Inspection on 17/01/06 for Manor Court

This inspection was carried out on 17th January 2006.

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

Manor Court 31/10/06

Manor Court 08/09/05

Manor Court 24/01/05

Manor Court 11/05/04

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

CARE HOMES FOR OLDER PEOPLE Manor Court Manor Court Road Nuneaton Warwickshire CV11 5HU Lead Inspector Patricia Flanaghan Unannounced Inspection 17th January 2006 11:00 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 Court DS0000004253.V279991.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 Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Manor Court Address Manor Court Road Nuneaton Warwickshire CV11 5HU 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) 02476 383787 02476 383787 Swinnerton Trust Mrs Yvonne Thompson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Manor Court may also provide care to the service user named in the variation application dated 28th November 2005. 8th September 2005 Date of last inspection Brief Description of the Service: The Swinnerton Trust (a voluntary organisation) owns and manages Manor Court. Manor Court is a Victorian house, which has been adapted to provide long-term care and accommodation for 24 older people. The home is located close to Nuneaton town centre, which provides local services e.g. shops, schools, public houses, restaurants and coffee bar, and is set in its own spacious grounds on the site of a medieval priory. Manor Court benefits from a well-established garden which is attractive, well maintained and accessible. Included in the grounds are a stream and spinney. There is car parking space available for a number of vehicles. Accommodation is available on three floors. Three rooms are located on the ground floor, twelve rooms on the second floor and a further eight rooms on the top floor of the premises. Service users can choose to use either a slow moving shaft lift or a stair lift for easy access to the fist and second floors. There are three bathrooms two of which offer assisted baths; the third bathroom also accommodates a shower facility. Communal accommodation comprises of a dining room, two lounges and a conservatory. Service users can furnish and redecorate their private room to their own taste if they wish. Due to the size and layout of the premises the home may not be suitable for wheelchair users. Wheelchairs can however be used to assist service users to transfer. Manor Court is registered to provide care and accommodation for older people assessed as not requiring either specialist dementia care or nursing care. Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second visit of the inspection year and took place over two days for a total of six hours. The inspector spent time talking to the registered manager, examining records, policies and procedures, talking to residents, two visitors and observing staff working practices. The inspector observed the care being delivered and the excellent interaction between staff and residents. A discussion took place with a member of care staff on duty, who was able to describe how the home were meeting the needs of the residents. The inspection focused on the standards relating to staffing and management. What the service does well: What has improved since the last inspection? The manager has consulted with residents to ensure that the activities programme has been developed taking into account their preferences. The care planning documentation has been updated and these continue to be regularly reviewed and evaluated ensuring that the care needs of the residents are kept up to date. Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 6 Appropriate risk assessments have been developed for individual residents. 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 Court DS0000004253.V279991.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 Court DS0000004253.V279991.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): None of these standards were assessed at this visit. Standards 3 and 5 were reviewed at the inspection of 08/09/05 and found to be met. EVIDENCE: Manor Court DS0000004253.V279991.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): 9 The medicine management within the home was satisfactory but further improvements must be made to demonstrate that the residents needs are fully met. EVIDENCE: The home’s medication policy requires updating to reflect current good practice. For example, it didn’t address, medication for residents who are out of the home for holidays/visits, oxygen, PRN medication. The following issues were identified and discussed with the senior member of staff on duty at the time of the inspection visit. Audits demonstrated that the medicines administered from the Monitored Dosage System (MDS) supplied by the community pharmacist are administered and recorded correctly. Senior staff did not routinely record the quantities of medicines dispensed in boxes and carried over from previous cycles so it could not be demonstrated that these medicines had been administered as prescribed. Some gaps were found on the Medicines Administration Record (MAR) chart and it could not always be demonstrated whether a resident had received the medicine and the MAR chart had not been Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 10 signed. Medications transcribed by hand had not been initialled by staff, for example, one resident’s eye drops had been hand written to be ‘administered to the right eye.’ This had been changed in pencil to read the ‘left eye’. PRN medications did not consistently record the number of tablets given, for example, when the amount of medications can be one or two it should be recorded how many tablets were administered to the resident. Manor Court DS0000004253.V279991.