Inspection on 26/03/07 for Manor Cheshire Home

This inspection was carried out on 26th March 2007.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Manor Cheshire Home 28/02/06

Manor Cheshire Home 15/06/05

Manor Cheshire Home 22/10/04

Manor Cheshire Home 01/06/04

Manor Cheshire Home 17/03/04

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

CARE HOME ADULTS 18-65 Manor Cheshire Home Church Road Brampton Cambridgeshire PE28 4PF Lead Inspector Andy Green Key Unannounced Inspection 26th March 2007 10:00 Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 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 Manor Cheshire Home DS0000015185.V328495.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 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. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor Cheshire Home Address Church Road Brampton Cambridgeshire PE28 4PF 01480 412412 01480 413737 wendy.carter@lc-uk.org www.leonard-cheshire.org.uk Leonard Cheshire 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) Janet Audrey Larter Care Home 21 Category(ies) of Physical disability (21) registration, with number of places Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 Brief Description of the Service: The Manor Cheshire care home is situated in the village of Brampton, about three miles from the centre of the busy market town of Huntingdon, which has a range of shops, pubs, restaurants and leisure facilities. The home is purpose built, adjacent to the old Manor House, and offers accommodation in a main building and in three bungalows. The main building has thirteen single bedrooms on the ground floor and four on the first floor. The bedrooms on the ground floor have en-suite facilities. Two of the three bungalows offer single accommodation: the third bungalow has two single bedrooms, sitting room, kitchen and bathroom. Communal areas consist of a lounge/dining room, smoking room, activities area and a physiotherapy room. The home has well maintained grounds. The old Manor House is in a state of disrepair and is only used for staff training. The village of Brampton offers a range of local facilities, such as pubs, takeaway restaurants, shops and banks. The cities of Cambridge, Peterborough and Bedford are all within a half hour drive and offer a range of indoor and outdoor leisure facilities, as well as a large number of shops, restaurants and other amenities. Huntingdon has good road and rail links to London and major cities north. The fees range from £815 to £12373 per week. Copies of CSCI reports are made available to service users and their relatives upon request. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Regulation Inspector, Andy Green on 26th March 2007. The inspector met with the acting care manager, members of staff and service users. A number of records were inspected including service user plans, training records, staff files, health and safety documents and a tour of the premises was undertaken. What the service does well: What has improved since the last inspection? What they could do better: The carpets in hallways and a number of bedrooms are showing their age and are stained. Although they are regularly cleaned the carpets still show signs of old stains. As the carpets have not been changed for many years (an estimate of at least 17 years was given by staff) the home must carry out an audit/programme to replace carpeting and send a copy of proposed action, including timescales, to CSCI. A number of doors, doorframes and walls are continually being damaged due to wheelchair usage. This creates a poor impression of the home and the provider must ensure that steps are taken to improve the maintenance in areas that are consistently affected/damaged. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to good information, and can make an informed choice regarding the home’s services. EVIDENCE: There have been no changes made to The Statement of Purpose and the Service User Guide since the last inspection. The acting care manager stated that these documents are reviewed during the year to ensure that they accurately reflect the services that are provided. The home obtains detailed information via the care management process to ensure that they can meet the individual’s assessed needs. Usually two senior staff carry out assessments which includes a visit to the prospective service user. Relatives are also encouraged to be involved in the referral process where appropriate. A number of visits to the home can be arranged so that prospective service users can “test drive” the home before moving in. There have been no changes to the assessment procedure since the last inspection. Risk assessments are carried out to ensure that service users physical needs can be safely met in the home. There were 20 service users in residence and one referral is currently being assessed for admission to the home. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 9 All records held about service users are kept securely and staff are aware of the policies regarding confidentiality. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care and support provided at the home is of a high standard. Detailed care plans are in place to ensure that staff have sufficient information to satisfactorily meet the service users assessed needs. EVIDENCE: The care plans of three service users were seen and they were presented in a professional manner giving clear guidelines regarding the care and support needs that each service user requires and how it should be given. Regular monthly reviews of care plans take place and include any updates or changes in care. A person centred approach s being used in the home, which involves the service user as much as possible to ensure they can maximise their choice and independence. One service user is receiving psychology input from the Zangwell Centre in Ely to assist with coping strategies for daily living/skills. This has been a useful development and the service user and staff team are engaged in monitoring daily behaviour. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 11 A variety of healthcare professionals regularly visit the home to provide specialist input and service users also benefit from the physiotherapy /gym facilities provided in the home. Three service users spoken to confirmed that they were fully involved in making choices about their lives and are able to frequently access the community which has included trips to local towns, markets, pubs, museums, theatres including London, swimming Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff provide appropriate support to ensure that service users have access to activities in the community. EVIDENCE: The acting care manager stated that the activities coordinator has worked hard to recruit volunteers and there are now 80-90 people involved in different ways with service users. All volunteers are CRB checked before they can have one to one time with service users. Organised activities have included trips to local towns, seaside, cinema, fishing and sailing. Holidays have for individual service users have also been organised to Tenerife and Africa. Exchange visits have been organised to other Leonard Cheshire homes so that service users can visit other areas of the country. This has particularly benefited one service user who was able to stay in a home so that he could visit a match at Liverpool FC. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 13 The acting care manager stated that a number of service users have accessed courses involving ; assertiveness, confidence building and IT skills which are held in a centre in Peterborough. There are no restrictions on visitors to the home: they can come and go when they please, provided the residents are comfortable with the arrangements. Residents continue invite their families to have a meal with them and friends and family are also invited to parties and special events at the home. Barbecues are also frequently arranged during the summer months. The chef meets regularly with service users to discuss meal references. There is a choice of 3 meals at lunch and teatime. Service users confirmed that the meals provided were of good quality. The coffee/snack area, in the communal lounge/dining room, has proved to be a successful development and many of the service users were seen making their own drinks and snacks during the day. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. 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. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive appropriate health and personal care to meet their assessed needs together with support in taking prescribed medication. EVIDENCE: The doctor visits the home on a monthly basis to review residents’ medication with the acting care manager. The doctor continues to see residents during this visit but usually serviced users make their own appointments at the local surgery. Following discussions, held with CSCI, the delegation of nursing tasks have been reviewed. All nursing procedures are now being carried out by the district nursing staff with the exception of enemas, manual evacuations and catheter care for eight service users. These procedures are undertaken by senior staff in the home who are regularly assessed/monitored by district nurses to ensure safe practice. This has been agreed with CSCI. The acting care manager stated that one service users is being reassessed as he requires more on to one support and discussions are underway with the individuals funding authority to hopefully secure additional staffing so that he can remain in the home. The medication records, including controlled medication, were accurate. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 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 satisfactory complaints process to make sure that service users have their complaints or concerns listened to and acted upon properly. There are suitable arrangements for ensuring the protection of service users from neglect or harm. EVIDENCE: The home has a complaints procedure including agreed timescales to make sure that all complaints are fully investigated and actioned appropriately. The home has not received any complaints since the last inspection. The home ensures that adult protection issues are dealt with in line with local authority policies, to make sure that service users are protected from abuse. Care staff receive appropriate training to ensure they are aware of adult protection procedures. The home has a whistle-blowing policy. It was observed that care staff spoke to service users in a friendly and social manner appropriate to individual need. Care staff were observed to knock on service users’ doors before entering. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is homely and clean and suitable for the needs of those living in the home. Improvements need to be made to the decoration in a number of areas and a number of carpets need to be replaced. EVIDENCE: The acting care manager stated that there had been no major changes to the home since the last inspection. Service users bedrooms are decorated and personalised to reflect the person’s interests and preferences. The home and gardens meet the needs of service users and are generally well maintained Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 17 However some improvements need to be made a number of areas in the home. The carpets in hallways and a number of bedrooms are showing their age and are stained. Although they are regularly cleaned the carpets still show signs of old stains. As the carpets have not been changed for many years (an estimate of at least 17 years was given by staff) the home must carry out an audit/programme to replace carpeting and send a copy of proposed action, including timescales, to CSCI. A number of doors, doorframes and walls are continually being damaged due to wheelchair usage. This gives creates a poor impression of the home and the provider must ensure that steps are taken to improve the maintenance in areas that are consistently affected/damaged. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and processes makes sure that service users are protected from harm. Training is provided to make sure that care staff are competent to deliver care to the service users they support. EVIDENCE: Training is well co-ordinated and staff receive a variety of mandatory and client specific courses. The training co-ordinator has a matrix of all training undertaken throughout the year and refreshers/updates are booked on an ongoing basis. Appropriate training is also provided for all staff who administer medication in the home. NVQ training is well established in the home. The training co-ordinator stated that approximately 70 of staff have completed NVQ at either level 2 or 3. 3 staff files were inspected and they contained the required documentation including CRB checks and references. A checklist is contained in all staff files to ensure that all required documents are in place. Staff receive regular recorded supervision to ensure that their practice and development needs are monitored. Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. 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 home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the manager provides supportive leadership and guidance to staff to ensure that service users receive high quality care. EVIDENCE: The home is well managed and it was clear that there is an open and inclusive style of management, with service users fully involved in all aspects of the running of their home. This view was confirmed by service users spoken to during the inspection. The registered manager has completed NVQ Level 4 since the last inspection. The record of tests of the fire alarm system were seen and showed that tests are carried out weekly as required. The emergency lighting system is also Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 20 tested regularly. Each of the service users gas an individual fire evacuation plan to ensure that staff are aware if there was a fire in the home. Records of daily bath temperatures were accurately recorded. Equipment in the home is regularly serviced and PAT tests are carried out. The home employs a maintenance person who carries out small repairs and decoration work in the home. He also drives the homes vehicles so that service users can access the community . Manor Cheshire Home DS0000015185.V328495.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 Adults 18-65 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 3 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 2 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 3 X X 3 X Manor Cheshire Home DS0000015185.V328495.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. 1 Standard YA24 Regulation 23(2)(a) Requirement Timescale for action 30/06/07 2 YA28 23(2)(d) Maintenance and decoration must be carried out to communal areas including hallways, doors and doorframes. Carpets must be replaced in a 30/06/07 number of corridors and bedrooms RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Manor Cheshire Home DS0000015185.V328495.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Manor Cheshire Home DS0000015185.V328495.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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