Inspection on 26/02/09 for Dean Wood Manor

This inspection was carried out on 26th 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

Dean Wood Manor 22/05/08

Dean Wood Manor 22/08/07

Dean Wood Manor 20/12/06

Dean Wood Manor 11/05/06

Dean Wood Manor 27/02/06

Dean Wood Manor 11/10/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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: Dean Wood Manor Spring Road Orrell Wigan Greater Manchester WN5 0JH     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: Michael Murphy     Date: 2 6 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 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Dean Wood Manor Spring Road Orrell Wigan Greater Manchester WN5 0JH 01942223982 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : deanwoodmanor@mimosahealthcare.com Mimosa Healthcare Limited care home 50 Number of places (if applicable): Under 65 Over 65 0 1 0 dementia old age, not falling within any other category physical disability Additional conditions: 50 0 1 The registered person may provide the following category of service only:- Care home with nursing - Code N To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Old age, not falling within any other category - Code OP (maximum number of places: 1) Physical disability - Code PD (maximum number of places: 1) The maximum number of people who can be accommodated is: 50. Date of last inspection Brief description of the care home Dean Wood Manor is located off the main Orrell to Standish road. The premises comprising Dean Wood Manor are based around an original Grade II listed building that has been extended to provide care and accommodation to a total of 50 people in the main for people suffering with dementia. The home provides care and accommodation for people requiring residential care and nursing care. The gardens Care Homes for Older People Page 4 of 25 Brief description of the care home surrounding the home are extensive and well presented. Car parking for visitors is good. Fees range from 362.27 pounds to 550.00 pounds per week. Please contact the home for further details Care Homes for Older People Page 5 of 25 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: This inspection included an unannounced visit to the home on the 26th February 2009 between 9am and 5pm. During the visit we talked to residents, relatives, staff and the new home manager. We also looked at documents and records the home have to keep such as residents care records, medicine records, written policies and other records. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Older People Page 7 of 25 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 8 of 25 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. Peoples needs are assessed before they move into the home to ensure that their care needs can be met. Evidence: Before being admitted prospective residents are assessed by senior staff from Deanwood manor. The purpose of this assessment is to make sure the home can look after them properly by meeting their care and support needs. Residents and their family were actively involved in these assessments and their views were taken into account. The assessment before admission is used to develop the plan of care to be developed following admission to the home. Additional information is also obtained from assessments that have been done by social workers. All newly admitted residents have their placement formally reviewed within about 6 weeks of admission. The new home manager informed us that she was currently reviewing the information that is provided for prospective residents and their relatives. Care Homes for Older People Page 9 of 25 Care Homes for Older People Page 10 of 25 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. The health and personal care that people receive is based on their individual needs so they receive personal care in a way they prefer and in a way that shows respect for their privacy and dignity. Evidence: The way care records are kept have been reviewed and (as we required) improved since the last inspection. The care records of 3 residents were looked at during the inspection. These contained care plans that describe how each individual resident needs to be supported and cared for properly. The care plans also identified what residents could do for themselves, which helps them maintain their independence. Care records also identified what areas of risk were an issue for individual residents and how such risks could be reduced. For example identifying the risk of poor mobility and describing what to do to maintain mobility as safely as possible. Care records looked at were being reviewed regularly and up to date. However it is recommended that the daily progress notes made by staff are all timed to ensure a completely accurate record is made. Residents were registered with a local GP and were accessing Care Homes for Older People Page 11 of 25 Evidence: health care services such as those provided by opticians, chiropodists, district nurses and other specialists. Residents medicines were being looked after properly and those requirements we made at the last inspection about medicines in the home have been addressed. Medicines were kept securely and residents medicine administration records were properly documented. Medicines were looked after and given to residents by the nursing staff who have had appropriate training in doing so. Residents and visitors spoken to said that staff were respectful to them and sought to protect the privacy and dignity of residents at Deanwood manor. Comments included I feel that the nurses and staff look after me in