Inspection on 07/04/05 for Maple House

This inspection was carried out on 7th April 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Maple House 25/07/07

Maple House 03/11/06

Maple House 28/09/05

Maple House 20/10/04

Maple House 28/06/04

Maple House 03/03/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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 23 Manor Road Aldershot Hampshire GU11 3DG Lead Inspector Val Sevier Unannounced 7 April 2005 10.00am 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 Nursing Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Manor House Nursing Home Address 23 Manor Road, Aldershot, Hampshire, GU11 3DG 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) 01252 325753 01252 341963 Dr Zyreida Denning Mrs Jacqueline Sylvester CRH 30 Category(ies) of DE 6, DE(E) 34, OP 34 registration, with number of places Manor House Nursing Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Service users in the DE category can only be admitted between the ages of 5565 years. Date of last inspection 20 October 2004 Brief Description of the Service: Manor House is a nursing home able to accommodate 34 service users. It is situated off of one of the main roads into Aldershot. The service offered is for older people with mental health frailty and nursing needs. The accommodation is offered over two floors with twp lounge areas and a separate dinning room, seating is also available in the conservatory. The home has a garden area accessed from the conservatory, which has seating available. Manor House Nursing Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of the home in this inspection year. It was unannounced and took place over five hours. The registered manager of the home has moved to manage the sister home five minutes away. Two managers have been appointed but currently there is no one in that position. There is a deputy manager and the manager of the sister home supports her in the management duties. The manager from the other home was called to Manor House and assisted the inspector with the inspection. The inspector viewed six staff files and five care plans. Other records such as fire and medication were also seen. The inspector spent nearly two hours talking with relatives, residents and staff and observing the interaction at the home. What the service does well: What has improved since the last inspection? The home seems more homely now because of the change in carpeting with the same throughout. The home is generally well maintained and this has improved. The pre admission assessment form now seems to be established at the home and definite links between that and the care plans were seen. Manor House Nursing Home Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Manor House Nursing Home Version 1.10 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 Nursing Home Version 1.10 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) 3 and 4. The home has a comprehensive pre admission assessment form. The manner in which is completed is variable dependent on the strengths of the individual staff member and therefore there is a risk of insufficient evidence. The staff generally have a good understanding of residents needs, supported by the training offered at the home. EVIDENCE: There was evidence on three residents files that a pre admission assessment had been completed. The other files seen were of residents admitted to the home prior to this document being used. The assessment itself contains all areas needed in the standards however the manner in which information needed to make the assessment was varied. There was evidence that the assessment had been used to establish a care plan. Staff have undertaken training in dementia which includes communication. There is also training available in other areas of health needs such as wound care. Manor House Nursing Home Version 1.10 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 and 10. The care planning procedures in this home are good, however lack of attention to detail and poor communication at times, prevents all care needs being met. The stem of administration of medication is not sufficient and potentially places residents at risk. EVIDENCE: Care plans were in place for all residents including those recently admitted to the home. They had been reviewed regularly. They contained information on all care needs identified in the pre admission assessment. There were risk assessments in place. One relative spoken with was on the whole happy with the care at the home, however on the day of the inspection there had been no drink or tissues available to the resident. Resident’s spoken with said they were happy although there are some staff they don’t get on with. Residents who wore glasses had them on but they were dirty. Fingernails were being cut in the lounge. Two residents were seen being pulled backwards in wheelchairs with no footplates on, the manager stated an acceptable reason for this method being used for one resident this must be documented. Manor House Nursing Home Version 1.10 Page 10 One resident seen in bed although had a fluid-monitoring chart was noted to have a very dry mouth. The privacy and dignity of residents needs to be monitored with male and females able to wander into each other’s rooms. There were few gaps in the medication administration records this is an improvement. However it was noted that the pulse had not always been recorded prior to the administration of Digoxin. Where residents could receive a higher or lower dose of a medication e.g. one or two tablets there was not always a records of what had been administered. Privacy and dignity were seen to be held when staff carried out personal care. However residents spoken with said that they found it rude that staff spoke to each other over their heads in their own language. It was observed that staff did not communicate with residents before and during carrying out care or interaction. One resident became cross and agitated and asked staff to ‘talk to me’, as they were moving him without talking to him about what they were going to do. It was noted that one member of staff sitting with a resident didn’t communicate at all with the residents in the room. This was discussed with the manager. Manor House Nursing Home Version 1.10 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 and 15. Social activities are adequately arranged. The quality of the meals do not meet the expectations of the residents and appear inadequate. EVIDENCE: Residents spoken with