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Inspection on 27/07/05 for Manor Farm House Residential Home

Also see our care home review for Manor Farm House Residential Home for more information

This inspection was carried out on 27th July 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.

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

What the care home does well

The home employs caring and attentive staff who are much appreciated by the residents. "Staff are very kind" said one, and "you only have to ask and its done" said another. The home puts staff through a comprehensive drug training programme which ensures better protection for residents. There is an excellent Fire Risk Assessment which meets the Fire Precautions Regulations.

What has improved since the last inspection?

A spacious new shower room has been installed which is more suitable for residents. A new post to cover laundry and domestic duties has been created and is being advertised.

What the care home could do better:

Care plans need regular auditing to make sure they reflect current needs of residents. A more systematic way of keeping the care plan sheets would help to make them more usable. Although there are examples of good training, a training plan would identify staff training needs and gaps in training. More training is needed in the protection of vulnerable adults. The home must record and monitor complaints and concerns to ensure that residents and relatives have confidence that the proper procedure is followed. The laundry room floor does not comply with hygiene requirements. The home must provide a secure lockable medicines trolley to prevent any accidental misuse while it is unsupervised.

CARE HOMES FOR OLDER PEOPLE Manor Farm House Residential Home Church Road Kessingland Lowestoft NR33 7SJ Lead Inspector John Goodship Announced 27 July 2005 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 Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Manor Farm House Residential Home Address Church Road Kessingland Lowestoft Suffolk NR33 7SJ 01502 740161 01502 740756 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) Mr Hector Jackson Mrs Alison Palmer Care Home 25 Category(ies) of OP Old Age (25) registration, with number of places Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18/03/05 Brief Description of the Service: Manor Farm House is a residential care home registered under the provisions of the Care Standards Act 2000 to accommodate 25 older persons. It is privately owned, and personally supervised, by Mr and Mrs Jackson.Located in the village of Kessingland, Manor Farm House is close to main amenities although transport would be required to access them. Manor Farm House was first registered in 1983 and consists of a two storey main building with a bungalow extension that is linked to the main building. The Home provides 17 single bedrooms and four double bedrooms that are all provided with a wash hand basin. There is a choice of areas for service users to sit, either in the large lounge in the extension, a smaller seating area, or the conservatory. The dining room is situated at the front of the home and provides views of the open countryside. There is a stair-lift fitted to assist service users to access the first floor. Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and was the first one in the current inspection year. The owner was in hospital, but the manager Mrs Alison Palmer was available throughout the day. The inspectors spoke to many residents in the lounge and dining room, as well as those who were in their own room. Some of their quotes have been included here as well as in the main report. 2 visitors also spoke to the inspectors. They were both very satisfied with the care of their friends. What the service does well: What has improved since the last inspection? A spacious new shower room has been installed which is more suitable for residents. A new post to cover laundry and domestic duties has been created and is being advertised. Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 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 Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 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 Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 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) 1,3,6 Prospective residents have the information required to make an informed choice about the home. The home also ensures that it can meet their needs before a decision is made. EVIDENCE: The Statement of Purpose and the Service User Guide contain all the items of information required for residents and their families. The layout and language could be changed to make them easier to read. All prospective residents are assessed by the manager before the home agrees that it can meet their needs. Standard 6 does not apply to this home. Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 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) 7,8,9,11. Residents’ care needs are generally identified and monitored, but regular auditing and better filing would ensure that all needs had been covered. Residents are well protected by good drug training programmes. The lack of a secure drug trolley was a danger to residents. EVIDENCE: Care plans for 5 residents admitted since March 2005 were not always fully completed and up-to-date. The topic sheets in the plans covered the range of needs of the residents, but not all topics were in each plan file. In addition, the way they were filed was not consistent and with some loose sheets. There was no separate record in every file of visits by GPs and other health professionals, although these were noted in the daily record. Care plans were subject to monthly reviews by the keyworker. There was information in some care plans about the residents’ wishes at the end of life. The drug administration procedures were correct and ensured that residents had taken the medication before signing the chart. There