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): 15 Residents receive suitable meals in pleasant surroundings, which promotes social interaction and wellbeing. EVIDENCE: Meals are served by care staff in the pleasant, large dining room. Meals can also be served in residents own rooms if preferred. Choices are available at mealtimes. Meals were served by care staff and looked well presented. However, one resident was seen to have a liquidified meal whereby the meat and vegetables had been liquidised together making it difficult for the resident to distinguish what they were actually eating. A number of residents spoken with on the day of the inspection commented positively on the quality of the food served in the home. A brief inspection of the kitchen found it to be clean and in good order Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 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 the following standard(s): 18 There is a clear Adult Protection policy in place, to make staff aware of their responsibilities to provide a proper response to any suspicion or allegation of abuse. EVIDENCE: The home have in place an Adult Protection Policy, which is in line with the Social Services Policy and the Department of Health document, “No Secrets”. All staff have taken part in Adult Protection Training. Staff spoken to during the inspection were aware of their responsibilities under the Protection of Vulnerable Adults Scheme Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 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 the following standard(s): None of these standards were assessed at this visit. Standards 19, 20, 24 and 26 were reviewed at the inspection of 08/09/05 and found to be met. EVIDENCE: Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 14 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): 28, 29 and 30 The home is adequately staff by people who are well trained. There are robust recruitment procedures in place, which protect the residents. EVIDENCE: Training records examined show that staff have attended regular training on the conditions associated with old age. Fifteen care staff have an NVQ Level 2 in Care, representing 53 of staff. Recent training undertaken by staff include Malnutrition Screening, Expert witness, Protection of Vulnerable Adults, Continence, Oral Health and Safe Handling of Medication. Evidence of new staff receiving a clear induction programme was available. The staff files of two recently appointed staff were reviewed and indicated that the registered manager has completed all necessary recruitment checks to ensure the protection of service users. As a matter of good practice the manager keeps a record of all questions asked at interview on file, clearly demonstrating that recruitment is based on equal opportunities. Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 15 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, 33, 35 and 38 The home has an experienced Manager and is effectively and well managed. Systems are in place to monitor the quality of the service provided and identify areas in need of improvement. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The Registered Manager has many years experience in managing a care home for older people. There are clear lines of accountability within the home. Observations made and discussions with both residents and staff indicated that the manager is available and approachable should they wish to discuss any Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 16 issues. The manager continues to update her knowledge and skills and is curently undertaking a Certificate in Providing Therapeutic Activities for the Elderly. The quality of the service was continuously monitored through feedback received from the residents and their relatives. The manager said that every resident received an annual questionnaire that sought their opinion of the care and service they had received. An analysis of the results was then made available. Feedback from relatives and others was obtained in a less formal manner during ‘one to one’ meetings and from thank you letters and cards. Monies held at the home on behalf of residents are handled in line with the homes policy of handling residents money, ensuring their financial interests are safeguarded. A sample was checked and found to be satisfactory at the inspection visit. Evidence was seen to confirm that staff receive regular training in moving and handling, fire safety, first aid and food hygiene. Certificates were seen during the inspection for the maintenance and service of major systems. No health and safety hazards were observed at this inspection. Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X x STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 18 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 OP9 Regulation 13(2) Sch 3(3)(i) Requirement All senior staff must refer to the Medicines Administration Record (MAR) chart before the administration of medicines and directly sign following the transaction or record the reasons for non-administration. The MAR chart must accurately reflect what has been administered within the home. The quantities of all medicines carried over from previous MAR charts must be recorded to enable audits to take place to demonstrate medicines are administered as prescribed. All hand written MAR charts must accurately record all the medication the service user has been prescribed, the strength of the medicines and the correct dose. The medication policy must be rewritten to reflect good practice in medicine management. Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 19 Timescale for action 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations It is recommended that liquidified meals are presented in a manner which is attractive and appealing in terms of texture, flavour and appearance in order to maintain appetite and nutrition. Manor Court DS0000004253.V279991.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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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