commented on the activity lady in particular the exercise class held once a week. One resident also commented on the painting and puzzles. One resident has the paper daily. There are no specific visiting times at the home. There were no residents managing their own affairs on the day of inspection. The menu is four weekly and was seen to be on the dinning room wall. Residents spoken with said that the meal that day was not nice the meat was very hard. Often they have hard vegetables and there is little variety with a lot of ‘stews’. Fresh fruit is available on request with one resident eating a lot of bananas. The meal looked all right on the plates seen and staff assisted appropriately although again with little or no interaction with the residents. Manor House Nursing Home Version 1.10 Page 12 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 and 18. The complaints procedure at this home is comprehensive. The home has a satisfactory adult protection policy, with evidence that staff have an awareness of it. EVIDENCE: No complaints have been received at CSCI or at the home since the last inspection. There is a complaints procedure available. Relatives spoken with were aware of how they could make a complaint. The manager has just undertaken a course in training staff in Adult Protection and plans for all staff to receive training in this are over the next two months. There have been no allegations under adult protection. Manor House Nursing Home Version 1.10 Page 13 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 and 26. With recent investment the home appears more homely now however, storage continues to be an issue. The noise and working environment of the laundry is still of concern. EVIDENCE: The inspector undertook a tour of the home. The action requested previously regarding the bathroom has been carried out. New carpeting has been put in the hallways and landing of the home. This now gives a more homely feeling. Regular maintenance is carried out by the homes handyperson who has a book in which staff write when they have found something he then signs when complete. The laundry and its position near bedrooms and the noise needs to be reviewed however, it was seen to be better maintained than previously. There was an unpleasant odour in some bedrooms staff were aware of these. On the day of the inspection the domestic had to leave early so these rooms were not addressed. Manor House Nursing Home Version 1.10 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30. Recruitment procedures need to be strict to ensure the safety of residents. Staffing levels appeared to meet the needs of the residents on the day. There is training to support staff in meeting needs of residents. EVIDENCE: The rotas for the month around the inspection date were seen and staffing ranges from 10 in the morning to five staff in the afternoon. On average there are 8 staff in the morning two nurses and five care staff and two nurses and five care in the afternoon. Six staff files were seen and it was observed that with the exception of one all had had appropriate checks carried out. References were obtained verbally from the Philippines and were written by a member of staff who is able to speak both Philippino and English, however they were not signed to this effect and not followed up in writing. . Staff spoken with were about to undertake training in venapuncture. Staff were also aware of the training in Alzheimers and had completed the course with an exam. Manor House Nursing Home Version 1.10 Page 15 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) 33, 35 and 38. The systems for consultation are good with a variety of evidence that relatives, residents where possible and other professional’s views are sought. The systems for training and checking equipment for health and safety and are not sufficient to ensure residents safety. EVIDENCE: The manager undertakes a quality survey every six months these are by questionnaires and are sent to relatives, social workers and GP’s. An action plan was seen to have been made from the comments made in these forms. Relative’s spoken with prefer to speak to the manager as issues arise. The home does not look after resident’s monies. Staff were observed to use moving and handling equipment appropriately with the exception of a verbal explanation of what was happening. Staff spoken with were aware of health and safety of chemicals and the fire policy of the home. The fire records were seen and it was noted that regular fire alarm checks are carried out weekly. A visual check of the fire equipment and Manor House Nursing Home Version 1.10 Page 16 emergency lighting is also carried out monthly although the lighting has only been done in March and April. Staff fire training has slipped from being six monthly but the manager stated that arrangements had been made that all staff would be trained on 27th April. Manor House Nursing Home Version 1.10 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 2 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 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 x 3 x x 3 x 3 x x 2 Manor House Nursing Home Version 1.10 Page 18 Yes 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 4 Regulation 12, 18 (1) Requirement Staff must be able to meet the needs of service users this includes having an understanding of their needs and methods of communication. Staff must not speak in thir own language if not English around and over residents. Personal care must be carried out in an appropriate place. Residents must have their fluids maintained appropriately. Items such as hearing aids and glasses must be usable to help maintain independence. Staff must ensure that the home is odour free. Where references are taken verbally from referees abroad this must be clear and the person who has taken them should sign to say they are an accurate reflection of the conversation. Where possible they should be followed up in writing. Staff must use wheelchairs safely and appropriatley. Timescale for action 31/07/05 2. 3 8,10 8, 10 12 (1)(2)(3) (4) (5) 12 (1) (2) (3)(4)(5) 31/05/05 31/05/05 4 5 26 29 16, 13 19 Sch 2 15/05/05 31/05/05 6 38 13(5) 15/05/05 Manor House Nursing Home Version 1.10 Page 19 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 Good Practice Recommendations Manor House Nursing Home Version 1.10 Page 20 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hants, SO15 1GW 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. 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