Inspection on 24/05/05 for Iden Manor Care Home

This inspection was carried out on 24th May 2005.

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

Iden Manor Care Home 14/10/08

Iden Manor Care Home 19/12/06

Iden Manor Care Home 06/10/05

Iden Manor Care Home 31/01/05

Iden Manor Care Home 11/10/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Iden Manor Care Home Cranbrook Road Staplehurst Tonbridge Kent TN12 0ER Lead Inspector Gary Bartlett Unannounced 24 May 2005 10:00 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 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. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Iden Manor Care Home Address Cranbrook Road Staplehurst Tonbridge Kent TN12 0ER 01580 891261 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Whitepost Health Care Centre CRH Care Home 45 Category(ies) of Dementia (20) registration, with number Old age (25) of places Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users between 55 and 65 years of age that have physical and mental conditions usually associated with older persons may be admitted. 2. The following rooms have been identified for service users experiencing difficulties with memory loss or a diagnosis of dementia. Rooms 32, 33, 34, 35, 36, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, and 51. 3. It has been agreed that room numbers 36 and 50 can be shared by married couples or siblings who request this facility. Date of last inspection 31 January 2005 Brief Description of the Service: Iden Manor Care Home is owned and operated by Whitepost Health Care Centre. It is a Victorian Manor House situated in fifteen acres of land on the edge of Staplehurst. Staplehurst offers the usual facilities of a small town and has a mainline railway station. Currently, phases one and two have almost been completed and the Home provides 25 beds for low dependency service users and 20 beds for dementia care. The Home is being developed in four phases, the intention being to eventually provide a total of 51 nursing care beds. A shaft lift and stair lift provides access to the first floor. There is car parking to the front.The Home employs care staff that work a roster that gives 24-hour cover. The Home also employs other staff for catering, domestic and maintenance tasks. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission was represented by Gary Bartlett and Harbinder Ghir, Regulatory Inspectors who were in Iden Manor from 10.00 a.m. until 4.30 pm. During that time some residents, a visitor and staff agreed to speak with the Inspectors. Parts of the Home and some records were inspected. Due to the nature of the service provided by the Good Shepherd Wing it is difficult to reliably incorporate accurate reflections of residents’ reflections of that service in the report. The focus of the inspection was to assess progress made to meet notified required and recommended actions in the last inspection report, gaining evidence against standards from records, observation and discussion. What the service does well: What has improved since the last inspection? What they could do better: Residents would benefit from increased staffing levels at peak times of activity. Residents’ financial interests would benefit from more regular audits of the records kept. The R.G.N’s work diary must be maintained in such a way as to preserve confidentiality. To ensure residents’ safety, all staff must complete the induction programme and participate in fire training/practices. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 6 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. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 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 standard(s) 3 and 5 Residents can be confident that they are appropriately placed due to good preadmission assessments and benefited from being able to visit the Home prior to admission. The Home does not provide intermediate care. EVIDENCE: The Deputy Manager described how a pre-admission assessment was made of each prospective resident using an aide-memoir. The records seen included a medical history, activities of daily living, usual reliance on medical services, and any existing care manager or nursing assessments. Prospective residents, their families, advocates, and relevant health care professionals were involved in the assessment process. Residents said they or their families had been able to visit Iden Manor before moving in. This was confirmed by a relative present. They also said staff had been very helpful in assisting them to settle in. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 9 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 standard(s) 8 and 10 Residents’ health needs were well met with evidence of good multi disciplinary work taking place. Personal care was offered to residents in a way that protected their privacy and dignity and promoted independence. EVIDENCE: Records seen and discussion with staff and residents indicated that residents were able to have access to appropriate health care professionals as and when required. A Community Psychiatric Nurse visited the Home during the inspection. Residents felt that staff were kind and gentle, this was confirmed by observation. Staff were seen to be very considerate of the age and dignity of residents and to treat them with courtesy. Privacy was maintained through lockable toilet and bathroom doors and residents could meet with visitors and make telephone calls in private. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12, 13 and 14 Residents had some choices about their daily lives, were able to have visitors at any reasonable time and enjoyed continued links with the local community where this was their preference. Social activities were well organised and creative. Residents would benefit from greater availability and, on the Good Shepherd Wing, from staff having more specialist knowledge in providing activities for people with cognitive and sensory impairments. EVIDENCE: Most residents said the routines of daily living were tailored to their individual preferences as far as was practicable, although one resident indicated they would like to be given a wider range of choice such as having a “lie-in”. On a positive note, another resident said they got up at time that suited them and of staff “if you want to ask them anything, they’ll help you.” Concerning choice of meals a resident mentioned they “did not feel comfortable asking for a different choice as had been refused before”. Most residents were happy with the choices provided saying “lovely food” and “very nice” although one considered the meals to be “boring”. During the inspection a number of visitors were seen in the Home and the visitor’s book recorded regular visits by families, friends and others. A visitor Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 11 said they were welcome at the Home at any reasonable time and a resident mentioned “we get quite a few visitors here”. The Manager (designate) stated it was intended for the Home to have its own minibus. Residents would benefit from this as the outings that had been arranged had been very popular. A staff member had identified training to broaden their understanding of working with people with cognitive and sensory impairments and supervising reminiscence sessions. It evident that the staff member was supported to attend a two-day course but not a five-day course that would more fully benefit the service to residents. