Inspection on 11/12/07 for Manor House Care Home

This inspection was carried out on 11th December 2007.

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

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

CARE HOMES FOR OLDER PEOPLE Manor House Care Home 58/60 Main Street Middleton Market Harborough Leicestershire LE16 8YU Lead Inspector Sarah Jenkins Unannounced Inspection 08:15a 11 December 2007 th 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 Care Home DS0000070658.V355441.R01.S.doc Version 5.2 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 Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor House Care Home Address 58/60 Main Street Middleton Market Harborough Leicestershire LE16 8YU 01536 771722 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) RKL Living Ltd Mrs Frances Mary Tuck Care Home 22 Category(ies) of Dementia (22) registration, with number of places Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following category of service only: Care Home - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Dementia - Code DE. The maximum number of service users who can be accommodated is: 22. N/A Date of last inspection Brief Description of the Service: Manor House is situated in Middleton, a village location between Market Harborough and Corby. The home was at one time the local Manor house for the village. There are recent conversions to the older part of the home, which is a separate facility of flats for assisted living, owned and run by the same owner but not part of the registered facilities. Manor House has been running as a Residential care home for a number of years but has recently re-registered under new owners. The Registered Manager and most of the staff have worked at the home for some time. The registered home is a separate unit, accessed from the car park and is known as “The Orchards”. The Orchards can admit up to 22 service users who are suffering from dementia. Service users have their own rooms and the enclosed communal areas include two lounges, corridors and a patio courtyard area where service users can wander safely and freely. Information about the home is available from the Registered Manager in the form of the Statement of Purpose and Service Users Guide. The fees for residential care range from £359 to £424 per week, and items such as hairdressing, toiletries, chiropody and some travel are charged separately. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 3 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the morning to observe practices by staff and to meet with service users. Service users have various degrees of Dementia and thereby communication for many is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was largely through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. The Inspector spent five hours in the home, and also reviewed the history of the home and feedback from relatives as part of the inspection. Fourteen comment cards were received from service users, relatives and staff and these were generally very positive. What the service does well: Staff relationships with service users were judged to be excellent and to be in the best interests of service users. There is stability in the staff group leading to consistency, good relationships and a full and sensitive understanding of service users individual needs. There is a good atmosphere in the home and service users are active and generally happy. They interact confidently with each other, with staff and visitors, and with the environment, and are enabled to make choices, and empowered to make decisions about their lives. Medication is used appropriately. Difficult behaviours are addressed through good practice and attention from staff rather than being seen as a problem that automatically requires increased medication. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 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 Care Home DS0000070658.V355441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (This home does not offer intermediate care) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs and wishes are properly assessed prior to their admission to the home, and they can be confident through this process that the home will meet their needs. EVIDENCE: The Inspector reviewed the admission process of a recently admitted service user, and found that a proper assessment of the service users needs had been undertaken. Information on file was sufficient to offer preliminary care and risk assessments had been undertaken. The service user concerned appeared to have settled in well and expressed general contentment about the process although it was not appropriate to seek full details. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 9 Staff confirmed that all aspects of service users care including their introduction to the home was undertaken with sensitivity and understanding. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users health and personal care needs are properly assessed and responded to. They can be confident that they will be treated with consideration and respect. EVIDENCE: Service users had care plans that gave detailed information on specific aspects of care. These were not always fully inclusive of all aspects of service users lives e.g. social and emotional needs. However there was evidence from observations and discussions with staff that service users interests were well known. There were also histories of service users lives and records of activities that they got involved with. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 11 There was evidence that input had been sought appropriately from other professionals in the drawing up of care plans and for example the Community Psychiatric nurse had given advice on best practice for dealing with specific problem behaviours. There was evidence on service users records of a full and effective overview of all healthcare needs and staff stated that they were well supported by community healthcare teams. Improvements have been made to the routine for giving out medications and this was observed to be effective and safe. The senior staff member administering the medication at the time of the inspection was fully trained and suitably experienced and undertook this role with a good understanding of individual service users needs, for example spending time with service users appropriately, and giving explanations to encourage them to take their necessary medications. Staff attention to service users rights, privacy and dignity were exceptional. Service users were always spoken to with great respect and affection even when their behaviour was unacceptable in general terms. There was a sensitive understanding of the service users difficulties and discreet use of diversion techniques. Service users were offered explanations at all times and whenever necessary, and were offered the same information patiently, as many times as was necessary, and with no implication that they had already been given the information. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users lead active and stimulating lifestyles with activities and regular trips away from the home environment provided. The quality of service users lives is enhanced through the relationships that they have with staff who are interested in their individual lives and are committed to ensuring their wellbeing and happiness. EVIDENCE: Service users lifestyles are enhanced in quality through the care, kindness and professionalism of the staff team. The inspector observed a number of interactions through the course of the inspection demonstrating the excellent relationships that staff have established with service users and the ways in which these relationships benefit service users. Staff were regularly involving service users in conversation in the course of their duties and had good knowledge of service users backgrounds and Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 13 experiences to enable them to prompt pleasant memories, and remind them of recent events. In interviews with staff it was evident that they had a very good understanding of dealing professionally with service users with dementia and challenging behaviours, and that they used discreet and non-confrontational approaches. Close observation of service users was known to be integral to good care practices, and the inspector observed that early intervention was used to prevent escalation of minor conflicts between service users. Service users are enabled to move freely around the home and a relative commented: “Mum can walk around and is not restricted too much, she can walk around and behave as normal but with expert care and observation from staff” Mealtimes are flexible according to the needs and wishes of the service users. Service users were given choices and properly informed about these. Service users were seen to enjoy their breakfasts and their midday meal. Meals were seen to be appetizing, nutritious and well presented. Staff were sitting with service users to assist and encourage those who needed help. Relatives comments included “ The food is always nutritious and served to suit the requirements of the individual”. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The good quality of communication and response to service users needs, by staff, are likely protect service users and to pre-empt their complaints. EVIDENCE: Policies and procedures are in place and staff are aware of safeguarding (Protection of Vulnerable Adults issues). Most staff have received appropriate training in this area and new staff are to undertake this shortly. There have been no complaints about the home to either the Commission for Social Care Inspection or to the Registered persons. The Inspector observed the commitment of staff to good care, and to service users rights, and is confidant staff would advocate on residents behalf if any level or form of abuse were indicated. Relatives who responded to the feedback comment card indicated that they had been informed of the complaints procedure but had never had cause to complain. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have a safe and pleasant environment where they can wander freely. EVIDENCE: The premises are designed so that service users can wander freely to different areas. Bedroom doors are locked to facilitate this, but service users are enabled to access their own rooms as required. There is a pleasant outdoor courtyard area, where service users can be involved in planting flowers and can wander freely when the weather permits. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 16 Service users rooms were sampled and seen to meet the needs of the individuals. Service users said that their rooms and their beds were comfortable. The home was very clean and odour free throughout. The small kitchenette area integral to the lounge is in need of refurbishment. This has already been recognized by the owners and is to be refitted early in the New Year. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are well met by a well-trained and experienced staff group. Staff work well as a team and are sensitive and responsive to the needs of service users with dementia. EVIDENCE: At the time of the inspection there were sufficient staff on duty to meet the needs of the service users at that time. Senior staff confirmed that it was possible to call in more staff or agency staff if circumstances demanded. Staff feel that there are generally enough staff on duty, although there is recognition that things can get very busy sometimes when service users occasionally unsettle each other through unusual behaviours. One out of the four service users, and four out of the six staff who returned comment cards, indicated that there were “usually” enough staff in contrast to the other nine people who sent feedback, who thought there were “always” enough staff. The interactions between care staff and service users demonstrated knowledgeable and professional approaches to care. Staff were seen to be very Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 18 caring with a good understanding of the principles of care. Without exception, in the interactions observed, service users individual needs were recognized and understood and service users were treated with respect and dignity. Service users often praised the staff with phases such as “You’re very nice” and “You are so kind”. Comments from relatives about staff included “The dedication shown by them is beyond our comprehension”. “My mother receives excellent care”. Staff were well trained and spoke positively of the training opportunities at the home. Records of training and the training programme showed that there are regular training events and that the Manager ensures staff are appropriately updated. All staff, except new recruits, are qualified to National Vocational Qualification level 2 or 3. A recently recruited staff member described the professional recruitment process that had been followed, and the staff file demonstrated this. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is effective and responsive to the client group. The wellbeing and happiness of service users is central to the running of the home. EVIDENCE: The Registered Manager is well qualified to work with this client group and keeps herself updated in professional practice and training. Staff speak highly of the Manager and her Deputy and find the management team approachable and supportive. They feel that the Manager is responsive to Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 20 any concerns that they might have. Staff comments included “I know her door is always open for any problems or questions staff may have” The Registered Manager undertakes Quality Audit on the outcomes for service users and responds appropriately to any issues arising. Relatives, in conjunction with the home, generally manage service users monies. The Registered Manager stated that all service users receive their personal allowances in cash or kind. Risk is well managed through observation and prompt response by staff but some risk assessments are in need of updating. No Health and Safety issues were identified at this inspection. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations Care should be taken to ensure that there is evidence that service users records, including risk assessments are kept under review and promptly updated. Manor House Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Care Home DS0000070658.V355441.R01.S.doc Version 5.2 Page 24 - 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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