CARE HOMES FOR OLDER PEOPLE
Manor Lodge 8 Portland Avenue Exmouth Devon EX8 2BS Lead Inspector
Michelle Oliver Announced 15 July 2005 09:30hrs 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 Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Manor Lodge Address 8 Portland Avenue Exmouth Devon EX8 2BS 01395 266691 01395 277886 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) Manor Lodge (Devon) Ltd Mrs Eileen ONeill Care Home 23 Category(ies) of OP Old age (23) registration, with number of places Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 16 November 2004 Brief Description of the Service: Manor Lodge is a detached house in a quiet residential avenue close to Exmouth sea front, hospital and town centre. It provides personal care for up to 23 older people. The accommodation is arranged over ground and first floors and all rooms have en suite facilities. There is a passenger lift and a stair lift between the ground and first floor. The lounge and dining rooms are on the ground floor. There is a large parking area at the front of the house and landscaped level gardens to the front and rear of the property that also has an extensive decked area. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on Wednesday 13th July 2005 from 9.30am to 12.45.pm. The providers, and manager were present throughout the inspection. The inspector spoke to 8 residents on this visit. All members of staff on duty also took part in the inspection. The atmosphere in the home was warm, welcoming and friendly and residents were relaxed, content and spoke highly of the care they received in the home. The inspector looked around the home, a number of records were inspected, which included pre inspection questionnaire, comment cards, thank you letters from relatives, staff file and a recent service user survey and results. The manager and staff were very helpful on the day of the inspection and a lot of positive discussions, advice and suggestions took place throughout the inspection. What the service does well: What has improved since the last inspection?
No requirements or recommendations were made at the last inspection. A bathroom at the home is being completely refurbished to include a specialist bath and plans to refit another bathroom to include a shower for those residents who have said they would prefer this facility.
Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 Page 6 A new fireplace has been fitted in the lounge. This has increased floor space is visually pleasing. The staff handbook has been updated and policies have been condensed to be more user friendly for staff to refer to. Staff continue to have access to policies in the home. The manager has recorded a “Disaster Plan” which includes all telephone numbers and relevant information easily accessible to all staff in the case of an emergency. The home’s brochure has been updated and includes comprehensive information and photos to further assist potential residents in making a choice of living at the home. 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 Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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 Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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 & 6. Residents benefit from good admission and assessment practice which ensures that the home is able to meet their needs. EVIDENCE: Care needs are well met through a full assessment process that is carried out before a resident decides to live at the home. Care plans are completed from this information. The assessment includes all the elements listed in the standard. A comprehensive assessment was seen for a resident recently admitted to the home. The home does not admit residents for intermediate care. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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 & 10. Resident’s health and social care needs are well met and promoted by good planning arrangements. Resident’s privacy and dignity are met and promoted by the staff and management team at Manor Lodge. EVIDENCE: All residents have individual plans of care based initially on a pre admission assessment. The plans of care are regularly updated to reflect up to date care needs. The format has been improved since the last inspection after staff confirmed at a staff meeting that they did not find the plans easy to use. The manager and staff have worked together in producing very comprehensive plans of care for all residents. The plans clearly explain residents needs and how they are to be met with good individual detail. Daily reports and staff handovers ensure staff are aware of any changes in each service users needs. Residents confirmed that they are treated with respect and their right to privacy is maintained. Residents said, “Nothing was too much trouble for the staff”. The Inspector saw care staff knock on service users’ doors and wait to be invited before entering. The interaction between the staff and residents was friendly and respectful. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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 standard(s) 12 & 15. Social activities and meals are well managed, creative and provide daily variation and interest for people living at the home. EVIDENCE: Staff and management have worked hard to gain information about individual residents social and leisure needs and this is included in care plans. The home has a good selection of books, jigsaws, crafts and games. Activities including bingo, scrabble, skittles and exercises are regularly provided. Residents told the Inspector that they enjoyed walking around the garden and the decked area. Since the last inspection a Memorial Garden has been created which gives several residents pleasure. At a residents meeting it was decided that they would like to have some outside speakers visit the home to give talks on chosen topics. As a result of a talk given by a representative of Devon Air Ambulance the residents have decided that this will be their chosen Charity this year and are busy arranging fund raising events. A variable, nutritious diet is provided at the home. This was confirmed by residents and from the meal on the day of the visit. A menu is displayed in the dining room. Meals and activities are amongst the topics discussed at residents meetings. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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 standard(s) 16 & 18. Residents and relatives are confidant that they are listened to and their requests actioned. Satisfactory arrangements are in place for protecting residents and responding to concerns. EVIDENCE: Residents are aware of how to make a complaint at Manor Lodge. They were confident that any issues raised by them would be listened to, taken seriously and acted upon. A resident said that a concern would never get to be a complaint because the manager or providers would deal with it immediately. Also, any “grumbles” are discussed at the regular residents’ meetings. The home has received one complaint since the last inspection. The investigation was carried out by the manager. A record is kept of all responses and investigations into complaints received at the home. Members of staff confirmed they are aware of the homes policy on the prevention of abuse and the Whistle Blowing policy and would not hesitate to report any incidents of poor care practice at the home. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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 standard(s) 19 & 26 The standard of the environment within the home is very good providing the residents with an attractive and homely place to live. Residents’ rooms suit their needs and have been personalised. Attention has been made to the safety of residents and staff. EVIDENCE: The property is very well maintained, with homely and comfortable communal spaces. The home offers a large lounge and two dining rooms. Residents confirmed that they felt that they were safe and that the home is well maintained. The home was attractively decorated and well maintained internally and externally. The standard of furniture, furnishings, fittings and equipment is of a high quality. Residents’ rooms were personalised with sentimental items, photographs and small pieces of furniture and all expressed their satisfaction with the accommodation provided. The home was very clean and free from offensive odours throughout. The laundry facilities were well organised and met the National Minimum Standard. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 Page 13 The large well laid out landscaped gardens are very attractive and there is a large decked patio, which the residents said that they get great enjoyment from. Having won the Exmouth in Bloom[ Residential Category] last year the home has just been judged for this years competition. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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 Residents benefit from having skilled, experienced and friendly staff who have a good understanding of their needs. EVIDENCE: The manager aims to provide 4 carers on duty between 8am-2.30pm, 3 between 2.30pm and 8.30pm and 1 sleeping and waking carer on duty between 8.30 pm an 8.am. Residents said, “ This is a well run, clean home, where the staff and management do everything they can to make our time here a happy one”. During the visit staff spent time with residents and responded to their needs promptly. The providers and manager are committed to providing training Manor Lodge. Records confirmed staff had attended a variety of training sessions. All staff were confident that they were able to needs of the residents at the home. All staff are given induction training. for all staff at relevant meet the and foundation Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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 & 38 The manager provides clear leadership and guidance to staff to ensure that residents receive consistent care in a safe environment. EVIDENCE: The providers and manager give a clear lead and direction to staff. Residents and a visitor confirmed that the providers and manager are approachable and seek to ensure that all their needs are met. A resident said, “They go that extra mile” The systems for resident, staff and relatives consultation are good with evidence that indicates residents’ views are both sought and acted upon. A Resident meeting is held monthly which covers subjects such as catering, personal care support and residents questionnaires and results. The providers inspect the home monthly and sends a report to the CSCI and the manager. The quality of these reports is excellent. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 Page 16 Safe working practices are employed and risk assessments are undertaken. Manual handling training is undertaken by the deputy manager who attends yearly training updates. Records show that staff undertake regular training in the prevention of fire. Fire alarms and emergency lighting are regularly checked. Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 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. 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 4
COMPLAINTS AND PROTECTION 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 x 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 4 x x x x 3 Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 Page 18 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 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 Good Practice Recommendations Manor Lodge D54 D06_s62219_manorlodge_v225470_280605 stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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