the right way, they always knock on my door before they come in and I do feel that my privacy and dignity are respected, the staff care for my relative well and seem to be concious not to make the residents feel embarrassed when they are being cared for, I think the staff are hardworking and have a pleasant and caring manner, certainly my relative has been very content and settled since coming here. Care Homes for Older People Page 12 of 25 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. Residents are encouraged to maintain contacts with family and friends, to make personal choices in their daily life and join in social and leisure activities. The quality of the food is said to be consistently good. Evidence: A variety of leisure and social activities were being provided and included arts and craft sessions, table games, armchair exercises, singsongs, music and discussions about times gone by. Residents are able to go on regular outings. Trips since the last inspection include Blackpool illuminations, Knowsley safari park and an outing on a canal barge. Entertainers visit the home about once per month. The home also organise an annual garden fete in the grounds and an annual plant sale. The home was well provided for in respect of televisions, DVD players, music centers, radios and books/magazines. Photographs of residents enjoying the various activities, events and outings were displayed throught the home. Home routines although fairly structured appear to be as reasonably flexible as is practical in a care home setting. Discussion with residents, relatives and staff indicate that residents are enabled to maintain contact with family and friends and there were no unreasonable visiting Care Homes for Older People Page 13 of 25 Evidence: restrictions. Residents can receive their visitors in private - either in their own room or a quieter lounge area in the home. Discussion with residents, relatives, staff indicate that residents are encouraged and enabled to make choices and exercise control over their lives, whilst at the same time being kept safe. Comments made by residents included I am able to get up and go to bed whenever I want to, I can choose how much time I spend in my room or the lounge, I have the choice of what I want to eat and drink and staff respect all the choices I make. Dining areas were pleasant, suitably heated, well lit and ventilated. They were suitably/appropriately furnished and tables were appropriately set. Menus were varied, balanced and provided choice. Mealtimes were reasonable and as flexible as possible in a care home setting - especially breakfast when residents are provided with their breakfast as they get up. Lunch was observed on the day of this unannounced inspection. This was a hot substantial meal, good portions were provided and the meal was well presented. Residents were seen to enjoy this meal. Staff served and assisted residents appropriately and sensitively. Meals are prepared by a qualified cook. Care staff did not prepare meals - although they do prepare light snacks outside main meal times as required. Residents spoken to and comments from visitors and staff indicate food is of a consistently good quality, alternatives to the menu can always be had and light snacks and drinks are provided at all times. We were informed by the manager that the kitchen was to be refurbished soon after this inspection. Care Homes for Older People Page 14 of 25 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. There is an accessible procedure in place to deal with complaints. Staff have been provided with recent safeguarding training and there are procedures in place that describe how to protect residents and keep them safe. Evidence: Information on how to make a complaint was prominently displayed in the home. This information detailed who to contact and how the complaint would be dealt with. A complaints record is kept by the home - 1 formal complaint had been recorded since the last inspection in May 2008. This appeared to have been dealt with properly. Discussion with residents and relatives indicated that manager and senior staff are available and that any issues raised are dealt with promptly and rarely need to become formal complaints. The home operates safeguarding and whistle-blowing policies (including those developed locally and operated by Wigan social services) that seek to keep residents safe. Staff spoken to were aware of the importance of safeguarding and protecting residents and described their role in doing so. They confirmed they have been provided with recent safeguarding training. Inspection of training records submitted to us show that safeguarding training has been provided to all staff at the home as required at the last inspection in May 2008. There has been 1 safeguarding referral (involving a number of residents at the home) made to Wigan social services since the last inspection in May 2008. This referral was made by the then home manager following Care Homes for Older People Page 15 of 25 Evidence: an alert by staff at the home. Care Homes for Older People Page 16 of 25 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 provided a clean, pleasant, comfortable and suitably adapted environment for residents. Evidence: The building appeared to be in a good state of repair and decoration. The lounges and dining areas were clean, appropriately and adequately heated, comfortably and appropriately furnished and provided a suitable environment for residents to be cared for and supported properly. Televisions, music centers and other leisure equipment were available throughout the home. Suitably adapted bathing and toilet areas were provided. The home has generally been suitably adapted and equipped to meet the needs of residents. For example there is an adequate provision of hoists, grab rails, and other equipment. Individual residents specialist needs are met after referral to the appropriate health care worker for assessment. Residents bedrooms that were inspected were clean, suitably furnished and equipped and some were very personalized. The home was very clean and odours were managed well. Suitable arrangements were in place to manage residents laundry needs. And appropriate measures were being taken to minimize the potential spread of infection within the home such as adequate hand washing facilities and the provision of protective clothing for staff as well as appropriate cleaning practices within the home. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 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. The staffing arrangements, staff recruitment process and the training arrangements at the home seek to ensure residents are cared for and supported safely and appropriately. Evidence: Staffing arrangements at the home were supporting residents and ensuring their needs were met. There is always a qualified nurse on duty who leads a team of carers. Discussion with residents, relatives, staff and the new home manager (who has conducted a review of staffing provision) revealed they were of the view sufficient staff were available to make sure suitable care and support was provided. There were also appropriate arrangements in place to ensure there were sufficient staff in respect of the administration, catering, laundry and housekeeping functions of the home. There is a proper process in place in respect of recruiting staff. This is important to ensure residents are being cared for and supported by suitable people. The recruitment process included making police checks and another check regarding the suitability of the applicant working with vulnerable people. There were suitable arrangements for training staff to ensure that residents care and support needs are being met by competent staff. Discussion with the manager, staff and inspection of training records revealed that a well organized and in the main suitable training programme was in place in respect of all staff employed at the home. Care Homes for Older People Page 19 of 25 Evidence: However discussion with the home manager and inspection of training records identified the need to provide staff with updated training in respect of dementia. This is important to ensure staff are able to care for and support residents suffering with dementia confidently and skilfully. A few days after this inspection the home manager informed us that such training had been organized for all staff at the home. Training is provided at the home and through the local authority training partnership. Training records were detailed and up to date. Over 50 of the care staff have obtained a national qualification in care (NVQ). The remaining carers were undergoing this training or expected to do so in the near future. Care Homes for Older People Page 20 of 25 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 was being managed effectively and in the best interests of residents. Evidence: A new home manager has been appointed since the last inspection in May 2008. She is a qualified psychiatric nurse. We were informed that it is intended to propose the home manager to be the registered manager of the home. This means that the manager will apply to be registered as the manager of the home with the CSCI. This is a legal requirement and the process should begin as soon as possible. Discussion with residents, relatives and staff indicate that the manager makes herself available, is approachable, listens and manages the home properly. A system of checks were in place to ensure the home is properly run. For example checks were being made and documented about how good or effective things like care records were being kept, how safe medicines were being handled and how safe and comfortable the environment was for residents. Staff meetings are regualrly held to provide them with information and establish their views. This is important as people Care Homes for Older People Page 21 of 25 Evidence: need to be confident their opinions are listened to and acted upon. The manager informed us that she was trying to establish a relatives group to support them and seek their views on the home. Residents relatives are encouraged to manage residents monies where they are unable to do so themselves. However where this is done by the home the arrangements are secure and appropriately documented. There are arrangements in place to ensure as far as is practicable the health, safety and welfare of residents, staff and visitors. For example action has been taken to ensure the safe storage and disposal of hazardous substances, regular servicing of boilers and the central heating system and other equipment, and the proper maintenance of electrical and gas systems in the home. Also safe practices are encouraged by the use of proper moving and handling techniques and equipment, fire safety provision, first aid training for care staff, food hygiene training and measures to prevent the spread of infection. Care Homes for Older People Page 22 of 25 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 23 of 25 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 1 7 To ensure records are fully accurate all daily progress entries in the care records should be timed. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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