Inspection on 01/03/06 for Gotton Manor Care Home

This inspection was carried out on 1st March 2006.

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

Gotton Manor Care Home 20/06/08

Gotton Manor Care Home 19/10/06

Gotton Manor Care Home 04/08/05

Gotton Manor Care Home 10/12/04

Gotton Manor Care Home 17/06/04

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

CARE HOMES FOR OLDER PEOPLE Gotton Manor Care Home West Monkton Taunton Somerset TA2 8LL Lead Inspector Barbara Ludlow Unannounced Inspection 1st March 2006 11:10 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 Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 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. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gotton Manor Care Home Address West Monkton Taunton Somerset TA2 8LL 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) 01823 413118 01823 412943 Grandcross Limited(wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Susan Yvonne Stephens Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Gotton Manor - Up to 27 places for older persons of either sex, not less than 60 years of age, who require general nursing care. Gotton Manor - Up to 6 places for personal care, for persons not less than 65 years of age. The Coach House - Up to 27 places for persons over the age of 65 who require personal care. 4th August 2005 Date of last inspection Brief Description of the Service: Gotton Manor Care Home is registered in total for 60 service users, and provides nursing care for those over the age of 60 and personal care for those over the age of 65. The home is split into two sites, The Coach House and Gotton Manor. The Coach House caters for 27 people requiring personal care only. Gotton Manor caters for 27 people requiring nursing care and 6 requiring personal care. The providers are Four Seasons Health Care Ltd and the Registered Manager is Ms Susan Stephens. The home is situated in the countryside, near the village of West Monkton, about 4 miles from the centre of Taunton. There are extensive grounds, with attractive views, which are accessible to service users. Both sites share a kitchen and laundry facility. A ramp is available for wheelchair users to enter the sites. Passenger lifts and a stair lift are available to access all areas. There is a call system throughout. Locks are provided to each bedroom door. There are dining areas and large lounges available. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors for CSCI carried out this unannounced inspection. The Manager was on duty and available to assist with the inspection process. Discussion took place at the start of the inspection, confirming that the requirements made at the last inspection had been acted upon. The manager was also informed of the forthcoming changes to the CSCI programming. There were a total of 58 service users in residence and two persons in hospital. A tour of the premises was made. Service users and staff were seen and spoken with. Lunch was observed in the dining areas of the home. Visitors were also seen and spoken with. Records were sampled these included care plans, medication records, staff recruitment and maintenance records. Feedback was given to the Manager at the end of the inspection period. This was a positive inspection. The inspectors would like to thanks service users, the manager and staff for their input and assistance with the inspection process. What the service does well: What has improved since the last inspection? Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 6 There has been some redecoration completed in the coach house. The coach house kitchen has been swapped with the treatment room to improve the kitchen facility. 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. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 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 Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 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 the following standard(s): 1,3,NMS 6 does not apply. The home provides information for service users and their families/carers. A pre admission assessment is undertaken before an admission is accepted to ensure that care needs can be met. EVIDENCE: The homes current CSCI Certificate of Registration was seen on display. The home has a Statement of Purpose and Service User Guide. Contracts were not examined at this inspection. However, at the last inspection it was commented that: “The homes administrator confirmed that the company is reviewing the contract and that not all service users had contracts.” This will therefore be reviewed at the next inspection. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 9 Care plans were sampled and the homes Manager evidence of pre-admission assessments were seen and hospital discharge information, this helps to ensure that care needs can be met at the home. The home has six bedrooms in the nursing wing that are used for more ambulant service users for personal care only and are contracted by Social Services. No changes to this arrangement were identified at this inspection. Day care is offered at the home. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Service users were seen and heard to be treated well and respectfully by staff. Care planning in The Coach House was good; Gotton Manor’s care planning should be more detailed and up to date. EVIDENCE: All service users have individual care plans. The care plans sampled in The Coach House were clearly recorded; there was signed service user input into the care planning. There was evidence of good community health care service links. Regular CPN visits to the home were noted. Input by the District Nurse, Speech and language therapist and the GP’s was documented in the care plans. Service users had falls risk assessments, Waterlow and nutritional assessments. One person was reported have been a pressure sore, preadmission this was attended and care documented. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 11 Gotton Manor care plans were sampled, where a mental health care needs assessment was indicated this had not been completed and a more detailed review of care was indicated. The care given to a very frail person was examined and seen to be sufficiently detailed. There was evidence of attention to pain and symptom control. Medications management was sampled and was satisfactory. Medications that were hand transcribed were all countersigned. Control drug management was checked and was satisfactory. The pharmaceutical waste for which disposal had been arranged but was reported to be changing; this was building up in quantity and should be collected. The manager was aware of this situation. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 There is dedicated activity staff time and a range of activities is offered at Gotton Manor and the Coach House. These activities are well publicised. Meals looked appetising and service users were complimentary about the food offered. EVIDENCE: The home has an activities organiser who is waiting for CRB clearance prior to commencing working at the home. The activity programmes are well advertised around the home and are sent around to service users. These programmes are headed, Daily Activities, Weekly Activities and Excursion Programme. The home has a mobile shop (trolley) every Wednesday. At the last inspection the inspectors were informed that: “Care staff are paid to attend some outings to ensure sufficient assistance is available for example where a visit requires one to one support. Staff also Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 13 attend outings in their own time to offer their support to the service users, this is commendable.” During the afternoon the activity in The Coach House was bingo, which was to be led by the senior carer. Service users confirmed that they were looking forward to this. Care plans indicated that participation socially is encouraged. A notice in the main home, Gotton Manor, reminds staff that service users must be brought down stairs to the lounge when dressed each morning to join in with the activities. Service users that were asked said that they enjoy the activities on offer. It was reported to the inspector that one person was planning to leave the home to go where there would be more activities available. The home has trips out which are welcomed by the service users. Service users can access private services; one person was reported to be having private physiotherapy and aromatherapy. Lunch was nicely served and looked appetising. Orange juice, liver and bacon, cauliflower, roast potatoes, swede and gravy, followed by trifle and cream. Meals were served on a tray. Soft diets were served in dishes with the soft food potions served separately. Assistance was given one to one where required. Drinks were available throughout the day. Fluid charts where used, were seen to be completed and up to date. One service user confirmed that their visitors are offered cups of tea. Service users were complimentary about the food; one said it was ‘out of this world, first class’ and ‘always two choices’. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has a complaints policy and procedure. The recruitment practice is well managed to protect service users from harm. EVIDENCE: The home has a complaints policy and procedure. This is displayed in the homes main entrance hall. Visitors who were asked said they would be able to raise any concerns with the manager or staff at the home. There have been no complaints made to the home or CSCI since the last inspection. Staff files were sampled and good recruitment practice was confirmed. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 This home is well maintained and is kept clean and tidy. The bedrooms are comfortable and can be personalised. The home is equipped to meet the assessed needs of service users; there are sufficient assisted bathing and toilet facilities. Communal rooms are comfortable and well used. The Coach House communal areas have been reorganised and are well used. EVIDENCE: A tour of the premises was made. Communal lounges, dining rooms, toilets and bathrooms and individual bedrooms were seen. The home was clean and well maintained. Communal space in the Coach House has been reorganised and the conservatory is now used as a dining Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 16 room. The Coach House communal areas are in need of redecoration and refurbishing. The Coach House kitchen has been swapped with the treatment room and both refitted. The new kitchen has an opening skylight, making the kitchen light and cool. It does not have a separate hand wash basin, there is a double sink unit with liquid soap but it is not clear which sink can be used, if either, for hand washing. Advice from the Environmental Health Officer should be sought to ensure best practice. A mop and empty bucket had been left in this kitchen, these should be stored elsewhere and were to be moved at the time of the inspection. The home has been adapted for purpose and provides suitable accommodation. The areas of the home where the access is by stairs or stair lift are occupied by more able service users who are able to manage them. The home has assisted bathing facilities and sufficient toilet facilities. One room was seen that was very hot and stuffy and had malodour. This room would benefit from improved ventilation; this was discussed with the manager and should receive some attention. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 The home was adequately staffed at this unannounced inspection. Recruitment practice is carefully managed and supports the safety of service users. EVIDENCE: Two new staff personnel files were sampled; these evidenced good recruitment practice with two references and CRB checks recorded as received prior to the new recruit commencing working at the home. There are 2 full time care staff vacancies; these hours were being covered at the time of the inspection by staff working overtime. The activities post for 20 hours has been filled and the new recruit is waiting for clearance to start work. The care staff currently cover the activities, trips out and in house events. There is ongoing training to meet the statutory and ongoing training needs of the skill mixed staff group. Staff receive supervision and records are kept. There was one domestic staff shortfall but the inspector was informed that other domestic staff were managing this. There was sufficient staff on duty in all other departments. There is a Registered Nurse on duty at all times in the Care Home. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 18 Although registered as one care home, the residential care in the Coach House is led by a Care Manager who reports directly to the homes Registered Manager, Mrs Stephens. The Coach House is overseen by an experienced and NVQ qualified senior carer at all other times. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,38 The home has an experienced Registered Manager and the home is well run. The maintenance of the home was satisfactory. EVIDENCE: Ms S Stephens is an experienced nurse manager and has managed the home for a number of years. Service user and staff meetings are held and feedback is welcomed and acted upon. One service user commented that the Manager carries out her work ‘thoroughly’. Maintenance records were sampled, in house fire alarm tests are carried out each week and the last entry was 24.02.06. The fire doors and exits are Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 20 checked, there was no paperwork to record separately the emergency lighting checks each month, this was brought to the managers attention, the existing paperwork will be used to incorporate this. Three monthly tests are carried out a contractor, the report on 01.02.06 recorded that the emergency lighting system ‘need test switches’. The handyman confirmed that this work would be arranged via head office; this should be followed up. Accidents are recorded and analysed, if falls are identified then a falls risk assessment is carried out. Accident records were seen and these were appropriately recorded and stored. One sash window was seen that had been repaired following the last inspection. Hot water requirements had also been addressed since the last inspection. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 3 Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action 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 3 4 Refer to Standard OP7 OP26 OP38 OP26 Good Practice Recommendations Care plans should be more carefully reviewed for service users receiving nursing care. One room was identified with malodour, this room was poorly very hot, and some attention to improve the ventilation should be made. The emergency lighting test switches should be considered in line with the contractor’s recommendation for the system. The Coach House kitchen, staff hand washing facility is not identified. The advice of the Environmental Health Officer should be taken to confirm a best practice solution. Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Gotton Manor Care Home DS0000003261.V278821.R01.S.doc Version 5.1 Page 24 - 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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