Inspection on 16/02/07 for Manor Lodge

This inspection was carried out on 16th February 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

Manor Lodge 09/12/08

Manor Lodge 17/01/06

Manor Lodge 29/07/05

Manor Lodge 06/01/05

Manor Lodge 03/08/04

Manor Lodge 05/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Manor Lodge 27-29 Alexandra Road Watford Hertfordshire WD17 3QX Lead Inspector Yoke-Lan Jackson Key Unannounced Inspection 10:00 16th February and 8th March 2007 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 Lodge DS0000019454.V330648.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 Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor Lodge Address 27-29 Alexandra Road Watford Hertfordshire WD17 3QX 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) 01923 221 451 01923 253 114 Follett Care Limited Mrs Julie Parker Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate one named service user who is under the age of 65 years. This condition will remain in force until 10 June 2007 or until the service user permanently leaves the home for any reason. 17th January 2006 Date of last inspection Brief Description of the Service: Manor Lodge is a large detached house that has been converted into a residential home for service users in the old age category. By agreement with the Commission, the home provides accommodation for 28 service users instead of the registered 34 as four of the bedrooms are smaller than required by the National Minimum Standards. The home is situated in a residential area within walking distance of the town centre of Watford and Watford Junction railway and bus stations. There are a limited number of free parking spaces outside the home. The administrative office, the staff room, the kitchen, the lounge/diner and the laundry room are all on the ground floor. Most of the bedrooms are on the first floor. There is a lift to the first floor. The assisted bathroom and toilet facilities are easily accessible. The only communal space is the lounge/diner which is spacious and overlooks the large patio and garden. There are tables and chairs in the garden, where most of the service users spend their lunch time in the summer months. The home charges £400 to £480 per week. Further information can be obtained from the home’s Statement of Purpose and the Service User Guide. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 16 February 2007. The registered manager and a deputy manager were present. There were 19 service users in the home. The inspection began with a tour of the premises. The inspector spent time with all the service users who were in the lounge during the visit. Several service users and staff were interviewed. Documents were examined. (Please see below for details of the inspection findings). What the service does well: What has improved since the last inspection? The front entrance to the building has had a ramp and a handrail installed. The patio and back garden have been redesigned to include new garden furniture, a ramp and handrails. All staff are undertaking training programmes that include Dementia Courses. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Manor Lodge DS0000019454.V330648.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 Lodge DS0000019454.V330648.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): 1, 2, 3, 4, 5. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their relatives are given the opportunity to visit and assess the facilities and suitability of the home. They have the information they need to make an informed choice. A comprehensive assessment is carried out before the prospective service user is admitted into the home. EVIDENCE: There is a revised Statement of Purpose and each service user has a copy of the Service User Guide. A trial period is arranged for each prospective service user. The pre-admission assessment details were seen in the service user files examined. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are treated with respect and dignity. Their wishes and preferences are accommodated. Each service user has a written care plan. Medication is administered in accordance with legislation. EVIDENCE: On the day of the inspection, the majority of the service users were in the sitting room. They appeared content, relaxed and well cared for. It was noted that two carers were assigned to provide personal care to a service user, aged 104. The service user had been living in the home for many Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 10 years. Her relatives gave very positive feedback about the care and service provided. A trained member of the management team administers the medication. The Medication Administration Record charts examined were correctly filled in and they were kept up to date. Each service user has a written care plan. Currently the written care plans are being revised to include more information on a service user’s recreational interests, their likes and dislikes so that activities can be plan to suit individual preferences. In addition, risk assessments are revised to make them more specific to a service user’s health condition. The management ensures that service users have access to health care services to meet assessed needs. The home has sought specialist advice for service users who had developed pressure sores. Currently there is no incident of pressure sore among the current group of service users. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are given every opportunity to participate in all aspects of routine living. They are encouraged to maintain links with their family and friends. In general, activities are provided in the home on a daily basis. However, not all the activities are stimulating enough for some service users. The meals provided are nutritious and wholesome. Choices of menu are given. EVIDENCE: Mealtimes have been the highlight of the day. The home has a chef who shows great interest in providing dishes that are appealing and nutritious. Service users gave very positive feedback about the meals that were served to them. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 12 There is a weekly activity programme and the activities are provided as part of the routine by the carers. However, feedback from some service users indicated that they are presently bored with the planned activities. It is recommended that the home recruit an activity co-ordinator to assist in providing a recreational programme that is both appealing and stimulating to meet the social needs of its current group of service users. (See Statutory Recommendations) Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust Complaint Policy and Procedure. Complaints are taken seriously and acted upon. EVIDENCE: The management responded to concerns raised immediately and appropriate changes were made as soon as possible. Staff have adequate training to promote safety and to protect the service users from abuse. They are aware of the Whistle Blowing policy. The home follows the Adult Protection Procedure of Hertfordshire Social Services. Since the last inspection, the home has had one complaint that was being investigated by the Hertfordshire Adult Protection Team. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, comfortable and homely environment. The facilities provided are adequate and well maintained. EVIDENCE: The premises appeared clean on the day of the inspection. There is an ongoing maintenance programme. Currently the corridors on the first and second floors are being redecorated. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 15 All the bedrooms appeared tidy and they are cleaned daily. There are personal items on display that reflected the personal interests of the occupants. Since the last inspection, the patio has been redesigned to include a ramp and handrails. The workmen were present on the day of the inspection to complete the work. New garden furniture replaced the old ones. The garden and patio will soon have new plants to add to the attraction. They are accessible to wheelchairs. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 16 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 are supported and protected by the home’s recruitment policies and practices. There is a skill mix of staff to meet service users’ care needs. The home has a rolling training programme for staff. EVIDENCE: The home’s recruitment and selection process complies with legislation. All new staff have an induction training package that complies with Skills for Care guidance. Each member of staff is given the Code of Practice issued by the General Social Care Council. The home does not employ agency workers. Staff are trained appropriately, including health and safety issues. Currently all staff are undertaking a training course on Dementia Care. It is recommended that all care workers have certified training in the management of pressure areas to minimize the risk of development of pressure sores. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 17 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, 32, 33, 34, 35, 36, 37, 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were shortfalls in the administration and management of the service. EVIDENCE: Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. A recent investigation into the management of pressure sores highlighted shortfalls in the record keeping procedures of the service. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 18 Written information regarding the condition and the management of a service user’s pressure sores were written in the home’s Management Communication Diary but not all the details were written in the service user’s personal Daily Notes. The registered manager must ensure that such details are properly recorded in the service user’s own notes. The home has sought specialist advice for service users who developed pressure sores. However, the management failed to inform The Commission for Social Care Inspection (Regulation 37, Care Homes Regulation 2001) in the case of three service users who had developed grade two pressure sores since the last inspection. It was noted that there was an occasion when a member of staff had carried out wound dressing on a service user with pressure sores because a district nurse was unable to attend to a service user at the time. The district nurse had given instructions by telephone. The registered manager must ensure that carers do not undertake any nursing tasks such as the dressing of a pressure sore. Simple dressing, specific to a service user, may be permitted provided it is within the home’s policy and procedure and that the carer has had certified training in the management of pressure sores and wound care. It is recommended that the home contact the service user’s own doctor or the District Nurse Manager if a district nurse is not readily available. (See Statutory Requirements and Recommendations and note that since the inspection, the management has rectified issues raised and revised relevant procedures. Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 19 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 3 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 3 3 2 3 Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 20 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 OP31 OP8 Regulation 13 (1)(b) Requirement The registered manager must ensure that care workers do not undertake nursing tasks. (Home’s Procedures have subsequently been rectified) The registered manager must ensure that the Commission is notified of pressure sores that are Grade 2 and above as soon as possible. (This has subsequently been rectified) The registered manager must ensure that information on a service user’s condition is properly recorded in the service user’s personal Daily Note file and not in the home’s Communication Book. (This has subsequently been rectified) Timescale for action 16/02/07 2. OP31 OP8 37 16/02/07 3. OP37 17(1)(a) Schedule 3 (l)(n) 16/02/07 Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 21 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 OP8 OP30 2. OP12 Good Practice Recommendations It is recommended that all care workers have certified training in the management of pressure areas to minimize the development of pressure sores. It is recommended that the home recruits an activity coordinator to assist with activities. (Arrangements have been made with Age Concern) Manor Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Lodge DS0000019454.V330648.R01.S.doc Version 5.2 Page 23 - 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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