Inspection on 22/02/07 for Carlton Manor Care Home

This inspection was carried out on 22nd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Carlton Manor Care Home 25/02/09

Carlton Manor Care Home 17/01/06

Carlton Manor Care Home 12/09/05

Carlton Manor Care Home 29/09/04

Carlton Manor Care Home 27/04/04

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE Carlton Manor Care Home Parkfield House 23 Parkfield Road Bradford West Yorkshire BD8 7AB Lead Inspector Mary Bentley Key Unannounced Inspection 22nd February 2007 09:30 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 Carlton Manor Care Home DS0000033997.V331008.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. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlton Manor Care Home Address Parkfield House 23 Parkfield Road Bradford West Yorkshire BD8 7AB 01274 544374 01274 491985 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) Carlton Nursing Homes Ltd Michelle Ann Holstead Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (24), Physical disability (14), Physical disability of places over 65 years of age (24) Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: Carlton Manor was originally built as a private residence and later used as a Convent before being converted to a care home. The home has retained many of the original features. It is situated in secluded grounds, ideally located for easy access to Bradford City centre. There are regular bus services to many local amenities and there is ample parking for visitors. The home provides personal and nursing care for 30 people. There are 14 places for adults with physical disabilities and the remaining places are for older people. There is a mixture of single and double rooms mostly with en-suite facilities. There is a passenger lift giving access to all parts of the home and there is a ramp at the side entrance. The home has three lounges one of which is used for smoking. There is a large dining room that easily accommodates all of the residents. In December 2006 the home told us the weekly fees ranged from £354.74 to £2135.00. Hairdressing is available and costs between £5.00 and £25.00. Holidays, transport, and private chiropody can be arranged and are charged at cost. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 we made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate”, and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk The last inspection was in January 2006 and there were no requirements. We have not made any additional visits to the home since then. An Adult Protection referral was made in January 2007 and this is still being dealt with. The purpose of this inspection was to look at how the needs of people living in the home are being met. I did this unannounced inspection in one day and spent 7.5 hours in the home. During the visit I talked to 8 residents and 2 relatives. I spoke to staff and management, examined various records, observed staff caring for residents, and looked at some parts of the home. The home completed a pre-inspection questionnaire and the information provided was used during the inspection. Comment cards were left at the home for residents and relatives. Comment cards give people the opportunity to share their views of the service with us. The information we get is shared with the home without identifying who has provided it. Three cards were returned and the information received is included in the report. What the service does well: Carlton Manor provides a clean and comfortable place for people to live. It has a friendly and welcoming atmosphere. Visitors are welcome at any time and people can see their visitors in private. People are encouraged to visit the home before deciding if it is the right place for them. The home has established good links with community health care teams. This means that people can get access to specialist treatment and equipment when they need it. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 6 People are encouraged to exercise choice and to be as independent as possible. Residents said the food is always good and there is plenty of choice. Residents and relatives are given information about how to make a complaint or raise any concerns they might have. Generally residents felt there were enough staff to meet their needs. Staff are given the training they need to help them understand and meet residents’ needs. Residents and/or their representatives are consulted about how care needs will be met and are given the opportunity to share their views of the service. What has improved since the last inspection? What they could do better: 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. Carlton Manor Care Home DS0000033997.V331008.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 Carlton Manor Care Home DS0000033997.V331008.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 & 5. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of prospective residents are assessed before admission and people are encouraged to visit the home or have a trial stay before making a final decision. EVIDENCE: Detailed pre-admission assessments were seen in the care records. Assessments done by other professionals were also available. Where necessary the home works with community health care teams to make sure that any special equipment that is needed is provided before admission. Evidence of this was seen during the visit. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 9 Prospective residents and/or their representatives are encouraged to visit the home before making a decision about admission. Residents can also stay for a trial period to test out the services if they are not sure whether the home is suitable for them. Similarly if the home has any doubts about whether they can meet the needs of prospective residents they will offer admission for a trial period. When considering the suitability of the home for new residents the manager takes account of the needs of people living in the home. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 10 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. Residents’ health and personal care needs are met in a way that respects their privacy and dignity and takes account of their wishes. EVIDENCE: I looked at the care records of four residents. The care plans provide staff with clear information on how to meet residents’ personal and health care needs. They include information on what residents can do for themselves. Information on social care is kept in a separate file. The plans are well set out and information is easy to find. The care plans have recently been updated and are now produced on a computer, the manager is planning to sit down with residents to discuss the plans and make any changes necessary to take account of residents’ views. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 11 Care staff said they get detailed reports from the nurses at each shift handover and they use the care plans to find out more about individual residents’ needs. Residents said they were consulted about their care needs and overall felt they were well cared for. One person said they needed help to move in bed to prevent pressure sores and they did not always get this help, they said it depended on which staff were not duty. Another resident said “they have put me back on my feet, I couldn’t do anything when I came here”. There are risk assessments in place for nutrition, continence, falls, moving and handling, and the risk of pressure sores. Where necessary care plans are in place showing how the risk will be managed. Individual risk assessments are also in place example for residents who smoke or go out alone. The records show that residents have access to a range of health care professionals including GPs, dieticians, speech and language therapists, diabetic specialist nurses and the tissue viability nurse specialist. The home employs a private physiotherapist who sees residents regularly. Residents have access to NHS chiropody services and some staff have been training to provide foot care. Medicines are managed safely. Some residents manage their own medicines and the appropriate risk assessments have been done. Residents are treated with respect and they are encouraged to be as independent as possible. The atmosphere in the home is relaxed and it was evident that there are good relationships between residents and staff; they are comfortable in each other’s company. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 12 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. Residents are helped to exercise choice and control over their lives and are supported in maintaining their life skills and independence. More attention must be given to making sure that residents have the opportunity to take part in varied social activities that reflect their needs, preferences, and abilities. EVIDENCE: The home has not had an activities organiser for a couple of months and the manager was interviewing for this post on the day of the visit. Some activities are still taking place; someone visits the home twice a week and does an exercise and music session and some residents have been out to the theatre and the pub. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 13 A number of residents commented on the lack of activities, one person said, “All we do is knock a ball about”. Some people who completed the quality monitoring surveys recently sent out by the home also mentioned that activities were an area that needed to be improved. One person said they would like more outings to be arranged. I looked at the activities records, which include personal profiles; social care assessments and records of activities for individual residents. There was no information on how social care needs would be met for the four residents whose care records I had looked at earlier. Most of the activities record sheets had not been completed since November 2006. The manager is aware that this aspect of the service needs to be improved. Daily routines are flexible; residents get up and go to bed when they want. Some residents have their main meal in the evening rather than at lunchtime. The home has a positive attitude to risk and understands the need to balance risks against benefits, they use risk assessments to support people in maintaining their life skills and independence. For example some residents go out alone. Others have kettles in their rooms to make their own drinks and there is a kettle in one of the lounges so that people can help themselves to drinks at any time. Other residents go on holidays. Visitors are welcomed at any time. One resident said that her husband had visited earlier and had been given coffee and biscuits as soon as he arrived, she said it really “perked him up” after a long bus journey. I sat in the dining room with residents while they were having lunch. The chef served lunch; there was a choice of two main courses and three puddings. The meals were nicely presented and residents said it was very good. They said the food is always very good and there is always a choice. The mealtime was relaxed and residents had plenty of time to enjoy their food. Drinks were served with the meal. When residents needed help this was offered discreetly. Residents are consulted about changes to the menu. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 14 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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given information about the complaints’ procedure and complaints and/or concerns are dealt with appropriately. There are systems in place to make sure that residents are protected from abuse. EVIDENCE: Information about the complaints’ procedure is available. Residents felt confident they could talk to the manager or the owner if they had any concerns. One regular visitor said that if there is anything one just needs to mention it and it is dealt with. The home has not had any complaints since the last inspection and none have been referred to us. There has been one referral to the Adult Protection team, at the time of the inspection this was still being investigated. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 15 Staff have received training on abuse and adult protection and are aware of how to report any concerns they might have. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 16 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, 20, 24, & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, pleasant, and safe place for people to live. EVIDENCE: The home was clean and well maintained. There is an ongoing programme of refurbishment and redecoration. People said the owners have made a lot of improvements to the building over the past few years. In recent months a Health and Safety officer and an Environmental Health officer have visited the home. The outcome of both these inspections was satisfactory. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 17 Work planned for this year includes the replacement of some old window frames and upgrading the disabled access shower. Residents’ bedrooms are comfortable and in most rooms residents had personal belongings such as photographs and ornaments. Door locks are fitted and keys are available if residents want them. Some residents have private telephones in their rooms. There are 3 lounges and a dining room on the ground floor giving residents a choice of where to spend their time when they are not in their own rooms. All the rooms are suitably furnished and have a number of sofas where residents can stretch out and relax. There is a large laundry in the basement, which is appropriately equipped to meet residents’ needs. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 18 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, & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough staff available to meet residents’ needs. Staff are supported in developing the skills and knowledge they need to meet residents’ needs. EVIDENCE: Duty rotas are available for all grades of staff. The duty rotas should show the hours actually worked. The manager is supernumerary. During the day there are usually 6 staff on the morning shift and 5 on the afternoon/evening shift, this includes one nurse. Overnight there are 2 care assistants and one nurse on duty. The home employs separate staff for housekeeping and kitchen duties. Residents were satisfied that staff were available when they needed them. Some people made very positive comments about the staff, describing them as friendly and caring. However, two people said that some staff were not as caring as others, one person said, “some staff can’t seem to be bothered about me or anything I do”. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 19 Information provided showed that 56 of care staff have achieved an NVQ (National Vocational Qualification) at level 2 or above, this exceeds the recommendations of the National Minimum Standards. Staff files showed that all the required checks are completed before new staff start work in the home. The home has its own induction checklist and new care staff undertake the Skills for Care Induction standards. These are nationally recognised standards designed to make sure that new care staff are helped to get the knowledge and skills needed for their work. The home has a good training programme, as well as mandatory training such as moving and handling and fire safety training has recently been provided on subjects such as palliative care, dementia, adult protection, physical activities for residents and wound care. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 20 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 good. This judgement has been made using available evidence including a visit to this service. The home is well managed; the interests of residents are safeguarded. People are given the opportunity to share their views of the service and contribute to the improvement and development of the service. EVIDENCE: The manager has been at the home for approximately seven years, she is a nurse and has completed the necessary management qualifications. She is clearly committed to making sure that the home is run in the best interests of the people who live there. Residents and relatives have confidence in the Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 21 management team, one person said, “This place is run well”. Staff said the management were approachable. The owners visit the home every month and look at all aspects of the service; we get copies of the reports from these visits. The home manages personal money for a number of residents, there are records of all transactions made on behalf of residents, and receipts are kept. To safeguard everyone involved in cash transactions, whenever possible, residents should be asked to sign for cash they have received. Residents said they were happy with the arrangement and said there was never any problem with getting access to their money. The home sends out quality monitoring questionnaires at least once a year. Comments from recent surveys showed that overall people are happy with the service. People said the staff are always helpful and the food is really good. Two areas for improvement were identified, these were activities and the disabled shower, and both of these are being dealt with. The records showed that the equipment and installations are checked and serviced at the required intervals. The fire alarm system is tested weekly. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 22 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP12 Regulation 16 Requirement The registered persons must make sure that residents are given the opportunity to take part in social activities that reflect their needs, preferences, and abilities. Timescale for action 29/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP27 OP35 Good Practice Recommendations The duty rotas should show the hours actually worked by staff i.e. the start and finish times or use a code to explain what hours of work the abbreviations E, L, and N refer to. Whenever possible residents should sign for cash. Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. Extracts may not be used or reproduced without the express permission of CSCI Carlton Manor Care Home DS0000033997.V331008.R01.S.doc Version 5.2 Page 25 - 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!