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Inspection on 30/08/05 for Manchester Court

Also see our care home review for Manchester Court for more information

This inspection was carried out on 30th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home allows individuals to pursue personal life styles, which meets with their wishes.

What has improved since the last inspection?

Parts of the communal areas of the home have been decorated. A number of improvements had been made to the physical environment and this included redecoration of some areas.

What the care home could do better:

Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 6Care planning must be improved to ensure specific needs are included; many of the service users have complex needs. A number of the needs required specific plans of care but it was evident that not all of the information passed to the home from other professionals was included in the plans. In a home of this size dedicated staff are seen to be necessary. The present arrangement includes care staff undertaking cleaning and catering duties. This model reduces the amount of care staff available to vulnerable service users during the waking day. Health care needs must be recorded in a manner which ensures staff are clear about the problems and of the action required by a range of professional health care workers. The recruitment process must comply with the current regulations. Staff must have training which is relevant to the categories of service users who are admitted to the home e.g. mental health Healthcare needs must be recorded and reviewed in and appropriate records held. Communal activities must be reviewed to ensure needs are met. Any restrictive practices must be recorded and reviewed and the records held in the home.

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Manchester Court 77 Clarence Street Cheltenham Glos GL50 3LB Lead Inspector Tim Cotterell Announced 30 August 2005 10:00 th 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 and Care Homes for Adults 18 – 65*. 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. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Manchester Court Address 77 Clarence Street Cheltenham Glos GL50 3LB 01242 523510 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) Raynsford Cheltenham Limited Mr Nicholas Yorke Care Home 20 Category(ies) of Old Age (10) registration, with number Mental Disorder (10) of places Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14/03/05 Brief Description of the Service: Manchester Court is a listed building in the centre of Cheltenham. It is near to the town centre with all its amenities, and central library and museum are a hundred yards away. The Parish and Roman Catholic churches are near by. Accommodation is on four floors. The kitchen, laundry and some storage areas are in the basement. On the ground floor is the communal dining room and lounge. A shaft lift and stairs serve all residential floors. The bedrooms are located on all floors and are for single occupancy. There are no ensuite facilities, although washbasins are provided in each room. There is level access to the rear of the building, which opens onto a courtyard with some adjacent car parking spaces. The front door has three steps down and opens directly on to Clarence Street. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection undertaken on three visits. The first visit was undertaken in four hours by one inspector. Another full day was completed by two inspectors and the third visit was completed in one hour the following week to look at staff records which were previously unavailable. The inspection consisted of looking at, the accommodation, a number of care plans and talking to service users and staff. During the inspection the following visiting professionals were spoken to, continence adviser, district nurse and Community Psychiatric Nurse. The manager and staff were helpful throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 6 Care planning must be improved to ensure specific needs are included; many of the service users have complex needs. A number of the needs required specific plans of care but it was evident that not all of the information passed to the home from other professionals was included in the plans. In a home of this size dedicated staff are seen to be necessary. The present arrangement includes care staff undertaking cleaning and catering duties. This model reduces the amount of care staff available to vulnerable service users during the waking day. Health care needs must be recorded in a manner which ensures staff are clear about the problems and of the action required by a range of professional health care workers. The recruitment process must comply with the current regulations. Staff must have training which is relevant to the categories of service users who are admitted to the home e.g. mental health Healthcare needs must be recorded and reviewed in and appropriate records held. Communal activities must be reviewed to ensure needs are met. Any restrictive practices must be recorded and reviewed and the records held in the home. 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. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Standards Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitablity of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,4. The home provides the prospective service users with adequate information, which enables them to make informed decisions about the ability of the home to meet their needs. EVIDENCE: The home has recently considered admitting a new service user, and the process has involved a number of visits in an attempt to determine if the placement would be successful. This process has allowed everyone to comment and this included the service user. The registered manager has now reviewed the assessment of need format. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 9 All new service users will receive a separate assessment of need and this will be completed by the registered manager. Where service users are seen as suffering from a mental illness it is essential that the assessment addresses these needs, and that the person making the assessment is competent. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6. Care plans did not include the specific actions required and the reviews did not offer any relevant comments this could jeopardise positive outcomes for service users. EVIDENCE: Care planning and the assessment of need was discussed. The home has a key worker system but there was some confusion about the functions of individual staff. One example of this was that all care plans had been written and subsequently reviewed by the registered manager with no evidence of input by the key worker. Also information and guidance provided by subsequent reviews of the Care Programme Approach plan, which should Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 11 have formed part of the amended plan of care was not evident. The Care Programme Approach was in place for one service user but there was no evidence of any subsequent review since the care plan was devised. The current plans were not seen as covering all the needs, in the circumstances the registered manager agreed to complete one new plan of care and submit it to the Commission to ensure that the model is seen as appropriate and acceptable. One of the main elements of the Care Programme Approach is that it is subject to regular review and that risks are assessed and reviewed and that there is written evidence. The home must then develop a plan of care to determine how the aims and objectives of the Care Programme Approach plan can be met. The inspectors were made aware of decisions which restricted the rights of residents e.g. staff holding cigarettes and rationing the amount they had and that their behaviour could affect this calculation, and the decision that certain food should be withheld on health grounds. If there are any restrictions of rights this must be determined in a multidisciplinary manner and the decisions recorded in the plan of care. It is not appropriate for the staff to make decisions on their own that may restrict the rights of service users. It is appreciated that the intention of staff was to provide a healthy life style after advice from a doctor, however, if a recommendation becomes a decision to restrict foods, such decisions should be made by all professionals involved in the care of the service user. The issue of care planning was raised in the last inspection report dated 30 March 2005 and a requirement was made (timescale for action 30 June 2005) Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experiencd in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13.14.15.17 The home provides limited activities and is not meeting the needs of the service users. Whilst there is some choice over food this present system does not encourage service users to elect options. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 13 EVIDENCE: The home provides a number of activities and this includes weekly bingo and quizzes and some of the residents are still able to access facilities in the immediate vicinity of the home. However the home accommodates a wide range of needs and abilities and it was felt that communal activities are not likely to be appropriate for many of the residents. In the circumstances it is essential that individual interests are determined and wherever possible met. Relatives and friends are encouraged to visit and are made welcome in the home. On the day of the inspection one visitor was spoken to and confirmed that the home makes them welcome and provides the facilities for them to see their relatives. The relative seen said they felt comfortable about raising issues with the manager. Residents who were able to comment felt that there was sufficient food and that choice was available. It is a requirement that a record of the food provided is maintained. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The lack of knowledge and understanding of the healthcare needs of some service users by staff means that some service users are at risk of receiving inadequate care. EVIDENCE: The healthcare records seen were not sufficiently detailed to adequately determine that all the healthcare needs of the service users were being met. The Continence adviser was spoken to and was able to confirm that she visits the home and gives the care staff verbal instructions regarding care for service users. There was no record of instructions given at these visits, and important information given to staff on the day of the inspection regarding a service user Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 15 was not recorded until the staff were prompted by the inspectors. However, the continence adviser found the staff were willing to carry out the instructions. Care staff spoken to were recording that blood tests were completed but had no idea what for, and were unsure in some cases what medical/mental health needs the service users had. The complex needs service users have should be known by the care staff, so that they can promote the mental and physical well being of all the service users accommodated. As mental health needs impact on the choices that some service users make about their physical conditions they should be included in the Care Programme Approach. There was no records of the Community Psychiatric Nurse instructions or evidence of any care staff training in caring for service users with depressive illnesses. A service user with insulin dependant diabetes had no regime recorded from a healthcare professional for recording blood sugar levels regularly. One service user had recently seen the healthcare professionals regarding a serious event and the instructions were not recording in the care plan. Risk assessments had not been updated since August 2003 to take into consideration this serious recent event, which could have had fatal consequences. A service user who had dietary needs had no record of having seen a dietician. The district nurse was spoken to on the day of the inspection and stated that she regularly visited the home to see a service user and felt the staff knew the service users wishes. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are sageguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The missing person procedure is inadequate. Service users rights are not fully safeguarded until multidisciplinary decisions are made. EVIDENCE: The current procedure in the event of a service user going missing from the home is being updated, and the copy seen had many manual amendments. The home must determine the new information/advice without further delay and ensure the form is complete and available for staff. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24.30 There have been a number of improvements since the last inspection; however, further works needs to be completed to ensure a homely environment for service users. EVIDENCE: The inspector looked at the accommodation with the registered manager and noted that redecoration of the communal areas continues. A number of corridors had been painted and papered and now presents a much more welcoming environment. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 18 Not all separate toilets have a call bell and in view of the growing dependency of some service users this will now be required. The call bell in one separate toilet on the third floor was not working. The bathroom on the ground floor was being converted to a sit in bath/shower and should meet the needs of the more dependent service users, and remove the need for hoisting and will offer the choice of showering. The manager should consult the Learning Disability Team to ensure the health and safety of service users who will be using this new facility, and it is also recommended that all other existing bath/toilet facilities are reviewed from the same perspective. All bedrooms are single and a number were inspected. Staff have encouraged service users to personalise the bedrooms and the result was that the rooms reflected the interests of the respective individuals. One bedroom had a faulty sash window and was potentially dangerous and one bedroom had a broken mirror; both matters were brought to the attention of the registered manager at the time of the visit. One bedroom was being used for all service users to have haircuts/hair care; this practice must cease immediately. One resident had an additional room to store clothes and has requested a lock to ensure the safety of the items held in the room. This must be provided without delay. The home must supply the Commission with the daily cleaning schedule. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 34 and 35 (Adults 18-65) and Standards 27,29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32.35 There is insufficient staff on during the waking day to meet the needs of a diverse and vulnerable group of service users. Staff are not suitable trained to care for people with a mental disorder. The recruitment records seen do not contain sufficient information to protect vulnerable adults. EVIDENCE: Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 20 In view of the number of service users, the layout of the building and the wide range of dependencies it is now felt that the minimum standards for the waking day should be. During the waking day Morning Shift:Carers 3 Domestic duties 3 hrs per day Catering 3hrs Afternoon Shift:Carers 3 Catering 2 hours Night Staffing Minimum 1 waking and 1 on call, sleeping in the home. If the registered manager is to be considered as part of the direct care team this must be reflected on the staff rota. The home accommodates up to ten residents who have a mental illness, however, it was not evident that any formal staff training had been undertaken. At the time of the inspection the staff records were not being held in the home. The recruitment practices were inspected and two personnel files were seen on a subsequent visit. The records seen did not meet the requirements of the Regulations, We refer specifically to, employment histories which were incomplete, references which did not match with the referees given by the applicants and the failure to produce evidence of a CRB check in one case. In both cases the applicants stated that they were or had been working in a care home previously to their application, but Manchester Court had not sought any references from them. The registered manager is now applying for a CRB disclosure in respect of one volunteer and has applied for a CRB disclosure in respect of the one member of staff mentioned. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 21 It is essential that the registered manager is aware of and meets the Regulations and associated standards in respect of the recruitment of staff as these were amended in 2004. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 39 and 42 (Adults 18-65) and Standards 33,35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37. The registered manager and staff require further training in the care of people with a mental disorder and the care of the older person to ensure they can properly meet the needs of the service users in their care. The registered manager is not suitably qualified. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 23 EVIDENCE: The registered manager has been required in previous inspection reports to undertake NVQ 4 in Care and The Managers Award. This is seen by the Commission as an appropriate qualification for a registered manager who is “unqualified”. The registered manager feels that this is not appropriate and wishes to undertake a degree course in health/social care. The registered manager is therefore required to advise the Commission in writing of why he feels he should not pursue the suggested NVQ studies. It may also be helpful if the manager approaches a local college accredited to provide NVQ 4 qualifications, to determine if any credits against the proposed NVQ studies could be awarded for the previous qualification he has obtained. The inspector was advised that staff records are held at the home of the registered manager. The current Regulations (17.2. Schedule 4) require staff records to be held in the care home. It is appreciated that security and confidentiality are concerns of the manager, however, it is his duty to ensure the records are held safely in the home. The issue of a volunteer was raised again and it is now required that usual checks (CRB and POVA) are taken without further delay, failure to undertake the checks would result in formal action. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x 3 x Standard No 22 23 Score x 1 Score ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 x x x x x x 3 2 3 x 2 Standard No 24 25 26 27 28 29 30 STAFFING 2 x x x x x 2 Score 11 12 13 14 15 16 17 Standard No 31 32 33 34 35 36 x 1 x x 1 x 2 x x x x x x Version 1.40 Page 25 CONDUCT & MANAGEMENT PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Manchester Court Score x 1 x x 37 38 39 40 41 42 43 D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc yes 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. 2. 3. 4. 5. 6. 7. Standard 24 17 23 24 24 32 35 Regulation 23 16 12 23 23 18 18 Requirement Fit call bells to all toilets/bathrooms Keep a record of the food provided Provide a clear missing person procedure. Repair bedroom window. Replace mirror and fit lock to bedroom door Provide the Commission with the homes cleaning schedule Ensure staff are trained in the areas indicated in the report Ensure the minimum levels of staff indicated in the report are maintained during the waking day ( the issue of staffing was raised in the inspection report dated 14 March 2005) Registered Manager to undertake NVQ4 and Managers award( The issue of training for the Registered Manager was raised in the inspection report dated 14 March 2005) To ensure health care needs (mental and physical) are noted and reviewed, to include guidance from health care Timescale for action 30 November 2005 15 August 2005 30 October 2005 30 October 2005 15 October 2005 31 March 2006 30 October 2005 8. 37 18 December 2006 9. 19 12 30 August 2005 Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 26 10. 11. 41 7 17(2) Schedule 4 15 professionals.( The issue of care plans was raised in the last inspection report) Staff records must be kept in the home A suitable plan must be devised by the home to describe how it will meet the needs of a service user which are expressed in the Care Programme Approach. There must be written protocols for insulin regimes 30 September 2005 30 October 2005 12. 13. 14. 19 19 23 12 12 17(2) Schedule 4 16 15. 16. 17. 14 There must be written records of visits to and advice from dieticians The home must have a procedure to be followed in the event of a service user becoming missing. Consult service users about the 30 October programme of activities arranged 2005 by or on behalf of the home. 30 September 2005 30 September 2005 30 September 2005 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 24 Good Practice Recommendations Consult Community Learning Disabilty Team over aids/adaptations to include all bathrooms and toilets. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 27 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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. Manchester Court D51_D03_S16498_ManchesterCourt_V237008_300805_Stage4_A.doc Version 1.40 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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