were no gaps in the charts. A bottle of Gaviscon was used for a resident other than the person for which it was prescribed. Both were prescribed Gaviscon and should have received it from their named bottle. The medication was put onto an open Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 10 trolley at the drug cupboards for taking to the residents. Although there were several staff present when the midday round took place, the recommendation of the Royal Pharmaceutical Society is that such a trolley should have sufficient capacity for all medicines to be locked away in an emergency during the medicines administration round. Staff do the 14 week distance learning course in the safe administration of drugs. The local chemist who supplies the home visits annually for training updates, and also visits regularly to do stock checks. One resident described her reduced mobility and eyesight. New glasses were helping the latter, and she had been able to move to a downstairs room to help with the former. Another resident said that the staff were very kind. “You only have to mention something to the manager, and its done.” Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 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. Residents are offered some activities and opportunities to stimulate and interest them, but the range is not enough to be attractive to all. Some resident have maintained good community links, and residents’ preferences for their daily lives are incorporated into their care plans. EVIDENCE: There was a published activities diary in the lounge, consisting mainly of music, card games and bingo. The manager explained that other activities had been introduced but interest waned. For example, gentle exercise sessions had been led by an outside person, but this had since stopped for lack of participants. Bingo was taking place in the lounge on the morning of the inspection with 7 residents taking part. Staff said it was increasingly difficult to generate interest. They did say that what the residents liked was when the staff dressed up and performed for them. One resident said that he was bored; this was partly a consequence of his reduced mobility since surgery. There were visitors in the home during the day. One visitor came regularly to talk to a resident and take them out. Others were visited by relatives. Many residents had lived locally so had contacts with the community in the village. Preferences for activities of daily living were listed in their care plans. Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 12 Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 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) 16,18 The lack of formal recording and monitoring of complaints and concerns does not ensure that residents and staff are protected. The care staff have not had sufficient training to recognise & respond to possible abuse appropriately. EVIDENCE: The home has a complaints procedure that is given to residents, or their relatives, when admitted & displayed on a notice board in the home. The procedure meets requirements but an amendment needs to be made to include the Commission of Social Care Inspection’s correct title & telephone number. The home does not have a complaints log. The manager said that there had not been a complaint for two years. The manager confirmed that any minor issues raised verbally tended to be resolved quickly and were not recorded as complaints. Two residents spoken to during the inspection said that they would feel able to complain direct to the manager but had not had cause to. The registered manager has had training on protecting adults at risk of abuse and has a copy of the Suffolk inter-agency policy, procedures and guidelines. The home also has its own “abuse policy” which needs to be reviewed & updated to ensure that its guidelines are in common with the Suffolk policy. Staff files looked at during the inspection did not provide evidence of staff training in relation to protection but staff meeting minutes had recorded some Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 14 discussion on the subject. Two of the staff spoken to during the inspection said that if they had any concerns regarding the safety of residents they would report them to the manager, however they had a limited understanding of the policies & procedures in place to protect vulnerable adults. The home has got financial procedures in place that include safe practices regarding the handling of resident’s monies and valuables. The records relating to cash held for three residents were checked during the inspection and tallied with the money held. Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 15 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) 19,20,21,23,24,25,26 The home is clean & tidy, bedrooms are adequately furnished & comfortable & the standard of decoration and facilities should continue to improve with the ongoing maintenance programme. The floor in the laundry room is permeable and does not ensure safe hygiene and infection control. EVIDENCE: Toilets are accessible and clearly marked. There are sufficient baths / showers to residents and since the last inspection the previously inadequate shower room has been replaced with a spacious and suitable alternative. The sluice is provided in a separate room away from residents wc’s and bathing facilities. Resident’s bedrooms are sufficient in size. There are 17 single rooms and 4 double rooms. The manager stated that those residents accommodated in double rooms are residents that prefer to share, however there was no evidence seen at this inspection to conclude that shared rooms had been a Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 16 positive choice or that single rooms are offered as an alternative when a shared place becomes vacant. The quality of the furnishings and décor in the bedrooms were variable. Several residents had provided their own furniture and personal items including pictures, photographs