Inspection on 19/10/06 for Gotton Manor Care Home

This inspection was carried out on 19th October 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 01/03/06

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 Shelagh Laver Key Unannounced Inspection 19th October 2006 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 Gotton Manor Care Home DS0000003261.V316715.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. Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 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.V316715.R01.S.doc Version 5.2 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. 1st March 2006 Date of last inspection Brief Description of the Service: Gotton Manor Care Home is registered for 60 service users. It is split into two sites, Gotton Manor and the Coach House. Gotton Manor caters for 27 people requiring nursing care and 6 requiring personal care. The Coach House caters for 27 people requiring personal care only. The providers are Four Seasons Health Care Ltd; 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 beautiful grounds that 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 separate dining areas and lounges available. Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 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 was available to assist the inspectors throughout the day. Discussion took place at the start of the inspection, confirming that the requirements made at the last inspection had been acted upon. The manager discussed the planned refurbishment to the Manor and the Coachhouse that is planned in the near future. There is to be a re-fit of the kitchen plus extensive redecoration of communal areas. The home is currently homely and comfortable. There were a total of 58 service users in residence. 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: The home is well managed. The manager has a clear vision of the standards that should be attained in the home and is pro-active in ensuring they are maintained. Gotton Manor is well presented, clean and well maintained. It has well kept gardens and grounds. Care plans for service users in The Coach House demonstrated a person centred approach to care and were well constructed. Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 Page 6 Staff spoken to during the inspection were able to describe recent training they had received. There is a team approach in the home that enabled a domestic vacancy on the day of inspection to be covered by a senior member of staff. Staff are encouraged to progress and take additional responsibility. There was very positive feedback from service users throughout the home. Staff were referred to as “very kind”. Another said, “It is very comfortable here.” A service user who had been at the home for four years said, “It is a lovely place. The care is marvellous.” In praise of the trained nurses one person said, “ good as gold…look after me and see if I want anything…” The home is developing skilled care for service users at the end of their lives by implementing the Gold Standard framework and Liverpool Pathway. These are comprehensive care initiatives that are designed to encompass many aspects of palliative care. The home is investing in training in this area for trained staff. 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. Gotton Manor Care Home DS0000003261.V316715.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 Gotton Manor Care Home DS0000003261.V316715.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): 1 2 3 4 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 examined and these detailed clearly the cost of care. Care plans were sampled and the homes Manager evidence of pre-admission assessments were seen and hospital discharge information, this helps to Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 Page 9 ensure that care needs can be met at the home. There is planned preparation for admissions that includes a detailed room check. 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.V316715.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 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were seen and heard to be treated well and respectfully by staff. Care planning in The Coach House and Gotton Manor was comprehensive. Service users were seen to be treated well and spoken with respectfully by staff. EVIDENCE: Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 Page 11 All service users have individual care plans. The care plans sampled in The Coach House were detailed and 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. A detailed social history is recorded. Daily records are particularly detailed and informative. There was evidence that sound nursing care is provided at Gotton Manor. There was evidence that wounds were healed and that appropriate interventions were in place to promote service users health. The home will admit service users with pressure damage and put appropriate assessment and treatment in place. There is a monthly evaluation of dependency levels. There was evidence of risk assessment for service users who were able to self medicate. Medications were organised and well managed. Hand transcribed entries on charts were all countersigned. It is good practice to sign and date anything that is written on a MAR sheet. Controlled drug management was checked and was satisfactory. Gotton Manor Care Home DS0000003261.V316715.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. Service users are supported and encouraged to spend their day as they chose. 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: Service users spoken to throughout the inspection were able to describe the different ways in which they spent their day. Some people chose to spend a lot of time in their rooms. Others enjoyed joining in the activities or spending time in the communal areas. A service user summed this up by saying “We can do what we like it is up to us.” The home has a pro-active activities organiser. The home is developing a series of clubs including gardening, art and photography. Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 Page 13 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. Activities were observed during the inspection. In the morning in the Manor there was flexercise and in the afternoon a film was shown. Care plans indicated that participation socially is encouraged. Service users that were asked said that they enjoy the activities on offer. 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. There was a choice that included spaghetti bolognaise and chicken in cream sauce. Staff should remember it is good practice to sit down when assisting service users to eat their meals. Meals were served on a tray if required. Soft diets were served in dishes with the soft food portions 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 and confirmed there was choice. One service user would like the choice of a cooked breakfast at weekends. One service user had guests who came to lunch, his was pre arranged with the home. A table was nicely prepared in the bedroom and staff served lunch and drinks. This was nicely done and appreciated by the visiting family. Gotton Manor Care Home DS0000003261.V316715.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. 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.V316715.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 22 23 24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 Page 16 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. The spacious entrance hallway to Gotton Manor is well presented. The visitors book, useful information about the home, the registration certificates, complaints procedure and event notices are well displayed. A tour of The Manor found the environment clean and fresh smelling. A tour of the Coach House showed bedrooms were comfortable and personalised. Some have lovely views and the building was very clean and pleasant. There are plans to redecorate and refurbish the Coach House communal areas. In response to quality audits bedroom curtains have been replaced. The home has been adapted for purpose and provides suitable accommodation. More able service users who are assessed as able to manage them occupy the areas of the home where the access is by stairs or stair lift. The home has assisted bathing facilities and sufficient toilet facilities. Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 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. 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. The home was adequately staffed at this unannounced inspection. Recruitment practice is carefully managed and supports the safety of service users. EVIDENCE: The recruitment procedures have been reviewed and up-dated in line with the new recruitment manual. 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. Staff receive supervision and records are kept. There was sufficient staff on duty in all departments on the day of the inspection. A reviewed Induction pack has been received for new care workers. Evidence was seen that staff receive regular training including one manual Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 Page 18 handling and two fire training up-dates each year. NVQ training is on-going with four staff currently waiting to commence training. A monthly training return records the training that has taken place in the home. Professional development and up-dating for trained nurses is well established. Nurses have recently undertaken training in palliative care, bowel care and venepuncture. Training is arranged on an individual basis to meet the needs of the home and the interests of the staff. There is a Registered Nurse on duty at all times in the Care Home. 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.V316715.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 34 35 36 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 Page 20 Service user and staff meetings are held and feedback is welcomed and acted upon. Service users knew who the Manager was and some said she had visited them to “sort things out”. Maintenance records were sampled; in house fire alarm tests are carried out each week. Hoists and lift maintenance was up-to-date. The home has maintenance contracts on most equipment. 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. Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 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 3 3 3 3 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 X 3 Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 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 Refer to Standard OP15 Good Practice Recommendations Staff should sit down when assisting service users to eat at meal times. Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Gotton Manor Care Home DS0000003261.V316715.R01.S.doc Version 5.2 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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