Inspection on 15/05/07 for Canford Manor Nursing Home

This inspection was carried out on 15th May 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Canford Manor Nursing Home 08/05/08

Canford Manor Nursing Home 17/01/06

Canford Manor Nursing Home 16/08/05

Canford Manor Nursing Home 17/02/05

Canford Manor Nursing Home 29/10/04

Canford Manor Nursing Home 01/03/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Canford Manor Nursing Home Manor Way Lee-on-Solent Hampshire PO13 9JH Lead Inspector Beverley Rand Unannounced Inspection 15th May 2007 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 Canford Manor Nursing Home DS0000011493.V336264.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. Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Canford Manor Nursing Home Address Manor Way Lee-on-Solent Hampshire PO13 9JH 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) (023) 92 550437 Mr Christopher Imonikhe Mrs Kathryn Dawn Imonikhe Margaret Phyllis Harper Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24), Physical disability (5), Physical disability of places over 65 years of age (24), Terminally ill (5), Terminally ill over 65 years of age (24) Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the PD and TI categories cannot be admitted under the age of 44 years. 31st May 2006 Date of last inspection Brief Description of the Service: Canford Manor is a care home providing nursing care for a maximum of 24 older persons. The home is located in a residential area of Lee on the Solent and is close to local amenities, shops and public transport. Accommodation comprises of 24 single rooms with en-suite facilities over two floors. A shaft lift is provided to give easy access to the upper floor. There is a large lounge/dining area and a separate small lounge is also available. There is a rear garden which is accessible to residents and there is car parking at the front of the home. Fees vary from local authority rates to £650 per week. The fee does not include toiletries, hairdressing, chiropody and items of a personal or luxury nature. Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection. The inspector reviewed records such as the last inspection report and four comment cards from relatives before the visit. The provider did not complete the Annual Quality Assurance Assessment within the required timeframe but this was received after the inspection. The information provided generally confirmed the inspection findings, except the unpleasant odour in some bedrooms. During the visit, the inspector looked around the home, spoke with three residents and two staff. The post of registered manager is currently vacant and the home is being managed by the providers. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that medication records are correct so that staff on the next shift can be sure that residents had their medication. The provider must be aware of the correct recruitment procedures to follow to ensure the risk of employing unsuitable staff is reduced. The provider needs to ensure the safety of all residents in their bedroom by consulting with the local authority fire safety officer and risk assessing the practice of wedging doors open. Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 6 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. Canford Manor Nursing Home DS0000011493.V336264.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 Canford Manor Nursing Home DS0000011493.V336264.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. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have a needs assessment undertaken prior to moving into the home which ensures the home can meet their needs. EVIDENCE: Mrs Imonikhe visits prospective residents where they currently are, whether it be at home or in hospital. She undertakes an assessment which involves the prospective resident, family and health and social care professionals. Prospective residents are welcome to visit the home to look around and decide whether they would like to live there. Mrs Imonikhe gave an example whereby she undertook two assessments to ensure that the home could meet the person’s needs. Two assessments were looked at and these contained the necessary information. Canford Manor Nursing Home DS0000011493.V336264.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. The home ensures that residents’ health and personal care needs are met with dignity. Medication procedures generally protect residents but may not have done on the day of the inspection. EVIDENCE: All residents had a care plan in place which included daily notes, nursing and personal care needs. The inspector looked at a care plan for a new resident which was not as comprehensive but Mrs Imonikhe explained that it took time to get to know someone before a thorough care plan could be drawn up. Care plans showed personal preferences such as what time residents liked to go to bed. One resident who was asked said that staff, ‘knew exactly what to do’. Residents are registered with General Practitioners who will visit when necessary. The home keeps information such as weight and blood pressure on file to assist GPs monitor residents’ health. The chiropodist visits every six Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 10 weeks or sooner if necessary. The home also consults with other healthcare professionals when needed such as the continence nurse and the tissue viability nurse. Throughout the tour of the home there was evidence of specialist equipment such as pressure relieving mattresses being available. The home has a policy for the receipt, storage, return and administration of medication. Medication records were generally up to date but the records for two residents had not been signed for the morning medication round. It was not known whether the residents had received their medication and Mrs Imonikhe said the staff member would be contacted. However the situation had not been resolved by the time the inspection was finished at 5.30pm. The home has a fridge for storing medication which needs refrigeration and the temperatures are recorded daily. Residents who need insulin injections receive these at the correct time. Controlled drugs were kept in a dedicated locked cabinet inside a locked room and records were kept accordingly. From speaking with staff and residents it was clear that privacy and dignity is respected whilst working with residents. Canford Manor Nursing Home DS0000011493.V336264.