and ornaments, others were supplied with adequate furnishings by the home. All of the bedrooms were carpeted & curtains were in place to provide a screen for privacy in double rooms. The provision of lockable storage was not evident during the inspection but the Manager said that it could be made available if a resident requests it. Residents spoken to during inspection said that they were happy with their rooms. The home has begun to refurbish & redecorate areas in the home, other areas are not as well maintained, but the home was clean & free from offensive odour and there were systems in place to control the spread of infection. Laundry facilities were provided in an outhouse with 3 household washing machines that could be programmed for temperatures up to 90°C. The laundry room floor was concrete and permeable, consequently the home needs to rectify this to ensure safe hygiene and infection control. Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 17 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) 27,29,30 The home follows safe recruitment procedures to ensure residents are protected and sufficient staff are on duty and available to meet residents needs. However, the lack of staff training and development plans does not ensure that staff are adequately trained. EVIDENCE: There is a recorded staff rota displaying which staff are on duty throughout the day and night. There is always a senior carer on duty in waking hours and numbers of staff are increased at peak times. The home has responded to the recommendation from the previous Inspection to separate laundry and domestic tasks from care duties and now has a designated post, currently being advertised. Four staff files were looked at during the inspection and included the documentation required to ensure that the homes recruitment procedures are sufficient to protect service users. They also contained evidence of induction training and certificates of training courses attended. The home did not have individual training and development plans in place to ensure that the staff receive necessary training. However staff spoken to during the inspection had received training in Moving and Handling, Health and hygiene, First Aid, Care Procedures, Medication and Fire prevention. The Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 18 homes care staff have yet to undertake NVQ awards. The manager is currently undertaking the Registered Managers Award. Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 19 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) 31,32,34,36,37,38. Residents have confidence in the staff and the manager to meet their needs. The home is financially sound, with its finances under the control of administrators. Health, safety and welfare issues were well controlled by regular maintenance and appropriate procedures. There was one shortfall in Standard 38 in the information sent to the Commission. EVIDENCE: The provider had been in voluntary administration for some years. This was expected to end within the next 12 months. This arrangement had had no discernible effect on the running and maintenance of the home. The manager confirmed that she was able to fill staff vacancies and fulfil National Minimum Standards without restriction. The manager had almost completed the Registered Managers Award. Indeed the assessor was at the home during the inspection, assessing how the manager handled the inspection! Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 20 Staff files contained records of staff supervision. Residents were very positive about the manager and the staff. “You only have to ask, and it’s done.” The Fire Risk Assessment was a model of completeness, and had already been reviewed once. The Environmental Health Officer had visited in July 2005. The only request was to put fly screens on the kitchen windows. The manager confirmed that this would be done. The Commission had been notified of all incidents listed under regulation 37 of the Care Standards Regulations (2001). Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 3 3 x 3 3 3 3 2 Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 22 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 9 Regulation 13(2) Requirement The registered person must ensure that medicines labelled for a particular resident are used only for that person. The registered person must ensure that medicines are moved around the home in a lockable trolley. The registered person must include the current name and telephone number of the CSCI in the complaints procedure. The registered person must maintain a record of complaints. The registered person must ensure that all staff receive training in the protection of vulnerable adults. The registered person must provide a non-permeable floor for the laundry. Timescale for action Immediate and ongoing. 30 Sept 2005 Immediate 2. 9 13(2) 3. 16 22(7) 4. 5. 16 18 22(3) 13(6) Immediate Action\plan by 1st September 2005 Action plan by 1st Sept 2005. 6. 26 23(2) 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 I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 23 Manor Farm House Residential Home 1. 2. 3. 4. 5. 1 7 7 12 The registered person should review the layout and language of the Statement of Purpose and the Service Users Guide to make them easier to read and understand. The registered person should ensure that care plans are regularly audited to ensure that they are completed and up-to-date. The registered person should review the way care plans are stored and filed to make them easier to audit and use. The registered person should investigate ways to provide more stimulating activities based on residents needs. Manor Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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 Farm House Residential Home I54 - I04 S24440 Manor Farm V230416 050727 Stage 4.doc Version 1.40 Page 25 - 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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