Inspection on 07/03/06 for Manor Cottage Hotel

This inspection was carried out on 7th March 2006.

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

Other inspections for this house

Manor Cottage Hotel 09/03/07

Manor Cottage Hotel 09/08/05

Manor Cottage Hotel 16/02/05

Manor Cottage Hotel 05/05/04

Manor Cottage Hotel 23/09/03

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Manor Cottage Hotel Manor Cottage Hotel 1-3 Manor Crescent Preston Paignton Devon TQ3 2TN Lead Inspector Susan Samways Unannounced Inspection 7th March 2006 10:00 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 Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Manor Cottage Hotel Address Manor Cottage Hotel 1-3 Manor Crescent Preston Paignton Devon TQ3 2TN 01803 550363 01803 526546 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) Mr Kenneth Peek Mrs Hazel Susan Weaver Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One Service User (named elsewhere) in the category `Dementia` Date of last inspection 09/08/05 Brief Description of the Service: Manor Cottage provides care for up to eighteen service users who fall within the category of old age. It is a large, detached property situated on the level, close to all local amenities. The home benefits from a level garden. The accommodation is arranged over two floors with some bedrooms on the ground floor. There is a stair lift to assist service users to access the upper floor, however, it is still necessary for service users to manage a few steps at the top of the staircase. The owner has made improvements to the accommodation and work continues to ensure that the home complies with the environmental standards of the Care Standards Act. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which lasted for 5 hours. On arrival the deputy manager was in charge. Although off duty the registered manager called in to the home and chose to remain for most of the rest of the inspection. The registered provider also arrived before the inspector left. Several residents were spoken to and the home’s activities organiser was observed engaging residents in a card game. The records for recently admitted residents were examined as were those for two newly appointed staff. What the service does well: What has improved since the last inspection? The addition of three new care staff for night duty and the employment of a weekend cook means that the home is fully staffed. The manager regularly reviews all aspects of the running of the home and instigates or recommends to the registered provider improvements which need to be made. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 6 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. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective residents have a comprehensive assessment made which provides all those concerned with sufficient information to make the decision whether Manor Cottage is an appropriate home for them. EVIDENCE: The files of the three residents most recently admitted were examined. All were found to have comprehensive assessments completed by the registered manager. It is the manager’s practice to visit all prospective residents as part of the assessment and to gather information from all relevant sources. This was clearly demonstrated by the assessments seen. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9,11 Care plans are based on a comprehensive assessment and involve the resident or their representative in their development. Care for those coming to the end of their lives is provided in a caring and sensitive way. EVIDENCE: The records of the residents examined contained detailed care plans which had been signed by the resident. Information included the name they wished to be known by and any food preferences. Consent to medication forms and risk assessments were dated and had been signed by the resident. One resident requires the use of oxygen. The home’s policy and procedure for the use of oxygen was in the care plan as was the risk assessment for its use. The daily records were found to be complete. The records showed that care plan reviews are carried out each month. Each resident has a key worker and it is the key worker’s responsibility to organise and chair the monthly care plan reviews and record and, where appropriate, Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 10 action the decisions made. It is the resident’s responsibility to invite their relatives to the review if they wish them to be present. The health care needs of the residents were seen to be met and were documented in the care plans. An optician, a chiropodist and a dentist visit the home on a regular basis. Nutritional screening is undertaken for each new resident and residents’ weights are regularly monitored and were seen to be recorded in the care plans. The manager stated that the dietician is involved when required and the cook is invited to care plan meetings. The home has good relationships with the district nursing service especially with regard to pressure care. Records showed that at the time of the inspection three residents had been provided with different types of pressure relieving mattress by the district nurses. There is a good medication policy and procedure in place. Residents were seen to have given signed consent to medication. All medication records, including receipts and returns of medication, were seen to have been signed. The registered manager stated that when medication is received from the pharmacy it is checked immediately and any discrepancies reported to the pharmacist. Patient information leaflets for each form of medication used are kept for reference. Only named staff who have received basic training from a pharmacist may take responsibility for administering medication. Towards the end of the inspection the registered manager and the deputy manager left to attend an advanced medication course. The home has a policy on dealing with the death of a resident. The manager, while recognising that not everyone wishes to discuss the subject, has been able to ask all residents how they would like to be cared for if terminally ill and what arrangements should be made following death. Their comments have been included in their care plans. Where appropriate relatives have also been included in this. The manager has stated that the home’s intention is to care for residents who are coming to the end of their lives for as long as they are able to provide adequate care and this is included in the home’s training programme. The deputy manager said that when a resident is close to death they try to keep to the same staff providing the care and that the manager will, if required, remain on duty during the night to ensure a good level of care is provided. They endeavour to maintain good communication with the GP and district nurses to ensure as far as possible that the resident is comfortable, pain-free and that their dignity is maintained. The family’s wishes regarding being contacted are ascertained. If they wish to stay overnight they can be accommodated. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 The home enables residents to maintain control over their day to day lives by promoting choice. The dietary needs and preferences of the residents are met with the provision of nutritious and varied meals. EVIDENCE: Residents spoken to stated that the routines of daily living were flexible and that this was appreciated. Also there is a good range of activities which they can participate in or not as they choose. Information about forthcoming events is displayed on the notice board. The home has an activities organiser twice a week and part of a session was observed during the inspection. Six residents were engaged in a card game and another was expected to join them later. Other activities include table games, quizzes, crafts and simple cooking. Staff endeavour to provide activities at other times of the week. The manager regularly organises social events and parties and visits are made to the home by donkeys and PAT dogs. The Bridge-a-gap group, which is associated with the local GP surgery, hold regular coffee morning at the home which are well attended by both residents and members of the local community. Members of local churches visit the home to hold services. Residents said that if they do Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 12 not wish to participate in any of the activities or social gatherings there is another room that they can use or they retire to their own rooms. Once again all residents spoken to praised the standard of the meals, the range of choice they are given and the fact that they are involved in planning the menus. They appreciate the fact that their dietary requirements and food preferences are taken into consideration by the cook who has been observed ensuring that each resident gets the right meal. Meals are cooked using primarily fresh ingredients. Residents said that they can have a drink at any time including during the night if they can’t sleep. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were examined during this inspection. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,25,26 Manor Cottage provides a homely and comfortably furnished environment which is clean and hygienic with well laid out communal space. In some areas of the home residents’ safety is compromised by the lack of radiator guards. EVIDENCE: The home is suitable for its stated purpose. It was seen to be well maintained, providing a homely and comfortable environment. The premises were seen to be clean, hygienic and free from offensive odours. The home employs a housekeeper who has responsibility for ensuring that the home is clean and hygienic. The laundry room is used for residents’ personal items only. All other laundry is contracted out which includes special bags for foul laundry. Information obtained from the Health Protection Agency was seen to be available for staff and has been incorporated into the home’s infection control policy. Records showed that staff have received training in infection control. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 15 Despite frequent reminders some radiator guards have still not been fitted and this must now be addressed as a matter of urgency. Three residents have stated that they do not wish to have their radiators covered. The manager has explained the reasons for providing guards but they have refused. The manager has therefore completed risk assessments for those rooms and the residents concerned have signed to say that they have declined the provision of radiator guards. The manager agreed that when those rooms are vacated the guards will be fitted before another resident moves in. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 Staff recruitment procedures safeguard residents. EVIDENCE: At the time of the inspection the home was fully staffed as three new staff for night duty and a weekend cook had recently been recruited. On arrival at the home sufficient staff were found to be on duty to provide an adequate level of care. The files for the newly recruited staff were examined and all the required documentation was found to be present including POVA and CRB checks and two references. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35,38 The management style is open and receptive to the views of the residents and others involved with the home. The policies, procedures and safe working practices provide protection for both residents and staff. EVIDENCE: The manager is well qualified and experienced and the home is well run. The deputy manager is waiting to start NVQ Level 3 in Care. In separate discussions with the manager and the deputy manager they both demonstrated a detailed knowledge of the running of the home and of all the residents, their needs and how they should be met. During the inspection it was observed that staff and residents approached the manager with confidence Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 18 and those spoken to said that they could raise any concerns with her or make suggestions and know that they would be well received. Systems are in place for dealing with residents’ money when required with detailed records being kept, but wherever possible residents are encouraged to manage their own affairs. Records showed that the majority of the staff have had training in manual handling, infection control, first aid and food hygiene. Dates for refresher training were also in place. All staff have had fire safety training. Fire safety checks were seen to have been carried out at the required intervals. As already recorded under standard 25, some radiators have been covered, the rest need to be completed as a matter of urgency. The premises are locked at night when the night staff come on duty. Information on all relevant Health and Safety legislation is available in the home. Required risk assessments are in place. Accidents were seen to have been recorded. Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 19 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 x 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x 3 x x 2 Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP25 Regulation 13 Requirement The registered person must ensure that all parts of the home to which Service Users have access are, so far as is reasonably practicable, free from hazards to their safety. The registered person must guard hot surfaces such as radiators. (timescale of 31/08/05 not met) Timescale for action 30/06/06 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 Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Manor Cottage Hotel DS0000034029.V263006.R01.S.doc Version 5.1 Page 22 - 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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