Inspection on 25/02/09 for Carlton Manor Care Home

This inspection was carried out on 25th February 2009.

CSCI found this care home to be providing an Good service.

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 22/02/07

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

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Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Carlton Manor Care Home Parkfield House 23 Parkfield Road Bradford West Yorkshire BD8 7AB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary Bentley     Date: 2 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Carlton Manor Care Home 23 Parkfield Road Parkfield House Bradford West Yorkshire BD8 7AB 01274544374 01274491985 carltonmanor@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Carlton Nursing Homes Ltd Name of registered manager (if applicable) Michelle Ann Holstead Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 30 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 30 Dementia Code DE, maximum number of places 30 Physical Disability, Code PD, maximum number of places 5 Date of last inspection Brief description of the care home Carlton Manor was originally built as a private residence and later used as a Convent before being converted to a care home. It is situated in secluded grounds, ideally located for easy access to Bradford City centre. There are regular bus services to many Care Homes for Older People Page 4 of 26 care home 30 Over 65 30 0 0 30 Brief description of the care home local amenities and there is ample parking for visitors. The home provides personal and nursing care for 30 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. There is a ramp at the side entrance which provides access for wheelchair users. The communal rooms are on the ground floor and consist of three lounges and a large dining room. One of the lounges in the designated smoking area. In February 2009 the fees ranged from 383.00 to 1500.00 pounds per week. The home offers services such as hairdressing and holidays which are not included in the fees. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection was carried out on 22 February 2007. Since then we have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward to this report as recommendations but only when it is considered that people using services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely enforcement action will be taken. During the inspection we spoke to people living in the home, visitors, staff and management. We looked at various records including care plans, staff files and maintenance files and we looked around the home. Care Homes for Older People Page 6 of 26 This inspection was unannounced and was carried out in one day by one inspector between the hours of 9:30 and 4:45. Before the visit we sent surveys to the home to distribute. These included surveys for people using the service, staff and visiting health care professionals. Only one was returned. We asked the home to complete a self-assessment (Annual Quality Assurance Assessment). This was completed and returned to us in good time and contained all the information we asked for. What the care home does well: What has improved since the last inspection? What they could do better: There are no requirements following this inspection. Some people said they would like to see more opportunities for people to go out. Care Homes for Older People Page 8 of 26 The home identified some areas for improvement in their self-assessment and others were discussed with the manager during the visit. These include making sure that people using the service are given information about the results of the homes quality assurance questionnaires. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not move in until their needs have been assessed and whenever possible people or those close to them are involved in this assessment. Evidence: The home told us that peoples needs are always assessed before they move in and we saw evidence of this in the records. The manager understands the importance of considering the needs of people already living in the home when she is doing preadmission assessments for new people. The home encourages people to visit or have a trial stay before moving in permanently. One person told us her daughter had visited the home on her behalf before she moved in. The home is updating the Statement of Purpose to make sure people are given clear Care Homes for Older People Page 11 of 26 Evidence: and up to date information about the range of services offered. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met in a way that takes account of their wishes and abilities and their privacy and dignity are respected. Evidence: We looked at three peoples care plans. The care plans are well organised and information is easy to find. The care plans set out how peoples personal and health care needs are to be met. The care plans are kept up to date and reviewed every month. We saw that in most cases people or those close them are involved in drawing up and reviewing the care plans. People living in the home told us they are well cared for and we received similar comments from relatives. There are appropriate risk assessments in place, for example in relation to nutrition, falls and pressure sores. Where risks are identified care plans have been put in place to show how these risks will be managed. Other areas of risk such as when people go out alone are also identified. Care Homes for Older People Page 13 of 26 Evidence: The record showed that people have access to a range of NHS services and where necessary the home seeks specialist advice. For example they get advice on the management of wound care from the Tissue Viability nurses. The daily notes could be improved by including more information about peoples general well being and/or how they spend their time. This was discussed with the manager. Staff have recently had training on palliative care and the home has started to develop end of life care plans for people. This is good practice as it helps to make sure that when people reach the end of their lives they are cared for in accordance with their wishes. Medicines are managed safely. Some people manage their own medicines and the appropriate risk assessments are in place. One health care professional said they would like to see more people in the home being encouraged and supported to manage his/her own medicines. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given the opportunity to take part in a variety of social activities which take account of their abilities and preferences. People are encouraged to make choices about their lifestyle and are supported in making the most of their abilities. Evidence: Peoples care records include a personal profile which has information about their life experiences, their present circumstances and their interests and hobbies. This information is used to develop social care plans dealing with peoples social, cultural and spiritual needs. The activities records show that people take part in a variety of events such as quizzes, music and chair exercises. Aromatherapy, massage and physiotherapy are provided twice a week. The home organises outings which include going to the theatre, the pub and shopping trips. Some people go away on holiday. The home has employed an activities organiser who is very enthusiastic about her role. People told us that activities have improved. Some people said they thought this could be further improved by giving people more opportunities to go out. Daily routines are flexible. The home understands the need to balance risks and Care Homes for Older People Page 15 of 26 Evidence: benefits and supports people in maintaining their independence. There is plenty of communal space and this means that there is room for people with different interests to get together. For example, the smokers lounge is used more by some of the younger people who live in the home. There is a kettle in this lounge so that people can help themselves to drinks. The home has a computer which is accessible to people living in the home. Age Concern is going to provide training for people who are interested in developing their computer skills. People are supported in keeping in contact with their family and friends. Visitors are welcomed at any time and are offered refreshments. People told us they enjoy the food and confirmed they have meetings with the chef to discuss changes to the menu. People are offered choices at every meal and the menus are clearly displayed in the dining room. People can choose whether to eat in the dining room or in their own rooms. The meal service at lunch was well organised and people were given time to enjoy their food. Staff were available and where necessary helped people discreetly. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are dealt with appropriately and there are suitable systems in place to make sure that people are protected from abuse. Evidence: The manager works hard to create an open atmosphere and encourages people to talk to her if they have any concerns. The home keeps detailed records of all complaints and this includes information on the outcome. The homes records show that they have had 7 complaints since we last visited in February 2007 and all these have been dealt with. No complaints have been referred to us. The manager is aware of the local safeguarding (adult protection) procedures and makes appropriate referrals when necessary. All staff receive training on safeguarding and are aware of how to report any concerns they might have about peoples welfare. Training has taken place on the Mental Capacity Act and more training is planned to help make sure staff are aware of their legal responsibilities in protecting the rights of the people they are caring for. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, comfortable and pleasant place for people to live. Evidence: When we visited the home was clean and there were no unpleasant odours. There is an ongoing programme of redecoration and refurbishment. For example since our last visit the first floor bathroom has been converted to a wet room making it much easier for people to use. The home has plenty of communal space for people to use. This is on the ground floor and consists of a dining room, two lounges and a separate smoking area. These rooms are suitably furnished and decorated to a good standard. The bedrooms are suitably equipped and we saw that people are encouraged to have some personal belongings such as photographs and ornaments in their rooms. People can have a key to their bedroom if they wish. The laundry is in the basement and is very clean, tidy and well organised. The majority of staff have had training in the control of infection and the arrangements for reducing the risk of cross infection are generally satisfactory. Some of the pull cord light switches are looking the worse for wear and should be replaced. The manager said she Care Homes for Older People Page 18 of 26 Evidence: would deal with this. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough suitably trained and competent staff available to meet peoples needs. People are protected because all the required checks are done before new staff start work. Evidence: There are usually 4 care staff and a nurse on duty all day. Overnight there are 3 staff one of whom is a nurse. People did not raise any concerns about the availability of staff and said that when they use their call bells to summon help staff generally respond quickly. Separate staff are employed for housekeeping and catering. The home told us that they carry out all the required checks on new staff before they are allowed to start work and the staff files we looked at confirmed this. New staff have a full induction using the Skills for Care induction standards. These are national standards designed to help make sure new staff get the knowledge and skills they need to care for people properly. The training records showed that staff have access to a good range of training. Subjects covered recently include dementia care, equality and diversity and the Mental Capacity Act. The company recently employed a training manager and this has helped Care Homes for Older People Page 20 of 26 Evidence: to make sure that all staff are provided with appropriate training. All but one of the care staff have done or are doing an NVQ (National Vocational Qualification) in care at Level 2 and some who have completed Level 2 are working towards Level 3. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately managed and provides good quality outcomes for people. Evidence: The registered manager has worked at the home for approximately 8 years. She is a nurse and has completed the registered Managers Award. She keeps up to date with training and has recently attended courses on subjects such as palliative care and cultural awareness. She is not included in the staff numbers however she does occasionally provide nursing cover for example when staff are on holiday. The manager is approachable and encourages an open and relaxed atmosphere where people are encouraged to share any concerns they might have. Questionnaires are sent to people using the service once a year. Last year the surveys were sent from the companys head office. The results of the questionnaires were not shared with the home or the people use the service. In order for the questionnaires to be an effective part of the homes quality assurance systems the results should be Care Homes for Older People Page 22 of 26 Evidence: analysed. The information should then be used to give feedback to people using the service, to identify areas where the home is performing well and to identify areas for improvements. The home has introduced a system for internal audits to make sure that standards are maintained across all areas of the service. A senior manager visits the home at least once a month to monitor the quality of the service and provide support for the manager. Records of these visits are kept in the home. There are meetings for people living in the home where they have the opportunity to have their say about how the home is run. People are also involved in an annual formal review of their care. Staff meetings take place approximately every two months. There are systems in place to make sure that staff have regular supervision and appraisals are done once a year. The home holds money for some people. All transactions are recorded and receipts are kept for any money spent on peoples behalf. Whenever possible people sign for the money they receive. In their self-assessment the home told us there are suitable health and safety systems in place and the records we looked at confirmed this. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!