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Inspection on 16/08/05 for Canford Manor Nursing Home

Also see our care home review for Canford Manor Nursing Home for more information

This inspection was carried out on 16th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is run for the benefit of its service users and provides care in a pleasant environment. Visitors are always welcome and relations in the home were relaxed and friendly. Service users spoken to stated that the staff were always kind and friendly and also said that the manager and staff are approachable. Service users spoken to praised the quality and choice of food available at the home. Staff stated that they enjoyed working at the home and that they were provided with regular training and updates in order for them to do their job effectively.

What has improved since the last inspection?

Since the last inspection some of the service users rooms have been redecorated and some of the older furnishing have been replaced. All radiators in the home have been fitted with covers and the home has made progress in providing additional adjustable height beds.

What the care home could do better:

The inspection report will make 2 requirements and 2 recommendations to the home, which will help improve the service provided for residents. The home reports that it carries out needs assessment before service users are admitted to the home, however no evidence was available for some service users that assessments had taken place. A requirement was made to ensure that the home carries out a full assessment of service users needs prior to them moving into the home and copies of these assessments must be available at the home. Care plans would benefit from additional information so that care staff has clear information available to meet the care needs of service users. A requirement was made for care plans to be further developed to give clear information to staff on how care and support is provided. Staff at times usewheelchairs to transport service users around the home and it was recommended that a clear procedures should be put in place, which give staff guidance on the correct use of wheelchairs. The home keeps some personal money for service users and this is accurately accounted for and kept secure, however it was recommended that this money is kept individually, which would make accounting easier for internal auditing and inspection.

