Inspection on 06/02/06 for Manor House Nursing Home

This inspection was carried out on 6th February 2006.

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

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

Other inspections for this house

Manor House Nursing Home 02/03/09

Manor House Nursing Home 12/03/08

Manor House Nursing Home 04/10/06

Manor House Nursing Home 20/11/05

Manor House Nursing Home 08/02/05

Manor House Nursing Home 12/08/04

Manor House Nursing Home 26/02/04

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

CARE HOMES FOR OLDER PEOPLE Manor House Nursing Home Merton Nr Bicester Oxfordshire OX25 2NF Lead Inspector Philippa MacMahon Unannounced Inspection 6th February 2006 10:00 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 Nursing Home DS0000042340.V282845.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 Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Manor House Nursing Home Address Merton Nr Bicester Oxfordshire OX25 2NF 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) 020 7723 7071 European Care (UK) Limited Mrs Dinalee Rodriguez Care Home 102 Category(ies) of Dementia - over 65 years of age (102), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (102) Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two unnamed residents under the age of 65 may be admitted to the home at any one time. The home has four named individuals who, on admission, were under the age of 65. The total number of service users to be accommodated at any one time must not exceed 102. 20th November 2005 Date of last inspection Brief Description of the Service: The Manor House Nursing Home is situated in a quiet rural location, within visiting distance of Oxford, Aylesbury and Banbury, and close to the market town of Bicester. It is easily accessible from the M40. It is set in over four acres of gardens and lawns, overlooking open countryside, with a small lake, pond and fountains. A landscaped enclosed courtyard has been created with a water feature. The original house is a 16th century manor house that has been considerably extended. The accommodation is provided on two floors and most rooms are single, en-suite. There are a few shared rooms. The home is divided up into four lodges, North, West, East, and Garden, each with its own complement of communal areas and staff. The Manor House Nursing Home is home to 102 frail older people, who require nursing care, and some require specialist care for various forms of dementia Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second to be carried out in the inspection year. The inspector was given a warm welcome by the staff and all cooperation was given throughout the inspection. Care plans were examined, and the medication system. Discussion with the manager and staff took place, and there was opportunity to talk with a number of visitors and relatives. Time was also given to observing the daily life for the residents’. The kitchen was visited and menus discussed with the chef. What the service does well: What has improved since the last inspection? What they could do better: The disposal of unwanted medication needs to be arranged with a licensed waste disposal company. The care planning documentation needs to be reviewed and rationalised, as two systems are in operation at the present time. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 6 Training in the specialist area of caring for people with diabetes mellitus needs to be implemented. Attention to detail in recording information about indwelling urinary catheter care. The quality assurance systems need to be further developed to ensure continuous improvements in the care provision. 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 Nursing Home DS0000042340.V282845.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 Nursing Home DS0000042340.V282845.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): None of these outcomes were inspected on this occasion having been addressed earlier in the inspection year. EVIDENCE: Manor House Nursing Home DS0000042340.V282845.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): 7,8,9. Every resident has a care plan in which their assessed care needs are identified and the action required to meet those needs. However the duplication of paperwork is making it difficult to easily identify what the residents care needs are. The nursing and care staff require an update and training in the care of people with Diabetes Mellitus. More detailed records need to be made about indwelling urinary catheters. The medication system within the home is in good order, and the only outstanding issue is the disposal of unwanted medicines. EVIDENCE: The inspector examined a sample of care plans on each of the four units. The home is in the process of introducing new documentation and running with both the old and new concurrently. This is causing a lot of distress to the staff, and the inspector found it difficult to ascertain what the immediate care needs of the residents was and how they would be met. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 10 It is recommended that consideration should be made into reviewing the implementation plan for the introduction of the new care planning methodology to ensure that the residents’ care needs are being met, and the documentation supports this. The home has previously implemented an excellent three-day assessment tool for new residents’, and this is not included in the new methodology. This will be a great loss as this gave the staff a very clear and accurate picture of the resident and their special care needs. Two of the care plans examined were for people who have diabetes and the care plans did not make it clear the special observations required such as foot care, and recognising the signs and symptoms of a very low blood glucose levels, and how to respond to such an event. It is recommended that further training in looking after people with diabetes should be arranged for the nursing and care staff. It was further observed by the inspector that where a resident had an indwelling urinary catheter, there was no record of the make, size, or batch number when a catheter was replaced. This is not good practice and it is recommended that whenever an indwelling urinary catheter is replaced the make, batch number, size, and balloon size, should be recorded in the care plan. Many of the manufacturers supply a sticky label in the packaging for this purpose. The medication systems in the home were examined on each unit and found to be in good order. The inspector asked how the home was disposing of unwanted medicines and was advised that they were returned to the dispensing surgery that supplies the medication. This is contrary to recent changes to the arrangements that affect the disposal of medicines in care homes with nursing. It is now necessary for registered providers to arrange for the safe disposal of unwanted medication with a licensed waste disposal company. It is a requirement that the registered manager must arrange for the safe disposal of unwanted medication with a licensed waste disposal company. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15. There is an excellent programme of activities provided to meet the needs of the present group of residents. The residents receive a wholesome and nutritious diet. EVIDENCE: The inspector found good evidence of the residents’ “life stories”, and the activities they had enjoyed within the care plans. There are three activities co-ordinators who have developed a comprehensive programme of activities, and many take place across the four units such as a birthday party that was taking place at the time of this inspection. This is commendable as it shows a commitment to be inclusive, and to broaden the social horizons for the residents’. Outings take place and a visit to a local musical at the weekend had been arranged. The activities staff work flexibly to enable them to support out of hours activities such as this. The home is to purchase a new mini bus to enable more residents to have the opportunity to go out. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 12 The inspector noticed very attractive displays that had been made by the residents’, with the assistance of the activities staff. Lunchtime was observed and the inspector observed staff assisting the residents’ in a most appropriate manner. The meal served looked appetising and wholesome and appeared to be enjoyed by the residents’. A sample of the menus was examined and showed that a variety of seasonal meals were prepared. In the afternoon a trolley of fresh fruit is taken round the lodges for the residents’ to enjoy. The cook explained to the inspector that she hoped to make further changes to the menus having discussed with the residents’ and relatives what would be good to have on the menu. The kitchen staff cover from 8am to 7pm each day to cover the three meals and to allow for the deep cleaning of the kitchen areas. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 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 the following standard(s): 16,17,18, The home has a clear policy and procedure for dealing with complaints that is readily available to residents’, relatives, and visitors. Residents’ are able to take part in the civic process. The registered manager makes every possible effort to ensure that the residents’ are protected from abuse. EVIDENCE: A copy of the complaints procedure is posted in the main reception area and is included in the service users guide. Residents’ are able to take part in the civic process if they wish to. A few residents’ go to the polling station, and others have a postal vote. The registered manager considers issues of abuse and confidentiality to be great importance and guidelines are given to all new staff as part of the induction pack, and this is followed up with further training. The registered manager is to attend an update on protection of vulnerable adults training in the near future. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 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 the following standard(s): None of these outcomes were addressed on this occasion as they were dealt with earlier in the inspection year. EVIDENCE: Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): None of these outcomes were addressed at this inspection as they were dealt with earlier in the inspection year. EVIDENCE: Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33. The home is very well managed and there are clear lines of accountabilities. The registered manager makes every effort to obtain the views of the residents’, their relatives and visitors, about the service that is provided. The service is very much focused on the residents, and their well being. The quality systems are developing well but their needs to be feedback to all participants to ensure continuous improvement. EVIDENCE: The registered manager has strong leadership skills and it is apparent from talking to staff that there is good teamwork and clear lines of accountability in the staff team. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 17 The manager and her deputy have an “open door” approach to management and relatives, staff, or residents are able to access them with any concerns they may have. European Care has a number of quality tools including regular internal audits, and a residents’ satisfaction questionnaire. This was last carried out about a year ago and as yet the results have not been fed back, or published. It is recommended that the results of this survey should be published and a copy sent to the inspector. The home has an excellent newsletter that is produced quarterly and is very much about the people who live and work in the home, as well as informative about management issues. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 X 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 3 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X X Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 19 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 OP9 Regulation 13(2) Requirement It is a requirement that the registered manager must arrange for the safe disposal of unwanted medication with a licensed waste disposal company. Timescale for action 31/03/06 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 OP7 Good Practice Recommendations It is recommended that consideration should be made into reviewing the implementation plan for the introduction of the new care planning methodology to ensure that the residents’ care needs are being met, and the documentation supports this. It is recommended that further training in looking after people with diabetes should be arranged for the nursing and care staff. It is recommended that whenever an indwelling urinary catheter is replaced the make, batch number, size, and DS0000042340.V282845.R01.S.doc Version 5.1 Page 20 2 OP8 3 OP8 Manor House Nursing Home balloon size, should be recorded in the care plan. Many of the manufacturers supply a sticky label in the packaging for this purpose. 4 OP33 It is recommended that the results of the residents’ satisfaction survey carried out last year should be published and a copy sent to the inspector. Manor House Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Nursing Home DS0000042340.V282845.R01.S.doc Version 5.1 Page 22 - 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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