Inspection on 11/08/05 for Manor House

This inspection was carried out on 11th August 2005.

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

The inspector 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 House 14/01/10

Manor House 18/02/09

Manor House 27/11/07

Manor House 21/11/06

Manor House 12/01/06

Manor House 21/02/05

Manor House 13/07/04

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

CARE HOMES FOR OLDER PEOPLE Manor House Higher Tremar Liskeard Cornwall PL14 5HJ Lead Inspector Philippa Cutting Unannounced 11 August 2005 09:30 a.m. 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 House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Manor House Address Higher Tremar Liskeard Cornwall PL14 5HJ 01579 343534 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) Mrs Nichola Jayne Broadhurst Mr Robert Anthony Broadhurst Care Home 16 Category(ies) of Dementia - over 65 years of age (6) registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (16) Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21 February 2005 Brief Description of the Service: The Manor House is a privately owned older style house and, although only approximately five miles from the town of Liskeard, it is situated in a quiet moorland village. The home offers care and accommodation to up to 16 older people who have mental heath needs or dementia. Accommodation is in mainly single rooms, one of which is en suite. Rooms are available on the first and ground floors with a stair lift linking the two floors. Communal rooms and a small sun lounge are available on the ground floor with a additional large sitting room (that includes facilities to dine) on the first floor. The home has a garden at the rear, which service users can use in clement weather.The owners live in a property adjacent to the home. Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place between 9.0am and 3.30pm. The inspector talked with the service users, staff, some visitors and the registered providers. The records and the premises were inspected and various issues that arose were discussed. Service users expressed satisfaction with their care and people commented to the inspector that they had seen the standard of care improve since the present owners took over. What the service does well: What has improved since the last inspection? What they could do better: The registered person needs to ensure that all staff are checked via POVA before a person starts work and that Criminal Records Bureau disclosures for new staff are undertaken. The medication procedures need to be reviewed to eliminate the use of dosette boxes as soon as possible. Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Manor House D52-D04 S48225 Manor House V234122 110805 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 House D52-D04 S48225 Manor House V234122 110805 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) 2,3,4,5 Service users are provided with information about the home and its services and an assessment made to ensure that their needs can be met. EVIDENCE: Service users have individual contracts outlining the terms and conditions of residence at The Manor House as well as local authority contracts, where applicable, which outline the financial terms. The registered person visits prospective clients prior to offering accommodation to ensure that the person’s needs and the home’s abilities are compatible. The needs of the existing clients groups are taken into consideration when making a decision. The registered person outlined her strategies if a request for an ‘out of county’ placement was sought. New people are invited to visit the home in advance but this is not always possible as some come from hospital. Families generally undertake an initial visit in these circumstances. All service users stay on a trial basis, on both sides, for the first month. Manor House D52-D04 S48225 Manor House V234122 110805 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) 7,8,9,10,11 Service users’ health needs are identified and responded to in a caring and competent manner. EVIDENCE: Care plans are available for all service users and were seen to be reviewed regularly. Most have been signed by the service user or their family; it would be helpful to have the rest signed. There was evidence of involvement by other agencies (Community Nurses, Community Psychiatric Nurses, Speech & Language Therapist) as needed. The majority of medication is supplied in a monitored dose system with the remainder coming in bottles and packets from a GP practice/Health Centre. It administered very carefully with two people checking the medication and records. The continued use of dosette boxes for those service users whose medication comes in bottles was discussed. The registered person is aware that this is secondary dispensing but she stated that she feels this is the safest method at the moment but it be will be reviewed once the staff have completed a safe handling of medication course. Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 10 Service users said that they were happy with the care that they were given and the manner in which it was provided. The home tries to care for everyone until his or her life’s end and is usually successful in this. It does however recognise when a person needs more care than they are able to provide and consults with the relevant people. Manor House D52-D04 S48225 Manor House V234122 110805 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) 12,13,14,15 Service users are encouraged to be as active and independent as they are able, within an assessed risk framework, and to retain contact with families and friends. EVIDENCE: The staff arrange various activities on most days as social stimulation is regarded as important. Some service users are frail and tend to be ‘observers’ rather than active participators but those who are more able are encouraged to be outside when the weather is good. It was noted that television is used selectively, either in the upstairs lounge or in peoples’ own rooms. Music appropriate to the service users’ age and taste is usually played in the sitting room. The volume does not preclude conversation. Visitors who called at the home during the inspection said they were pleased with the care their relative received and they were always made welcome when they visited. People are encouraged to go out with families and friends whenever possible. Service users expressed satisfaction with their meals, which can be taken in the dining room or peoples’ own rooms. All are encouraged to come to the dining room, as it is often easier for them to eat at a proper table. Help is Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 12 provided for anyone who has difficulty in managing his or her food. This can be by the presentation of the meal (cut up etc), special cutlery/crockery or physical help. Manor House D52-D04 S48225 Manor House V234122 110805 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) 16,17,18 The registered person has been active in promoting service users’ rights and seeks to safeguard them from harm. EVIDENCE: Any complaints are taken seriously and addressed. It was suggested that a log book of any compliments, concerns or complaints should be started as a record of these. No complaints have been received by the Commission for Social Care Inspection since the last inspection. Service users were offered postal votes for last election but no one chose to exercise their franchise rights. The registered manager has attended a POVA course organised by Social Servcies Department and has had cause to request a POVA meeting on behalf of a service user. Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 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) 19,20,21,22,23,24,25,26 The home is clean and comfortable. The standards are being improved by the present owners in order to provide improved facilities for service users. EVIDENCE: The property was in a run down state when the present owners purchased it. They are making improvements – major items such as new windows as well as routine re decoration and furnishings. A new shower room that replaced an awkward bathroom has been well used. The communal rooms face south and are sunny with a view over the surrounding area. The possibility of providing an approved automatic door opener to the sitting room and passage, to give the home a more open feeling, was discussed. The registered person plans, in time, to provide extra sitting space by moving the laundry. This will create a nicer first impression as well as giving service users more choice as to where they sit. Otherwise service users’ rooms were Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 15 seen to be decorated in various colours and styles giving each room an individual feel. Most had peoples’ own pieces of furniture or ornaments on show. The housekeeper was very thorough. She said that there were a few areas where regular attention to carpets and flooring were needed. She had the equipment to deal with this. The provision of specialised seating for one person was discussed. Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 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 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) 27,28,29,30 The staff appeared to be positive and supportive in their approach to service users. EVIDENCE: Staff are encouraged to undertake training National Vocational Qualifications etc, in order to consolidate their knowledge and skills. Four currently hold National Vocational Qualifications with two going onto the next level. Another is doing an access to nursing course. The registered person needs to ensure that POVA first checks are carried out for all staff and new staff need to have their Criminal Records Bureau checks updated rather than just accepting ones from previous employment. A copy of the guidance for the new care induction standards was given to the registered person. Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 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 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) 31,33,34,35,36,37,38 The registered person has a clear vision of the service she wishes to provide and tries to ensure that the staff work to her standards and adhere to legislative requirements at all times. EVIDENCE: The registered person is working towards her registered manager’s award. The home has a form on display that invites comments from service users, families and interested others on the services that they receive. It has not been circulated formally in recent months but there are letters from families and relatives expressing their satisfaction with the care provided for a relative. Supervision for care staff is provided and minuted staff meetings are held. Information about the new standards for induction training was left. Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 18 The Bank Manager was visiting the home on the same day as this inspection and he told the inspector that he was satisfied with the home’s financial organisation and progress. The home prefers not to look after service users’ money, other than holding some cash for safekeeping if asked to do so. The records required by statute were seen and included the insurance certificate, accident record, incidents and the fire log. The registered person was reminded that where there is a keypad in use, the number should be displayed somewhere nearby. Materials covered by COSHH were stored in a locked cupboard. Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x 3 3 3 x 3 3 3 STAFFING Standard No Score 27 x 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 2 3 3 3 3 3 Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 20 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 OP29 Regulation 19 Requirement The registered provider must ensure that all persons working in the home have had POVA clearance and CRB checks prior to taking up employment. The registered person shall give notice to the Commission without delay of the occurrence of - (a) the death of any service user, including the circumstances of his death;(b) the outbreak in the care home of any infectious disease which in the opinion of any registered medical practitioner attending persons in the care home is sufficiently serious to be so notified;(c) any serious injury to a service user;(d) serious illness of a service user at a care home at which nursing is not provided;(e) any event in the care home which adversely affects the wellbeing or safety of any service user;(f) any theft, burglary or accident in the care home;(g) any allegation of misconduct by the registered person or any person who works at the care home. (2) Any notification made in accordance with this D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Timescale for action 31.10.2005 2. OP12 37 Immediate on receipt of this report Manor House Version 1.40 Page 21 regulation which is given orally shall be confirmed in writing. 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. Refer to Standard OP9 OP33 Good Practice Recommendations The use of dosette boxes should be discontinued and medication dispensed directly from bottle/packet to service user. A further review of homes quality and effectiveness should be carried out amongst serice users and their relatives. This should be coupled with the homes annual development plan. The keypad code should be displayed discreetly. 3. OP38 Manor House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall, PL25 4AD 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 House D52-D04 S48225 Manor House V234122 110805 Stage 4.doc Version 1.40 Page 23 - 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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