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. Whilst the home generally satisfies residents’ needs, some residents may benefit from clearer morning and bedtime routines. The home welcomes visitors and residents can takes possessions into the home. Residents enjoy the food and are supported with eating where necessary. EVIDENCE: The home employs an activities co-ordinator who organises and records activities and evaluates how residents participate and enjoy them. Residents said there were activities and that they had particularly enjoyed a musician who had visited recently. Staff said other activities included a visiting PAT dog, bingo, films, baking and exercises to music. Two residents said they were happy with the routines but another was not. Staff told the inspector they were unclear as to why residents got up and went to bed when they did. Staff were unclear about the morning procedures which meant they were working in different ways. Three staff were asked about the daily routines: one said some residents were up before they came on duty and others were supported to get up in order of need, (needing to wash or attend Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 12 an appointment); another said two staff started downstairs and one upstairs; a third said staff worked downstairs before moving upstairs. None said the routine was influenced by personal preferences or care plans. However, they said that if a resident was asleep, feeling unwell etc. they would go back to them later and felt that if a new resident wished to get up at a certain time this would be accommodated. Mrs Imonikhe said it was always a matter of personal choice as to when residents got up or went to bed and that care plans detailed these choices. There was no explanation as to why one resident was going to bed earlier than their care plan stated, other than Mrs Imonikhe feeling confident that it would have been the resident’s choice. The home has a visitors policy and welcomes visitors at any time. This was confirmed by residents and staff. One comment card stated that, ‘visitors are always made welcome and you can go at anytime’. There was evidence around the home of residents personalising their bedrooms with photographs and ornaments. Three residents were asked about the food. One said it was, ‘wonderful’, the other two agreed it was, ‘lovely’. They also said the chef was aware of individual likes and dislikes and provided alternatives. However, two said that when they occasionally were served a meal they didn’t like, they would leave it and not ask for anything else. Mrs Imonikhe told the inspector that she had often reminded residents that they could request different food. The menu is created on a monthly basis and the chef keeps a record of food served. Residents can choose where they wish to eat: at the dining tables, on an individual table or in their room. Staff said they gave appropriate support to residents who needed help with eating and pureed food was provided where necessary. The inspector saw specialist equipment such as lipped plates which enable residents to maintain independence with eating. Mrs Imonikhe said the home does not currently provide for any specialist diets other than diabetic, as the needs of current residents meant this was not necessary. Canford Manor Nursing Home DS0000011493.V336264.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place which enable residents and their relatives to know how to make a complaint. Adult protection procedures enable staff to report any allegations or suspicions of abuse but need to be clearer to ensure staff are fully aware as to how residents can be protected. EVIDENCE: The home has a complaints procedure in place with the necessary timescales. Two residents and a visitor who were asked said they would feel able to complain if necessary, although one felt that although Mrs Imonikhe walked around and spoke with residents, she was too busy to address any issues. Mrs Imonikhe told the inspector she spent a lot of time working with residents and was therefore available if a resident wished to raise issues. All four comment cards received said they would know how to make a complaint. The induction programme covers adult protection and Mrs Imonikhe said nursing training also covers this. Although no formal training has been provided Mrs Imonikhe said she covers the topic in supervision sessions and plans to send a staff member on the Train the Trainer course so that they can train the staff. The home has adult protection procedures in place but staff were unclear as to the procedures which would be followed after the initial report to the providers. On reading the procedure, the inspector found it needed to be clearer with regard to the role of the local authority adult Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 14 services and Mrs Imonikhe agreed to amend it. The inspector discussed procedures with Mr and Mrs Imonikhe who were clear regarding the role of the local authority and said they would always report any allegations or suspicions of abuse straight away. Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 15 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure the décor is maintained and the home is clean although further strategies are needed to ensure more bedrooms are odour free. EVIDENCE: The home has two sitting rooms, one of which has dining tables and residents were seen to be using all areas. Mrs Imonikhe said she was aware of some vacant bedrooms which needed redecoration and that no new residents would be admitted to those rooms had been decorated. General maintenance and redecoration of the home is on an ongoing basis and as necessary. One resident who was asked said the decoration was, ‘pretty good, nothing wrong with it.’ The inspector did not look at all the bedrooms but found that three out of six had an unpleasant odour and spoke with Mrs Imonikhe about it. Mrs Imonikhe Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 16 said she was aware of two rooms with this problem and that she was working through a range of strategies to eliminate the problem. She also said the carpet cleaner was used on a daily basis. The rota includes two cleaners and Mrs Imonikhe said she had put extra cleaning hours in place that day. Staff were clear regarding infection control procedures and said that protective gloves and aprons were always available. However, there were not any gloves in the sluice room and the inspector was told by staff that they had to fetch gloves from downstairs. Mrs Imonikhe agreed that gloves would be put into the sluice room. Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The provider ensures adequate staffing and that staff undertake induction and ongoing training. Records are not robust enough to evidence that new staff are safe to be working with vulnerable people. EVIDENCE: The home has a rota which generally includes a nurse in charge, three care staff, two domestic staff and a chef. Comments about staff from residents included, ‘the nurses are so nice’, ‘they are lovely’. A comment card received from a relative said that, ‘the atmosphere always appears to be happy, friendly and calm. I am very happy with the excellent care my relative receives’. Another comment card said, ‘the staff are caring and approachable. Nothing seems too much trouble’. The inspector looked at three recruitment files for new staff. All contained two references each but the only date shown was the completion of the form by the referee. Mrs Imonikhe was advised that in order to fully evidence references being received prior to new staff beginning work, a record of the date references were received should be kept. A reference had not been requested from a new employee’s last employer, who was in the care sector. Mrs Imonikhe explained the reasons she had not sought a reference but was unaware that she was under a legal obligation to do so. She said she would Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 18 request one. Records showed that for two of the staff records sampled, staff began work after a satisfactory Protection of Vulnerable Adults, (POVA) check. However, records showed a start date for one staff member as being before the POVA check was received. Mr and Mrs Imonikhe felt this was an error in the recording and said the only way they could check the start date was by looking at duty rotas which were not on the premises. Mrs Imonikhe agreed that she would fax the information the following day but this information has not been received at the time of writing the report. Mrs Imonikhe said the home, ‘very much’ promotes staff achieving a National Vocational Qualification in care, (NVQ). The home employs twelve care staff and six have already achieved NVQ2 or 3. Four are currently studying towards an NVQ. Mrs Imonikhe said all new staff undertake a Skills for Care induction which covers the National Minimum Standards. This was confirmed by a care staff member who spoke with the inspector. Some staff continue with the foundation level standards. On-going training includes Food Hygiene, Nutrition, Infection Control, Medication and Moving and Handling. Mrs Imonikhe undertakes in-house training for Moving and Handling and regularly updates her Train the Trainer training in this regard. Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 19 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 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well run by the provider in the absence of a registered manager although some issues have been identified elsewhere in this report. Fire safety may be compromised by the wedging open of bedroom doors. EVIDENCE: The home does not currently have a registered manager. Mr and Mrs Imonikhe are actively seeking to fill the post and Mrs Imonikhe is currently managing the home. Mrs Imonikhe said surveys were sent to residents and relatives in November but she had not received many back. Mrs Imonikhe felt that being in the home Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 20 everyday, she was able to receive feedback regularly and acted on it accordingly. The home does not look after any money on behalf of the residents. Maintenance certificates for the hoists and the lift were seen to be up to date. Fire training happens regularly as does servicing of fire prevention equipment. However, on arrival at the beginning of the inspection, five bedroom doors in the main hall were wedged open with wedges, a cushion and a toy, with residents in the rooms. All these doors were labelled as fire doors and with an instruction to be kept shut. Mr Imonikhe felt that these doors were in a safe area as there were self-closing doors in other areas of the building which would therefore make the area safe. However, he agreed that the area was large, and said that normally that many doors would not be wedged open. Advice from Hampshire Fire and Rescue Service must be sought to ensure residents’ safety should there be a fire. Food was stored appropriately and kitchen records were kept. The last Food Hygiene inspection did not identify any areas of concern. Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 21 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 3 9 2 10 3 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 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score N/A X 3 X N/A X X 2 Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement Medication records must be completed to enable staff to know who has received their medication and action taken to confirm this is the case in the absence of records. Recruitment checks must be in place before new staff start work. References must always be sought from previous employers in the care sector. The provider must liaise with the Fire Safety Officer at Hampshire Fire and Rescue Service regarding the wedging open of bedroom doors. Timescale for action 22/06/07 2 OP29 19 (4) 22/06/07 3 OP38 23 (4) 22/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Canford Manor Nursing Home DS0000011493.V336264.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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