CARE HOMES FOR OLDER PEOPLE Canford Manor Nursing Home Lee on Solent Hampshire PO13 9JH Lead Inspector Michael Gough Unannounced 16 August 2005 - 10:00am 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 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 H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Canford Manor Nursing Home Address Manor Way Lee on Solent Hampshire PO13 9JH 023 9255 0437 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Christopher Imonikhe Margaret Phyllis Harper CRH 24 Category(ies) of OP - Old age (24) registration, with number PD - Physical disability (5) of places PD(E) - Physical disability - over 65 (24) TI - Terminally ill (5) TI(E) - Terminally ill - over 65 (24) Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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. 2. No more than 5 service users in total can be accommodated in the PD and TI categories. Date of last inspection 17 February 2005 Brief Description of the Service: Canford Manor is a care home providing nursing care for a maximum of 24 older persons. Service users can be supported in the following categories: Old age not falling within any other category (24) Physical disability/Terminall ill over 65 years of age (24), Physical disability/terminally ill (5). The home is located in a quiet residential area of Lee on Solent and is close to local amenities, shops and public transport. Accommodation comprises of 24 single rooms with en-suite facilities and is located on two floors. A shaft lift is provided to give easy access to the upper floor. There is a large lounge/dining area and a separte small lounge is also available. There is a rear garden which is accessible to service users and there is car parking at the front of the home. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours and was unannounced. The registered manager assisted the inspector’s during the course of the inspection. Evidence for this report was obtained by speaking with the homes manager, from reading and inspecting records, touring the home and from observing the interaction between staff and service users. It was also possible to speak with 8 service users and also 3 members of staff. What the service does well: What has improved since the last inspection? What they could do better: The inspection report will make 2 requirements and 2 recommendations to the home, which will help improve the service provided for residents. The home reports that it carries out needs assessment before service users are admitted to the home, however no evidence was available for some service users that assessments had taken place. A requirement was made to ensure that the home carries out a full assessment of service users needs prior to them moving into the home and copies of these assessments must be available at the home. Care plans would benefit from additional information so that care staff has clear information available to meet the care needs of service users. A requirement was made for care plans to be further developed to give clear information to staff on how care and support is provided. Staff at times use Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 6 wheelchairs to transport service users around the home and it was recommended that a clear procedures should be put in place, which give staff guidance on the correct use of wheelchairs. The home keeps some personal money for service users and this is accurately accounted for and kept secure, however it was recommended that this money is kept individually, which would make accounting easier for internal auditing and inspection. 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. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 standard(s) 3 & 6 In general service users have a full needs assessment undertaken before they move into the home, however a requirement was made for the home to ensure that a full assessment is carried out for every new service users before they are admitted to the home. EVIDENCE: Files were seen for 6 service users and needs assessments were available and on file for 4 of the 6 seen. The provider’s wife, who is a qualified nurse and who provides consultancy to the home, carries out assessments and she assured the inspectors that assessments are always undertaken. However there was no evidence of assessments for 2 of the service users and it is a requirement that the home carries out a full assessment of service users needs prior to them moving into the home and copies of these assessments must be available at the home to provide clear evidence that assessments have been undertaken. Intermediate care is not provided by the home. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 standard(s) 7 & 9 Service users health, personal and social care needs are set out in a plan of care and are generally met, however care plans would benefit from additional information being provided to give clear information to staff on how support for service users should be given. There is also a need to ensure individual mental health issues are addressed within the care plan framework. Service users are protected by the home policies and procedures for dealing with medicines. EVIDENCE: Care plans were seen for 6 service users and these gave information for staff on the care needs of individuals, there was evidence that risk assessments had been carried out and there was information on individual likes and dislikes. One care plan stated that the service users eating habits were not acceptable, however there was no evidence to say if the reason for these habits had been investigated and there was no strategy for overcoming this problem. There was also information on one service user who has sore heels (ulcers on both feet) the goal was to heal and prevent further breakdowns, the last evaluation of the wounds was on 3/7/05. It was seen on some of the care plans that there was a record that service users had dementia, however there was no evidence within the care plans that these needs are being met. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 10 These issues were discussed with the homes manager and it is a requirement that care plans must be further developed to give clear information to staff on how care and support is provided and care plans must show how needs are being met, nursing notes must be written up after treatment so that progress or lack of it can be clearly evidenced. The home has a policy for the receipt, storage, return and administration of medication and the manager has made plans for the disposal of medication in light of the new medication policy. Medication records sheets were inspected and found to be up to date and correct. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 standard(s) 12, 13 & 15 The home provides a range of activities for service users and the religious and recreational interests of service users at the home are provided for. Service users are able to maintain contact with family and friends and visitors are welcome at any time. Service users are provided with a wholesome and balanced diet in pleasant surroundings at time convenient to them. EVIDENCE: Activities at the home include a pat dog that visits the home once per week. Armchair aerobics are arranged fortnightly, a pianist visits once per week and guitarist also visits to provide entertainment. The local library leaves a number of books at the home and these are changed regularly. Service users spoken to were very happy with the activities provided, some stated that they preferred watching TV whilst others were happy relaxing and chatting with other service users. Service users interests are documented and there are no restrictions on bathing, getting up or going to bed. The home has a visiting policy and there are no restrictions on visitors, however visitors are asked to respect meal times. The visitors book at the home showed that there are a regular stream of visitors to the home. All service users spoken to were very happy with the food provided by the home and stated that the food was plentiful and good, service users are offered a choice at meal times and are able to eat their meals in the dining room or elsewhere if they prefer. The inspector observed lunch being taken in the dining room and staff provided suitable support for service users. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 standard(s) 16 & 18 There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures protect service users for any form of abuse. EVIDENCE: Service users spoken to were confident about raising any concerns they may have and stated that they would address any complaint they may have to a staff member or to the homes manager. The home has a policy and procedure for dealing with any complaints and this contained all of the required information and gave details of how to contact the CSCI. Staff members spoken to were also aware of the complaints procedure. Staff has received training on adult protection and the home has a whistle blowing policy and also a copy of the Hampshire Adult Protection procedure. Staff spoken to were aware of their responsibilities in this area and knew what to do should they suspect any form of abuse had taken place. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 22, 24 & 25 Service users live in a well maintained environment and have access to comfortable indoor and outdoor facilities, there is some specialist equipment available in the home to maximise service users independence and the inspector made one recommendation for the home to provide staff with written guidelines for the correct use of wheelchairs. Service users bedrooms are suitable for their needs and the homes heating, lighting and water supply provided for service users meet their needs. EVIDENCE: The inspector toured the building and found that fire doors, with the exception of doors to service users rooms were held open by approved magnetic devises, which are linked to the fire alarm system, the inspector discussed the issue of the doors to service users rooms which were marked “fire doors” and advised that the fire officer be contacted if service users required the doors to their rooms to be kept open. All areas of the home were clean and tidy and furniture was in a satisfactory state of repair. Service users were seen to be using both of the communal lounges in the home and these were bright and Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 14 airy and service users stated that they enjoyed sitting in the lounge and were happy and contented. Wheelchairs in use had footplates in place and the inspector discussed this issue with the homes manager who stated that one particular service user, would not use his wheelchair when the footrests were in place. The inspectors recommended that a clear procedure should be put in place, which gave staff guidance on the correct use of wheelchairs. In the case of the service user who refused to use footrests then comprehensive risk assessments need to be put in place and professional advice sought if needed. Service users bedrooms all contained the required furniture and fixtures and many had been personalised by the occupants. The home has made progress with the introduction of 3 height adjustable beds in the home and the inspector will continue to monitor the progress the home makes to increase the number of height adjustable beds to meet the changing needs of service users. All radiators in the home had covers in place and hot water outlets had thermostatic valves fitted and staff were also required to record the temperature of baths by means of a thermometer. There was a requirement at the last inspection for the provider to contact the Health & Safety Executive for guidance on restricting window openings in nursing homes, the manager confirmed that contact had been made but she was not fully aware of the outcome. Due to the provider being unavailable during this inspection this issue was not resolved, however the inspector will follow this up at the next inspection and it is expected that clear evidence would be available from the home, regarding the need to restrict window openings for service users who are accommodated on the first floor. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 Staffing numbers and mix of staff both qualified nurse and unqualified care staff meets the needs of service users and service users are protected by the homes recruitment procedures. EVIDENCE: The homes staff rota was examined and this showed that the home provides a minimum of 1 trained nurse plus 2 care staff on duty 24 hours a day, staffing numbers vary at different times of the day to meet service users needs. The home also employs a cook and domestic staff so that care staff can concentrate on the care needs of service users. The home has policies and procedures in place with regard to recruitment and staff recruitment records were inspected for 2 staff members and those seen contained all the required information including 2 references and a record of POVA/CRB checks. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Service users financial interests are generally safeguarded by the homes procedures, however it is recommended that each service users personal money held by the home for safekeeping is kept individually to make accounting, auditing and inspection easier. EVIDENCE: The home does not handle the financial affairs of any of its service users; it does however keep small sums of money on behalf of service users to pay for hairdressing chiropody etc. The inspector found that this money is all kept together, although individual written accounts for each service user is kept. The hairdresser who visits the home does not bill service users individually but gives one bill for all of the hairdressing carried out. The manager then has to break down the costs and transfer this to individual service users. The chiropodist carries out this same procedure. It is recommended that the home get both the hairdresser and the chiropodist to provide itemised bills to the home so that each service users is charged correctly. Service users money Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 17 can then be kept individually which will make accounting easier for internal audit and inspection and will provide a quicker process. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x 2 x 3 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 2 x x x Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 19 Are there any outstanding requirements from the last inspection? 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 3 Regulation 14 Requirement Timescale for action 31 October 2005 2. 7 15 It is a requirement that the home must carry out a full assessment of service users needs prior to them moving into the home and copies of these assessments must be available at the home to provide clear evidence that assessments have been undertaken. It is a requirement that care 31October plans must be further developed 2005 to give clear information to staff on how care and support is provided and care plans must show how needs are being met, nursing notes must be written up after treatment so that progress or lack of it can be clearly evidenced. 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 22 Good Practice Recommendations It is recommended that a clear procedure should be put in place, which gives staff guideance on the correct use of H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 20 Canford Manor Nursing Home 2. 35 wheelchairs. It is recommended that service users money held by the home is kept individually and that the home should get both the hairdresser and the chiropodist to provide an itemised bill so that each service user can be charged correctly. Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire SO15 1GW 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 Canford Manor Nursing Home H54 S11493 Canford Manor Nursing home V244212 160805 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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