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Inspection on 27/06/05 for Manor Place Nursing Home

Also see our care home review for Manor Place Nursing Home for more information

This inspection was carried out on 27th June 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and staff review care needs regularly and seek support appropriately to meet those needs. The assessments are now comprehensive with improvement in information noted. It would seem the staff in conjunction with the manager have worked at establishing a sense of openness at the home so that relatives and residents can voice their concerns. Relatives and staff also feel that they can voice concerns especially regarding the care of the residents. The home is well maintained and feels homely and there was evidence that health and safety is attended to protecting the well being of all at the home.

What has improved since the last inspection?

There have been improvements generally throughout the home. The manager is now at the home full time and not overseeing the sister home. There has been a change in some staff members and the home feels as if it is moving forward. There is now a consistency and improvement in the care plans and this is commended. There has been an improvement in the manner in which staff interact with residents in identifying their emotional and physical needs, staff are commended in this. Relatives are happy with the care they see residents receiving. The quality of food has improved with the new cook with fresh baking daily.

What the care home could do better:

Activities and stimulation for residents is limited at present the manager feels that this will change should they be successful in recruiting an activities coordinator.

CARE HOMES FOR OLDER PEOPLE Manor Place Nursing Home 116 Church Lane East Aldershot Hampshire GU11 3HN Lead Inspector Val Sevier Unannounced 27/06/05 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 Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Manor Place Nursing Home Address 116 Church Lane East, Aldershot, Hampshire, GU11 3HN 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 319738 01252 327899 Dr Zyrleda Denning To be confirmed CRH 35 Category(ies) of DE, OP registration, with number of places Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/12/04 Brief Description of the Service: Manor Place is a 35-bedded care home with nursing providing care and support for older persons and is owned solely by Dr Denning. The house is a late 19th Century Victorian mansion, which until the 1980’s was St Michael’s Vicarage. About 15 years ago a 17-bedded extension was built. The older part of the home has four shared rooms the rest are single rooms and accommodates 18 people. The newer side has 17 bedrooms all with ensuite facilities. There is an extension currently under construction which will offer further accommodation. The new bedrooms will offer en suite accommodation. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 6.5 hours. The inspector was able to speak with the manager and proprietor, several staff, three relatives and several residents. Records were sampled and a tour of the home was undertaken during which a sample of rooms were seen. There is construction taking place to offer more rooms at the home these will have ensuite facilities. It is hoped that these will be finished later this year. There has been some refurbishment and new carpets have been laid. At present there is no access to the garden due to landscaping and the new extension. It is hoped that there will be safe access to the garden soon. What the service does well: What has improved since the last inspection? There have been improvements generally throughout the home. The manager is now at the home full time and not overseeing the sister home. There has been a change in some staff members and the home feels as if it is moving forward. There is now a consistency and improvement in the care plans and this is commended. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 6 There has been an improvement in the manner in which staff interact with residents in identifying their emotional and physical needs, staff are commended in this. Relatives are happy with the care they see residents receiving. The quality of food has improved with the new cook with fresh baking daily. 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 Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.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 Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.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, 4 and 5 The home has a good understanding of residents needs using the assessment process. The staff have a good knowledge of residents support needs and have formed positive relationships with. EVIDENCE: The inspector looked at 5 care plans and each individual had had an assessment prior to moving to the home. The assessments are now comprehensive with improvement in information noted. There was information about physical and psychological needs of the individuals. It was observed that the information gained through the assessment had been used to complete the care plans. A relative spoken with on the day, explained what had happened at the assessment for his relative and how he had been involved when the resident was unable to speak for themselves. The relative felt that the needs could be met. The inspector was able to observe interaction between the staff and residents at the home. The manager had explained that staff had undertaken training in dementia and communication and this was evident in the observed interaction. Staff spoken with had an understanding of the needs of individuals and they said that they felt able to ask the manager if they were unsure. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 9 The admissions policy and service users guide state that prospective residents and their relatives or representatives are encouraged to visit the home. Relatives spoken to on the day said that they had been welcomed on the visit to the home and had been able to speak with other relatives before making a decision. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. There has been a gradual improvement in the care plans and the information in them since the manager joined the home, with involvement of other professionals as needed. There is now a consistency in them and that is commended. The systems for the administration of medication have improved with clear arrangements in place to ensure that resident’s medication needs are met. Staff were seen to behave appropriately with residents identifying their emotional and physical needs, staff are commended in this. EVIDENCE: The inspector viewed five care plans in conjunction with a sample of medication records and other health monitoring tools used at the home. When looking at the care plans it was seen that other professionals were also involved as necessary. One individual required additional support due to high needs and liaison with external support was evident. This person assists with care planning and offers training when it is identified for particular needs. The care plans had clear identified needs and action to be taken to assist the residents. It also had the strengths and abilities of the individuals, which staff Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 11 could then help to maintain. There were risk assessments and action to reduce risk such as hip protectors. Although there is no registered mental nurse employed at the home, there was evidence that the manager sought support to assist staff at the home to meet psychological and emotional needs of the residents. The care plans had been reviewed regularly and daily notes had been written enabling the inspector to have a picture of the daily life at the home for some. From written evidence of care plans and speaking with staff it would appear that the staff are equipped with knowledge and skills to care for the needs of people at the home. It would also seem speaking with staff and relatives that no one is afraid to ask questions about issues of concern about needs. It was seen in the care plans that physical health needs are also addressed with one resident being offered the opportunity to go to the audiology department on the day of the inspection. The medication records and stock were sampled and it was noted that there is a noticeable improvement in the records seen. The manager explained that she samples the records regularly to ensure that consistency is maintained. The staff explained that the pharmacist and GP are supportive regarding medication. Relatives spoken with said that they had been involved as necessary with medication especially if it had been difficult to give to an individual, they appreciated being asked and this approach fits with the policy of the home. Staff were observed speaking and assisting the residents with dignity and respect. Affection was given appropriately to those residents who sought it. It had been seen on care plans that the preferred choice of name had been recoded and staff were heard to speak to residents by the name they wished. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. The social needs of the residents at the home are as varied as they are individuals and the home is encouraged to resolve this in order to accommodate as many needs as possible. Dietary needs of residents are well catered for with a varied selection of food that meets resident’s tastes and choices, this is an improvement. EVIDENCE: The activities and choices available to residents were discussed with the manager. Currently there are four sessions of activity that take place during the week consisting of armchair exercise music and painting. On the day of the inspection a ball game was being played in one lounge. The needs and interest of residents due to their physical and mental limitations are not met currently; the manager was able to show that a job description and advert has been made for an activities coordinator for the home. Visitors sign in at the home and information for them and others is available in the hallway by the signing in book. Relatives spoken with said that they felt welcomed and involved in the continuing care of the residents. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 13 A new cook has been employed at the home since the last inspection. The menu is available daily in the hallway. The residents are offered a choice of meal and their preference is recorded with copies kept. Fruit was seen to be available and residents can choose where to have their meals. Residents spoken with said they liked the meals, although one said that sometimes they were cold and on cold plates. Relatives also said they were happy with what they had seen and some had meals with their relatives when they visited. The manager believes that the quality of the meals has improved with cakes and pastries baked daily and that there has been a positive impact on the health of the residents. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. It would seem the staff in conjunction with the manager have worked at establishing a sense of openness at the home so that relatives and residents can voice their concerns. Relatives and staff also feel that they can voice concerns especially regarding the care of the residents. EVIDENCE: There have been four complaints made since the last inspection to the home with none received at the CSCI. There was a record of the complaint and action taken by the home. Relatives were aware of how to complain and said they felt comfortable in speaking with the manager or deputy about any issues. There have been no allegations regarding adult protection at the home. The manager undertakes training the staff in this area, and staff spoken with were aware of the whistle blowing policy and the training. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. The home is well maintained and feels homely. EVIDENCE: The inspector undertook to walk around the home. A new extension is being built which is impacting on the garden area at the moment. New carpets have been laid in most communal areas the exception being the corridors of the last extension. No other changes with the exception of general maintenance of the home to ensure safety. It was seen to be clean and homely. The garden is being landscaped and a conservatory is to be added to the last extension. It is hoped that the garden will be accessible soon with the addition of a new ramp from the old part of the home. The manager said that the safety fences around the new build would be moved enabling residents to use the garden this summer. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 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 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. The level of staff and training programme would seem to meet the needs of the residents. The recruitment process and checks are maintained to ensure residents safety. EVIDENCE: The inspector was able to see the rotas for the week of the inspection and older ones and the staffing levels would seem to meet the needs of the residents. There are additional hours being purchased for one resident and these are currently met by the home, if this is not possible then agency staff are used. The rota also records laundry and domestic staff. The kitchen is staffed Monday to Friday with a cook and kitchen assistant, the weekends are covered by in house staff, who have had food hygiene training. All indicated that the staffing at the home is two nurses, one on each floor and ten care staff five on each floor. The manager explained extra staff are available if the needs of the residents indicate that further staff are needed. The staff spoken with felt that there were adequate staff and that holiday and sickness are always covered to ensure residents needs are met. The nurses have responsibility for the shift and are supported by experienced care staff. The home has a clear and improved recruitment policy that covers all the elements for the protection of residents including criminal records checks and references. Staff files that were read evidenced that this policy was being met. The manager has a training programme for the forthcoming year including mandatory training and areas needed to meet resident’s needs. There is one Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 17 nurse undertaking a mentorship course. Three carers have attended a care of catheter course whilst nursing staff have been offered and undertaken courses such as catheter insertion and vena puncture. Staff confirmed that training was available and they felt the information was used to assist them in caring for the residents. Mandatory and other training for needs and personal development is available at the home. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 18 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) 31, 33 and 38. The home regularly reviews aspects of its performance through a good programme of self-review and consultation, which includes seeking the views of residents, relatives and others, with evidence that the views are listened to and acted upon. There was evidence that health and safety is attended to protecting the well being of all at the home. EVIDENCE: The manager has applied to CSCI to be registered as the manager for the home. The manager is known to CSCI and has been registered previously. The manager undertakes annual surveys giving relatives questionnaires to complete. They are also invited to meetings with the manager to discuss care plans of their relative or residents they advocate for. The CSCI has received irregular Regulation 26 reports. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 19 The manager has recently established a health and safety file pulling together all aspects of safety at the home including legislation and how to manage chemicals. The file is very comprehensive and includes risk assessments. The records regarding fire safety and training were seen and were up to date. Staff spoken with confirmed that they had undertaken training recently. Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 20 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 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 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 3 x 2 x x x x 3 Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 21 No 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 33 Regulation 26 Requirement The registered person must undertake monthly visits to the home after which a report is to be sent to the CSCI and a copy retained at the home. Timescale for action 30/06/05 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 Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire, 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. Extracts may not be used or reproduced without the express permission of CSCI Manor Place Nursing Home H54 s12150 Manor Place Nursing Home v229229 270605 FINAL.doc Version 1.30 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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