Inspection on 16/09/05 for Attwoods Manor

This inspection was carried out on 16th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Attwoods Manor 04/06/09

Attwoods Manor 16/05/08

Attwoods Manor 11/05/07

Attwoods Manor 07/06/06

Attwoods Manor 22/04/05

Attwoods Manor 24/11/04

Attwoods Manor 27/07/04

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Attwoods Manor Mount Hill Halstead Essex CO9 1SL Lead Inspector Brian Bailey Final Report Unannounced Inspection 16th September 2005 3.30pm 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 Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 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. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Attwoods Manor Address Mount Hill Halstead Essex CO9 1SL 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) 01787 476892 01787 477769 Golden Age Management Limited Mrs Gina Juniper Care Home 42 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (42) of places Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 42 persons) One person over the age of 65 years who is diagnosed with dementia and whose name was made known to the Commission in May 2005 The total number of service users accommodated in the home must not exceed 42 persons 22nd April 2005 Date of last inspection Brief Description of the Service: Attwoods Manor is located approximately one mile from the town of Halstead, in a semi rural location. It is a detached period property set within approximately three acres of grounds, which were well tended, and had a pathway around the perimeter for the use of wheelchairs and other mobility equipment. A patio area at the front of the house is an ideal place for service users. There are service user bedrooms and communal areas on two floors that are accessible by passenger lift. There are twelve bedrooms on the ground floor (eleven singles and one double) and twenty-eight bedrooms on the first floor (twenty-five singles and two doubles). There are four lounge areas and a large dining room. There are various bathing and WC facilities throughout the home. The home is registered for 42 older people who need residential care. They do not offer nursing care, or placements for people with dementia. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Attwoods Manor took place on 16th September at 3.30pm and 19th September 2005 at 12.00pm. This was the second inspection visit to this home in the inspection year 2005/6. During the inspection days, the manager, staff, five residents and four visitors gave their views about the home. The majority of residents were seen during the inspection. A tour the building included a check of some bedrooms and bathrooms, the kitchen, laundry and the lounges and dining room. Residents’ care records, residents’ finances, medication, staffing levels, training and staff recruitment records were also checked and the midday meal was observed. What the service does well: What has improved since the last inspection? What they could do better: Care plans were not being reviewed on a sufficiently regular basis to enable staff to be up to date with any changes that might affect the care for each resident. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 6 The kitchen ceiling needs to be repaired following the refurbishment of the bathroom above. The staff roster shows that five staff on duty on each day shift but this includes the manager when on duty. This prevents the manager from being able to devote sufficient to managerial matters that include the supervision of staff and ensuring all records are and up to date. The home is finding it difficult to recruit new staff and are too reliant on agency staff, although the same agency is used to bring some degree of consistency. 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. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 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 Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 Residents and their relatives benefit from being able to visit the home to ask questions and to see for themselves whether it will meet their needs. EVIDENCE: Staff spoken to confirmed that in the majority of cases, prospective residents and or their relatives take the opportunity to visit the home to see for themselves the facilities available and to have a meal if they want. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. Limited progress has been made to ensure that the identified health, personal and social care needs of residents is reviewed at regular intervals. These shortfalls have a potential to place residents at risk. Residents benefit from a well managed system for the administration of medication. EVIDENCE: Individual care plans were checked again at this inspection. Whilst these were detailed and information relating to all aspects of residents’ health, personal and social care needs, little progress has been made to ensure that care plans are brought up to date and reviewed on a monthly basis. Two care plans had not been reviewed for several months. The manager was aware of this but said she was finding it difficult to have the time to carryout the reviews. A deputy manager has been appointed, which should enable this important task to be undertaken. Care records continue to show that visits by health care professionals were recorded and these were up to date. Staff spoken to said they felt that guidance and assistance from health care professional is sought promptly and appropriately. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 10 All medication is kept in a in a locked room, which is used solely for this purpose. General medication is kept within a locked trolley and controlled drugs are kept within a locked cupboard within the room. The Medication Administration Record sheets were checked and were up to date. The return of medication book was checked and found to be up to date. All packets and bottles of medication were dated on the day of opening. The home uses a monitored dosage system. The senior care assistant on duty was able to talk confidently about the system, procedures and expectations of her as responsible for the administration of medication and that residents were reliant on her being competent. Staff were observed to be friendly, patient and attentive. In general, residents spoke well of the staff and considered them to be kind and helpful. One resident said that sometimes, one or two staff did not seem to appreciate how careful they must be when providing assistance to dress and undress and that they should slow down. The resident did not think this was the permanent staff. There were no restrictions on residents returning to their rooms if they wished and a few people were seen prefer their own company. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14. On the information available, it would seem that residents are enabled to enjoy a varied programme of activities. Residents do benefit from being free to choose where they spend their time and from being able to have their friends and relatives visit. EVIDENCE: The home employs an activities co-ordinator for three afternoons per week. The coordinator was not available at the time of the inspection and there was little evidence of any activities taking place. However from discussions with staff and residents, it was evident that activities are provided. Residents said they enjoyed the exercise sessions and felt that that were sufficient opportunities to join in if they wanted Relatives spoken to during the inspection visits confirmed that they are able to visit at anytime and are always made to feel welcome. Although the standard relating to food was inspected at the inspection in April 05, staff and residents said they enjoyed the meals and considered the standard of food was good. The cook and staff were aware of those residents with special dietary needs including diabetics and appropriate food was provided. These were documented in the residents care records. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Residents and their relatives have access to a complaints procedure that they can use and feel safe that staff are trained in the protection of vulnerable adults from abuse. EVIDENCE: The home has a complaints procedure. Two complaints have been received by CSCI over the past six months alleging rudeness and poor care practices. Of the nine issues raised by the complainants, none were substantiated, as there was no evidence to support the allegations. None of the staff or residents spoken to had ever heard staff being rude or abusive. The home had a policy and procedure on the protection of vulnerable adults from abuse and guidance documents produced by Essex County Council. Training certificates were available to show that staff had attended training on the protection of older people from abuse. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26. Residents benefit from living in a well maintained property and have access to extensive grounds. EVIDENCE: Attwoods is a large detached property that has been adapted to meet the needs of older people. The building is well maintained and decorated and furnished to a good standard. There are excellent views of the gardens from the lounges and dining room. A first floor bathroom above the kitchen had been refurbished and new floor covering fitted. The kitchen ceiling had been damaged by a leak but was dry and repairs are to take place at a time that will not interfere with the preparation of meals. All areas of the home visited were clean, tidy and odour control was good. Ventilation was good in the lounges and dining room and residents said they did not object to the windows being opened during the day, particularly when the weather was warm. A large patio area at the front of the house provides Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 14 residents with an opportunity to sit outside and look at the garden, which was well maintained. Two residents spoken with said they liked the lounges and their bedrooms and enjoyed the opportunity to spend time in their own rooms if they wanted. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29. Residents benefit from an effective staff recruitment procedure. The number of staff on duty meets the requirement of the home’s registration. EVIDENCE: Staff rosters showed that five staff are on duty on each shift, which meets the minimum staffing levels. The manager is included as a member of the care staff team when on duty and further comment on this issue is contained under the next section “Management and Administration”. There were no volunteers at this home. The home continues to use agency staff on a regular basis because of the difficulties of recruiting staff. All night staff were waking staff. Staff files looked at during the inspection showed that the manager was following procedures and carrying out all the necessary recruitment checks for new staff. The files were well maintained and kept secure. Criminal Records Bureau disclosure checks were available for all staff with one exception, which the home was continuing to try and obtain from the CRB. Evidence was available to show that staff are provided with opportunities to access training courses, that include National Vocational Qualifications, Health and Safety, bereavement, equality and diversity and the protection of vulnerable adults from abuse. The home has an induction programme that all new staff are required to undertake, which the deputy manager had commenced. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 and 35. Residents, staff and relatives are not consulted as part of the Quality Assurance system on a sufficiently regular basis. The manager is not able to adequately monitor the standards of care when working as a member of the care staff. Residents benefit from the home having a good financial control system in place. EVIDENCE: The staff rosters showed that when the manager is on duty she is included on the roster as a carer. This does not allow the manager sufficient time to carryout her managerial duties and an agreement must be reached as to the number of shifts the manager will be supernumerary to the care staff. A deputy manager had been appointed within the past three weeks, which should permit the manager to organise the rota more effectively and be able to concentrate on monitoring staff and ensuring records and procedures are up to Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 17 date. Staff spoken with considered the manager to be involved and available. Two staff said the manager had brought a period of stability to the home. The home has a Quality Assurance system in operation, but the last survey of residents, relatives and staff was carried out in August 2004 and is now overdue. There was no evidence that the frequency of issuing surveys had been reviewed or that the outcome of a survey had been made available to residents and other interested parties. No residents’ money is kept in the home. The administrator invoices the residents’ relatives for any monies owed. All invoices and receipts checked were correct and financial record keeping within the home is very good. The monthly invoices contained sufficient information on those items considered as extra to the fees, such as chiropody, toiletries and newspapers. Since the last inspection, action had been taken to address the identified problem of water being too hot at outlets used by residents. Thermostatic valves to control the temperature had been fitted in bathrooms, which was the priority, and to the majority of bedrooms. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 18 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 x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 X X X X X 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X x 2 Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP7 OP19 Regulation 15 13 Requirement Residents care plans must be reveiwed regularly (Timescale 1/8/05 not met). The manager must ensure the remaining hot water outlets used by residents are regulated. (Timescale 6/5/05 not met) The kitchen ceiling must be repaired. The manager must organise the staff roster to ensure that some of her working hours each week are supernumary to the care staff. Timescale for action 01/12/05 01/11/05 3 4 OP19 OP31 23 10 01/12/05 01/11/05 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 OP33 Good Practice Recommendations The manager should arrange to consult residents, staff, relatives and all other interested parties on a more regular basis. Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 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 Attwoods Manor DS0000017756.V250409.R01.S.doc Version 5.0 Page 21 - 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!