which is important for optimum emotional and mental health. Assessments had been carried out on the residents prior to admission and the home only admits people they know they can care for. Care plans were well written and offered staff good direction on how to care for the people who live there. The staff were seen to be kind and caring with the residents and were knowledgeable about the needs of the residents. The food was of good quality, however the catering staff must have a means of keeping food hot while it is being delivered to residents in various parts of the home. All health and safety checks were carried out. Care Homes for Older People Page 17 of 20 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 18 of 20 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 1 12 5A That objects of stimulation are provided This requirement has now being met To ensure the residents are stimulated 30/11/2009 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 1 12 7 That all meals are served at an appropriate temperature So that residents can enjoy their food 30/01/2010 2 27 16 That there is sufficient staff on duty to ensure the needs and wishes of the residents are met. You must do this because the residents must be cared for appropriately 26/11/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 19 of 20 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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