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 12 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 standard(s) These Standards were not inspected. EVIDENCE: Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The standard of the environment within the Home was very good providing residents with an attractive, homely and safe place to live. EVIDENCE: Those parts of the Home inspected were clean and free from unpleasant odours. Residents said they were happy with their rooms and welcomed the opportunity to personalise them and had ready access to all parts of the Home they needed. The Manager spoke of plans for an alternative arrangement of the dining/communal living area in the Good Shepherd Wing to afford the residents more spacious accommodation when it was fully occupied. Framed photographs of the occupant of each bedroom in the Good Shepherd Unit had been put on the doors to promote residents’ independence and ability to identify their bedrooms. Hoists and wheelchairs were provided where there was assessed need and assisted bathing and toilet facilities were available to residents. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 14 Residents told the Inspectors that the current communal toilet and bathing facilities were adequate to meet their needs and had been enhanced by the provision of 2 toilets for persons with a physical disability close to the lounge area. The responsible person spoke of the further benefits that would be provided to residents with the installation of en-suite facilities to bedrooms established as phase one of the Home later this year. The temperature of the hot water was tested at several outlets and was at a safe temperature. The hot water pressure in a first floor bathroom was found to be low. A staff member confirmed that running some baths on the first floor was a protracted business that sometimes caused inconvenience to residents. Staff were seen to effectively maintain infection control to promote residents’ health. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Residents would benefit from increased staffing levels at peak times of activity. Recruitment processes are robust and offer protection to people living at the Home. EVIDENCE: Several residents spoke of their frustration and sometimes discomfort caused by having to wait for assistance from staff at busy times of the day. One resident stated there was “not enough staff overall, they are very busy”. This was confirmed by observation and by a visitor who said “there could be more staff here at times, after meals etc when residents need help toileting”. Residents spoke highly of staff and the staff rosters inspected did not indicate that staff were working overly long shifts or for protracted periods of time with inadequate time off. Threre staff files were inspected and indicated residents were protected through the use of robust staff recruitment processes. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 37 and 38 The Home had improved systems to protect residents’ financial interests that would benefit from more regular audits. Residents’ rights and best interests would be better safeguarded by improved confidentiality in record keeping. The Home could not demonstrate it was able to ensure residents’ safety in that not all staff had undertaken fire training or regular fire drills. Environmental risk assessments needed to be conducted more often to identify and address potential hazards to residents. EVIDENCE: Residents were encouraged to manage their own financial affairs or to have assistance from their families / representatives, although the Home would hold small quantities of cash for residents if requested. A simplified and improved system of holding and recording residents’ cash by the Home had been Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 17 introduced. The system certainly improved ease of monitoring. The Manager mentioned they were updating the records further to include residents’ signatures in the records. Two amounts of monies held were checked against the records. Whilst one amount balanced, the other did not by a few pence. This indicated residents’ interests would be better safeguarded by more regular audits of the amounts held. Residents did not express any concerns about the Home’s management of monies or valuables held on their behalf. The two care plans inspected were well maintained and preserved confidentiality. Unfortunately, residents’ privacy was not maintained through the collective recording of personal information in the R.G.N’s work diary. During the inspection areas identified by the Inspectors as being in need of repair to ensure residents’ safety were very quickly addressed. The Inspectors advised that these matters, (loose carpets and a scorched bedside lamp), would have been noticed by the Home through more frequent environmental risk assessments. Staff were seen to be diligent in minimising risks to residents by carefully placing equipment to avoid obstruction. Records seen indicated that some staff had not had fire training or participated in fire drills at the frequency recommended by the Fire Safety Officer. Records of maintenance and safety checks were not inspected. Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 x COMPLAINTS AND PROTECTION 3 2 2 3 3 3 2 3 STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x 2 x 2 2 Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 35 Regulation 17(2) Schedule 4 Requirement The registered person shall maintain in the care home a record of all money or other valuables deposited by a service user for safekeeping or received on the service users behalf in that these records must be accurate “The registered person shall make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users”, in that personal information must be kept confidential “The registered person shall ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home and, so far as practicable, service users, are aware of the procedure to be followed in case of fire, including the procedure for saving life” in that fire training must be provided at regular intervals. This refers to all staff, including night staff. Timescale for action To be completed by 30 June 2005 if not sooner 2. 37 12(4)(a) To be completed by 30 June 2005 if not sooner 3. 38 23(4) Action plan to be received by 17 June 2005 Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 20 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 12 Good Practice Recommendations It is recommended that relevent staff are encouraged and enabled to attend the most appropriate training courses available in providing activities, with particular regard to working with people with cognitive and sensory impairments and supervising reminiscence training. It is recommended a review be undertaken as to whether service users would benefit from the provision of additional staff hours dedicated to providing activities taking into account the size and layout of the Home. It is recommended residents are consulted to ensure the Home is being conducted so as to consistently maximise their capacity to exercise personal autonomy and choice. It is recommended consideration is given to an alternative arrangement of the dining/communal living area in the Good Shepherd Wing. It is recommended the deferred installation of en-suite facilities to bedrooms established as phase one of the Home be completed as soon as possible It is recommended the hot water supply to the first floor bathrooms be improved where required It is strongly recommended that a review of staffing levels at peak times of activity be undertaken It is recommended environmental risk assessments be undertaken more frequently 2. 12 3. 4. 5. 6. 7. 8. 14 20 21 22 27.4 38 Iden Manor Care Home H56-H06 S45153 Iden Manor V219986 240505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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. 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