Inspection on 04/05/05 for Manor Court

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Manor Court 15/06/07

Manor Court 22/11/06

Manor Court 14/10/05

Manor Court 14/09/04

Manor Court 28/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 Court 257 Blandford Road Efford Plymouth PL3 6ND Lead Inspector Jane Gurnell Announced 04/05/05 Unannounced19/05/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Manor Court Address 257 Blandford Road, Efford, Plymouth, Devon, PL3 6ND 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) 01752 768425 01752 785781 Anchor Trust vacant Care Home 37 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (37), of places Physical disability over 65 years of age (37) Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1.DE(E) Category for a maximum of 5 residents only. 2. Age 60 yrs 3.To admit one named Service User aged 55 years. Date of last inspection 14/09/04 Brief Description of the Service: Manor Court is a large home situated in Efford on the Northern side of Plymouth. The home is owned and managed by the Anchor Trust, a voluntary organisation. From the home the main central shopping area of Plymouth is accessible by either bus or car. The home has a comfortable, non-institutional atmosphere, despite being large and purpose built. The home has the categories of OP (older person), DEE (dementia elderly) and PDE (physical disability elderly). Though covering a wide variety of needs the home aims to maintain a balance, which enables the service to provide quality care for all the service users. The homes service is defined, within the statement of purpose, as providing support for older persons with low to medium levels of dependency. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken over 2 days: an announced visit on 4th May followed by an unannounced visit on the evening of 19th May 2005. The focus of the inspection was to consult with service users, review the care planning processes and administrative systems relating to staff recruitment, supervision and training. The inspector spoke to 30 service users, four relatives, a visiting GP, toured the building, examined care records and staff files and reviewed the administrative processes. What the service does well: What has improved since the last inspection? What they could do better: Staff supervision and training must address issues relating to performance, attitude and respect, as well as the skills required to support people with confusion and associated anxieties. Recruitment processes must be improved to ensure the necessary documents are obtained prior to the commencement of employment. The controlled drug register must be hard-backed and have pre-printed pages to prevent tampering. Arrangements must be made for service users to receive a more substantial supper and a record of the food items provided to stock the service users’ kitchens should be recorded. Service users must be involved with the review of their care plans and the Quality Assurance process must be expanded to include service user consultation. The variety and frequency of leisure and social activities should be reviewed to Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 6 ensure service users live in a stimulating environment and are able to continue with their own hobbies and interests. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 Thorough and comprehensive systems for admission allow service users and their relatives to be confident that their needs can be met. EVIDENCE: A statement of Purpose and Service User Guide were available for prospective service users and provided a clear description of the services offered. Assessments were undertaken to identify service users’ needs prior to admission. Service users said that they had been able to visit the home before making a decision to move in. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11 Whilst it was evident that service users’ health and personal care needs were being met, the attitude of some staff towards the service users demonstrated a lack of understanding towards the needs of older people, particularly those with memory loss and confusion. EVIDENCE: Service users said that the majority of staff were very kind and caring and that nothing was too much trouble. Some service users, however, described times when care staff have been abrupt and rude towards them raising concern that these staff demonstrate little understanding of the service users’ needs as well as a lack of understanding of their roles and responsibilities. Three visitors said that they found the staff very kind and welcoming whilst one visitor said that she was aware that at times staff had not responded well to service users who were agitated and confused. The Manager was aware of the need for staff training to address this issue. Care plans described the service users’ care needs, however one service user had not been involved in the review of his plan for some time. A visiting GP confirmed that service users’ health needs are addressed. Service users with terminal illnesses could remain in the care home as long as their needs could Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 10 continue to be met. Medication administration records were well maintained and medication was stored safely. The controlled drug register did not contain pre-printed page numbers to prevent the book from being tampered with. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 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 standard(s) 12, 13, 14 and 15 Meals are nutritious and varied, but the lack of a formal supper does not protect service users from hunger. Leisure and social activities provided are insufficient to ensure a stimulating environment and limit service users’ involvement in their own hobbies and interests. EVIDENCE: Service users described lunch and the evening meal as very good and that a choice was always available. On the first day of the inspection, some service users said that they were not offered supper or a hot milky drink, although on the evening of the second visit all service users were offered a milky drink and cake. The evening meal is offered at 4.30pm and biscuits and cakes, if available, are offered with a drink at 7.30pm: this does not address the nutritional needs of older people, particularly those who are unable to prepare themselves a snack meal. Service users are provided with a variety of provisions to keep in their rooms, such as tea, coffee, milk, cereals, bread and biscuits although as no record was maintained it was not possible to ensure that each service user was receiving what they were entitled to. Relatives said that they were made welcome and that they were kept informed of significant events. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 12 Themed events are provided once a month and trips to local places of interest every few weeks in more pleasant weather. Bingo, facilitated by a service user, is enjoyed twice a week. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 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 standard(s) 16, 17 and 18 Service users can be confident that the Manager and the Assistance Manager take their concerns and complaints seriously, however this confidence did not spread to the staff group as a whole. Not all staff have the skills necessary to deal with issues of conflict or abuse. EVIDENCE: Many service users said that they would not express any concerns to the care staff as they felt that resentments might build up, however service users did say that they had confidence in the newly appointed Manager and her assistant and were hopeful that matters would improve. Staff had not received training relating to the protection of vulnerable adults and their lack of understanding was reflected in their interactions with service users with agitation and confusion. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The service users live in a pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: The home is purpose built and meets well the needs of service users with physical disabilities. All communal rooms and bedrooms were pleasantly decorated and furnished and service users and visitors said that it was always very clean. All bedrooms have en suite shower facilities enabling service users to maintain their independence. Three further bathrooms are provided, 2 fitted with baths designed for people with physical disabilities. The building is well maintained and decorated and staff have access to a maintenance department for day-to-day repairs and redecoration. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The quality of the care and support provided by the staff team is undermined by the attitude and lack of understanding of service users’ needs by a small number of staff. Recruitment practices require improvement. EVIDENCE: Service users and visitors said the majority of staff were kind and caring, and that nothing was too much trouble for them, but that a small number could be rude and abrupt. The Manager said that staff are provided in sufficient numbers to meet the needs of the current service users, however as some staff work in a task orientated manner, spending time in the staff room between tasks, rather than through an holistic approach to care, this can giving the impression that staff do not have time to sit and talk with service users. Working practices are being changed to ensure staff do not take their breaks at the same time and that staff spend time with service users in conversation. Staff training has been planned over the next few weeks to address dementia care issues. Those staff files examined did not contain 2 written references therefore it was not possible to make an informed judgement regarding their suitability to work in a care setting. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 and 38 The newly appointed Manager has the skills to ensure that the home is well managed and is striving to address the shortcomings identified and to provide a stimulating, safe environment that respects and protects service users’ rights. EVIDENCE: The Manager has applied to the Commission for Social Care Inspection for registration. She is qualified to NVQ 4 in Care, has a Diploma in Management and has many years experience in a senior management position with care homes. Residents’ and staff meetings occur regularly and address issues relating to service users needs, staff training issues and day-to-day management. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 17 Anchor Homes’ Responsible Individual visits to meet staff and service users and to ensure policies and procedures are implemented. Sampling of National Minimum Standards compliance is undertaken at this time and these visits form the basis of the quality assurance process. Formal service users consultation does not take place, other than gathering service users’ views prior to their 6 monthly care plan review: these views relate only to care planning issues and are not collated. An Annual Development Plan was not available. Money is held for safekeeping for several service users and this was examined and found to be accurate. Health and safety practices were satisfactory ensuring that equipment was maintained in good working order and staff had received training in fire safety, first aid and manual handling. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 2 2 3 2 3 3 2 3 3 Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement The controlled drug register must be hard backed and have pre-printed page numbers to prevent tampering. Two written references must be obtained for each member of staff emplyed either in a paid or voluntary capacity. Staff must be suitably trained in issues relating to the care of older people and those with dementia. A system of formal review and improvement of the quality of care provided must be implemented that includes fromal service user and representative consultation. A report of this process must be made available to service users and the Commission for Social Care Inspection. Staff must receive supervision that addresses issues of care practices, philosophy of care and personal development. Arrangements must be made for service users to receive a more substantial supper. Service users must be treated respectfully at all times. Timescale for action 30.6.05 2. OP29 19 and Schedule 2 18 15.6.05 3. OP30 31.7.05 4. OP33 24 31.8.05 5. OP36 12 and 18 31.7.05 6. 7. OP15 OP10 16 12 31.5.05 4.5.05 Page 20 Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 8. 9. OP16 OP18 22 13 All staff must receive training relating to Anchor Trusts complaints procedure. All staff must receive training relating to the protection of vulnerable adults. 15.6.05 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. 2. 3. 4. Refer to Standard 7 12 15 31 Good Practice Recommendations Service users should be involved in the monthly reviews of their care plan. The frequency and variety of planned ativities should be reviewed. A record of provisions provided to each should be recorded. The manager should continue with her application to be registered with the Commission ofr Social Care Inspection. Manor Court D52-D04 S3540 Manor Court V214537 040505 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection 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. 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