CARE HOMES FOR OLDER PEOPLE
Manor House Manor House Station Road Annfield Plain Co Durham DH9 7UZ Lead Inspector
Ms Kathy Bell Unannounced Inspection 30th January 2006 10:45 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 House DS0000031192.V262708.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 House DS0000031192.V262708.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Manor House Address Manor House Station Road Annfield Plain Co Durham DH9 7UZ 01207 232 313 01207 282510 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) Durham County Council Mrs JacquelineThompson Care Home 28 Category(ies) of Dementia - over 65 years of age (9), Learning registration, with number disability over 65 years of age (6), Old age, not of places falling within any other category (28), Physical disability (8) Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Physical Disability Persons with a physical disability over the age of 55 years may be accommodated, commensurate with the home`s Statement of Purpose. 13th June 2005 Date of last inspection Brief Description of the Service: Manor House is registered to provide care (but not nursing care) for up to 28 people. The home is divided into three units on two floors. One unit provides a service for people who need care for a short period, with the aim that with intensive support and physiotherapy they can return to their own homes. The other units provide care for some older people with learning disabilities, up to nine people with dementia and other older people. The home was purpose-built and is part of a complex which includes sheltered flats and a day centre. The home can provide limited support and meals to people in the flats. The home is in the centre of the village of Annfield Plain, with a supermarket, shops, pubs, club and surgeries within easy reach. There are good bus services to the town centres of Consett and Stanley. Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place during one day in January 2006. The inspector, Kathy Bell, looked around the building, and at some records. She talked to 10 residents, and four staff as well as the manager. What the service does well: What has improved since the last inspection?
The manager has worked with health service professionals etc who refer people to the intermediate care unit to make sure that only people who can really benefit from this service are admitted. The lack of other improvements is not a bad sign: it reflects the high standards already in place.
Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Manor House DS0000031192.V262708.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 House DS0000031192.V262708.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): These standards were not assessed during this inspection. EVIDENCE: Manor House DS0000031192.V262708.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 arrangements for dealing with medication make sure that residents receive the medication they are prescribed. Residents who can do this safely, can look after their own medication, to maintain their independence. Medication for people in the intermediate care unit had not been kept as securely as it should be, but this was put right on the day of inspection. Residents are treated with respect, and privacy and dignity are valued in the home. EVIDENCE: There are satisfactory systems for ordering, giving out and recording medication. The written instructions when a drug is not meant to be given out every day are clear to reduce any chances of errors being made. Some residents in the intermediate care unit look after their own medication, as a way of maintaining their independence. Recently, staff have been storing the medication for this unit in a locked cupboard on the unit. This has not met the high standards required for safe storage of medication and the home moved this medication back to the secure storage as soon as this was drawn to the attention of staff. Residents who were spoken with said that they were treated with respect and that staff did knock and wait to be invited into their rooms. No one shares a bedroom unless they particularly wish to.
Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 14 Residents can spend their time as they wish to and staff try and provide suitable activities for those who need help to occupy their time. Residents can continue to make their own choices about their lives. EVIDENCE: Residents staying in the intermediate care unit spend some of their time having physiotherapy and rehabilitation. They are able to spend free time on the day-to-day activities they enjoyed at home, such as TV and reading. Many of the other residents have either learning disabilities or dementia and some are quite frail which limits their abilities to take part in leisure activities. Staff described how they try and involve them in games of dominoes or craft activities. They regularly put on music or videos which residents can enjoy. Staff receive help from the councils CREATE service, which provides craft activities and other leisure pursuits. One resident has a befriender, who can take her out once a week. Staff pick up a daily newspaper for residents who want one. The inspector saw that staff respected the wishes of all residents. Two residents with learning disabilities have been able to continue smoking although staff look after the cigarettes to help them make the limited number of cigarettes they can afford last the week. Residents were able to choose whether they wanted to go to their rooms or sit with other people. The people in the intermediate care unit definitely felt that they could make their own choices while living in the home.
Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 11 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): 16 & 18 Residents were confident that they could talk to staff about anything they werent happy about. The home has done all it can to make sure that people are aware of the complaints procedure so they know what to do if they want to complain. The home has systems in place to make sure that people are protected from financial abuse and all staff have had training to make them aware of how to protect people from abuse. EVIDENCE: The home has a satisfactory complaints procedure and information about this was on display. This information is also given to people when they come into the home. The manager plans to give staff refresher training on how to respond to complaints in the next staff meeting. Residents said that they would feel able to complain if they werent happy about something. A book is also available which people can write in if they want to mention minor things they are dissatisfied with. This is good because it allows people to mention things which they feel are not serious enough to complain about. This then gives the home the chance to respond to their concerns. No formal complaints have been received in the last year. The home has proper procedures to guide staff if there any concerns about abuse and staff have all received training in this area. There are satisfactory procedures for handling any money belonging to residents which protect them from financial abuse. Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home generally provides a comfortable and pleasant place to live. It seems well cared for except that one corridor smells of urine ( because of a particular problem with a past president) and staff have been unable to clear the smell. EVIDENCE: The home is divided into three wings, each with its own lounge, dining room and kitchenette. These provide a comfortable, domestic style of accommodation and all areas of the home are pleasantly furnished and decorated. The home provides all the facilities needed for residents who need help with bathing etc. It is in the centre of the village with local shops etc nearby. The home seemed clean throughout except that in one corridor there was a smell of urine. Staff said they had cleaned the carpet but the smell remained. They could seek a specialist cleaning service but if this does not work, the carpet must be replaced. Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 13 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 & 30 Over 70 of the care staff have achieved NVQ 2 in care, which is the recommended qualification to show that staff have the skills they need for their jobs. Up-to-date training records and complete records of recruitment of new staff were not available in the home so these standards could not be properly assessed. However the County Council, which runs this home has established systems for making sure that only suitable people are recruited and provides comprehensive training for staff. EVIDENCE: Over 70 of the care staff have achieved NVQ 2 in care (50 is recommended). This is a commendable achievement. Up-to-date records of training that staff have received were only kept on the computer system which is used by the County Councils Social Services Department, rather than a system which is just used within the home. As a result, the manager cannot always get access to the information when she wants to, and she could not get the information on the day of inspection. Although CSCI has agreed that large organisations can keep information on staff centrally, it is important that the manager has easy to read information on staff training so that she can make sure staff receive refresher training etc when they need it. The manager suggested that an updatable paper record within the home might serve her purposes better. The home had not yet received the information back from the central recruitment section on staff who have been recruited more recently. The County Councils procedures include carrying out a Criminal Records Bureau and obtaining two references.
Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 14 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): 33, 35 & 38 Although the management of the home does check that it is providing the service expected by residents, they should develop their systems to make sure that they receive good information back from residents and relatives. This would make sure that they hear about minor concerns, which people may not mention because they are so satisfied with every other aspect of the home. Where the home looks after residents money for them there is a system to make sure that they account for all the money and that it is kept safely so that residents are protected from abuse. Staff take good care that the home is a safe place to live and work. EVIDENCE: Senior staff from outside the home carry out a monthly inspection to check home is operating properly, and seek residents views on these visits. Independent surveys have been carried out in the past and people who use the respite care service are asked for feedback. However the home should try and obtain views from all residents, relatives and professionals who visit the home
Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 15 to make sure they obtain as full a picture as possible of how people see the home. This would help them find out if there are minor issues which people dont mention because they are so pleased with the service in general. The home keeps full records of any money they look after for residents and keeps receipts for money spent. There are good systems to make sure that the home is running safely. Equipment is serviced regularly and checks of the fire systems, water temperatures etc are carried out regularly. Staff receive regular training on fire safety, which makes them aware of what they must do in an emergency. Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 16 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 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 X 28 4 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 3 Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 17 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 OP26 Regulation 23 Requirement Further efforts should be made to control the odour in one corridor, including, if necessary, replacing floor covering . Timescale for action 15/02/06 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 OP33 Good Practice Recommendations The home should develop systems for finding out what residents, relatives, care managers etc think of the home. Manor House DS0000031192.V262708.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 DS0000031192.V262708.R01.S.doc Version 5.1 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
