Inspection on 25/07/05 for Manor Rest Home

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Manor Rest Home 04/12/08

Manor Rest Home 13/02/08

Manor Rest Home 01/03/07

Manor Rest Home 19/06/06

Manor Rest Home 26/01/06

Manor Rest Home 11/03/05

Manor Rest Home 07/12/04

Manor Rest Home 30/03/04

Manor Rest Home 30/10/03

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 Rest Home 35 Manor Road Westcliff-on-Sea Essex SS0 7SR Lead Inspector Bernadette Little Unannounced 25 July 2005 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 Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Manor Rest Home Address 35 Manor Road Westcliff-on-Sea Essex SS0 7SR 01702 343590 01702 343590 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) Mrs Rebecca Mary Hart Mrs Rebecca Mary Hart CRH 19 Category(ies) of DE(E) Dementia - over 65 -female (1) registration, with number MD(E) Mental Disorder -over 65 -female (1) of places OP Old Age (19) Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home provides accommodation and personal care for up to 19 older people over the age of 65 years. 2. The home provides accommodatiom and personal care for one service user with dementia over the age of 65 years whose identity is known to the Commisson of Social Care Inspection. 3. The home provides accommodation and personal care for one service user with a mental disorder over the age of 65 years whose idenitity is known to the Commission for Social Care Inspection. Date of last inspection 11th March 2005 Brief Description of the Service: Manor Rest Home provides personal care and accommodation for 19 older people in 7 single and 6 double rooms. Some rooms have en-suite facilities. The home is privately owned. The home was formerly two large semi-detached houses, which have been made into one property and is situated in a residential area of Westcliff-on-Sea. It is a short distance from bus routes, main line railway station and the seafront. There are two separate lounges, and a dining room/conservatory. There is a garden to the rear of the property with seating for residnts and a parking area at the front. The home has its own minibus. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection that took place on a Monday morning at about 10:30 am. Two inspectors took part in the inspection. Time was spent talking with residents, both in the communal rooms and in their bedrooms. Time was also spent talking with staff and visitors. The registered manager was not on duty at the time of the inspection and the deputy manager assisted the inspectors. A tour of the premises was undertaken and the home’s records and available documents were inspected. Residents, staff and visitors are thanked for their assistance during this inspection. What the service does well: What has improved since the last inspection? What they could do better: This report shows that the home needed to do a lot of things better. The registered manager/owner needs to ensure that all part of the home are safe and nicely kept for the residents. The Manager must keep all of the records required by law about the home and the people there, to make sure that everybody is safe. Training for staff needs to be provided and kept up-to-date to make sure staff Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 6 and residents are kept safe. The people responsible for Manor Rest Home had been told about a lot of these things before. They must now show the Commission that they have made much more effort to put thing right. The Commission may decide to do extra visits to Manor Rest Home until they are sure that this has been done. 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 Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 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 Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 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) 1, 2, 3, 6 Written information about the home was detailed. Adequate assessment procedures were in place. EVIDENCE: The statement of purpose and service user guide provided plenty of information about the home. They both needed to be updated and some parts of the service user guide could be written in plainer language. One resident contract sampled did not state who was responsible for paying fees. It did state which room the resident was to occupy, and was signed by the resident, which is positive. A written contract was not available for another resident. A pre-admission assessment had been undertaken for the most recently admitted resident. It considered all relevant areas of need, and included input from the resident and a relative. Photographs were available on seven resident files, and two files stated that the resident had refused to be photographed. Photographs of the other residents were not available as required. Manor Rest Home did not offer intermediate care. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 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 The care management system was not adequately detailed to provide staff with the information they need to satisfactorily meet all the needs of the Residents’. Aspects of the home’s practices in management of medication were poor and did not best safeguard residents. EVIDENCE: The care plan for a highly dependent resident had not been updated to reflect the current level of need. Areas of the residents’ care needs were not included, and where issues were identified, they did not provide clear and detailed information for staff to ensure consistency of care. Assessment tools to promote residents well-being, for example pressure area care, were not in use. Monitoring systems, for example turning charts for residents who had pressure sores, were not in place. A care plan by the Community Nurse was seen to be available. Care notes were not generally written daily to assist in monitoring the effectiveness of the plan of care. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 10 It was noted positively that a relative had signed a residents care plan, which is good practice. However, as this resident was able to sign their own contract it may have been more appropriate and respectful for them to be involved. There was evidence that Manor Rest Home assisted residents to access primary health care professionals and in one case, had sought the services of a private consultant to ensure the residents best interest. Staff had access to a copy of the current version of the Royal Pharmaceutical Society Guidelines for medication in care homes. The most recent medication directory available to staff was dated March 2001. The deputy manager stated that the home planned to obtain an updated copy. Medication was handled directly by a senior member of staff before being given to the resident, which is inappropriate. Advice was provided on how to do this safely and hygienically using the medication pots available. The Medication Administration Recording (MAR) sheets sampled showed omissions for several residents. It was not fully possible to determine if the residents actually received the medication. The member of staff advised that medication for the several newer residents was not yet part of the Monitored Dosage System. They were therefore unclear whether the medication actually started on the day indicated on the MAR sheet. The medication audited for one resident showed four omissions in a three-week period, yet there were insufficient tablets left in the pack to reach the end of the four week period. There were no photographs of any of the residents on the MAR sheets to assist with identification. The medication storage cabinet was dirty. One shelf on the inside of the door had a thick sticky substance, most likely to be Lactulose from the bottles stored on that shelf. A variety of tablets, both loose and in foil blister strips, were stuck into the substance and could not be picked up. A capsule was seen on another shelf. A tablet was seen on top of a music cassette that was stored in the bottom of the medication cabinet. Staff spoken with said that they had not had formal medication training. The deputy manager stated that she had not had formal medication training but that two care staff did. A sample record of staff signatures and initials was not available with the MAR sheets. The home maintained a record of medications returned, this had been signed by the receiving pharmacist, which is good practice. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 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. The home did not satisfy all resident’s social and recreational needs on a planned basis. The home encouraged visitors to the home and made them welcome. The home supplied sufficient quantities of food and offered residents a choice of meals and alternatives. EVIDENCE: From observations made during the inspection visit and discussions with residents and members of staff, it was apparent that activities were flexible and appeared to meet the needs of most of the residents, however, some residents who were unable to join in one activity undertaken by staff because of their cognitive impairment. In these cases, their needs, preferences and capacities should be considered when planning activities and these contained within their care plans. See Reg 16. One resident who was a keen gardener indicated that he looked after a small area of the patio garden and was responsible for the flowers. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 12 One member of staff spoke about activities away from the home and how they were planned in most cases at short notice. Residents spoken with confirmed that day trips and visits to the seaside were organised annually. During the inspection two visitors spoke about how they were always made welcome at the home. They also spoke highly of the staff and the good care and support they gave the residents. A private area was available for visitors. Residents’ financial affairs were managed by the home with invoices to support individual transactions. The Deputy Manager was reminded that it was not good practice to pool residents monies and was referred to the home’s last inspection requirement in respect of this activity. (See Recommendations) Advocacy services were in place for one resident who did not have an independent agent. Residents’ personal possessions were noted in bedrooms and around the communal areas during a tour of the premises. Records of these are entered into residents’ files. The home looked after one resident’s cigarettes. There was no written consent by the resident to this and no record of an infringement of their rights. Residents were spoken with during the their luncheon meal and said how good the food was and plentiful. Hot and cold drinks, together with snacks, were served during the visit, and were available throughout the day, evening and night. Menus were flexible to accommodate individual preferences. Staff see each resident the afternoon before, and ask what they would like to choose for the following day. Detailed records are kept that show individual residents particular preferences. One day a week residents have the option of a take away lunch of fish and chips from the local fish shop. The home did not employ a cook, senior care staff took on the responsibility of preparing and cooking the main meal of the day, with care staff preparing the tea time meal, which was a cold buffet or sandwiches. Food hygiene training has been undertaken by seniors only. The home should consult with their Environmental Health Officer regarding the level of Food Hygiene training that is required by the home, given that they do not employ a qualified cook. See Reg 38.2. Food storage, records of temperature checks for hot food and resident’s alternative food choices, were all in place and correct. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home had a satisfactory complaints procedure a copy of which was included in the service user guide. EVIDENCE: The home had a written complaints procedure that provided clear timescales for action. Residents spoken with said that they would be able to tell someone if there was something in the home they were unhappy with. The deputy manager confirmed that no complaints had been received by the home since the last inspection. A written compliment was seen thanking the staff and the home for the good care that had been provided for a relative. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. There has been no significant changes made to the home’s environment, with some areas posing a risk to residents wellbeing. The overall quality of fittings is poor and potentially dangerous, placing residents and visitors at risk of injury or harm. EVIDENCE: The general layout of the premises was suitable for its stated purpose with most areas meeting the needs of residents. These include a well-maintained garden area that is accessible, safe, and provides adequate seating for the number of residents accommodated. Areas that should be investigated as part of the home’s maintenance programme are the following: • Unsecured carpet edging between the conservatory and dining room. • Uneven or collapsed floor boarding between the dining room and passage approach to room 5. • Steps into the main office outside room 5. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 15 The home’s call system panel situated in the dining room was taped together but was exposing the wiring. • The cupboard containing domestic cleaning materials was not lockable. See Reg 13.(4). The Deputy Manager was advised to have these problems addressed particularly areas where there was a risk of falling. The home did not use any CCTV camera Communal facilities included two lounges, one being a quiet area that can be used for visitors and a main dining area with additional seating in a spacious conservatory. This area remains without a carpet. Residents had access to communal facilities through the provision of ramps and grab rails strategically positioned throughout the home but from the information gathered during the inspection visit, the home had not had an assessment of the premises and facilities by a qualified person. The home provides two bathrooms for use by residents, one on each of the floors. The bathroom on the first floor was due to be replaced to enable better access and the fitting of disability aids. The walk in bath on the ground floor was operational but had a leaking pipe joint, allowing water to fall onto the floor where individuals had to walk. The Deputy Manager explained that this facility had been recently serviced and would contact the contractors. Sluicing and laundry facilities remain the same as the previous inspection, with both requirements still outstanding, however, the Deputy Manager explained that soiled linen was placed into the appropriate bags and transported to the laundry room where the new washing machine had sluicing and disinfection programmes. Advice should be sought by the home’s management team from the local Environmental Health Officer to ensure that they are complying with infection control requirements. See Reg 13 (3). Bedroom furniture and fittings met the individual needs and lifestyles of residents although one shared bedroom room did not have sufficient double sockets in areas required, with extension cables used for a television and table lamp. Rooms having linoleum fitted to the floor have been highlighted to have carpets laid. Bedroom doors were not lockable. Cabinets were in place for residents to keep private items and keys available. Rooms were individually heated with some radiators having valve controls to allow adjustment of temperatures. Radiator covers or risk assessments are outstanding for the protection of residents. Since the last inspection the home’s hot water supply had been reset to ensure that temperatures were within the recommended guidelines. Toilet hand basin temperatures were recorded at 52 degrees centigrade and baths 44 degrees centigrade. The home should ensure that regular monitoring of temperatures is carried out and Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 16 • records kept. Lighting in some shared rooms would benefit from higher voltage bulbs. See Reg 13(4)(a)(c) Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 17 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, 28, 29, 30 Staffing levels were adequate to maintain basic care, but increased hours for ancillary staff would benefit residents by allowing staff additional time for increased individual attention. Recent recruitment procedures better protected residents, but continues to require additional safeguards. The home needs more effective management in terms of staff training and induction. EVIDENCE: The home provided a staffing level of three staff all day, including at least one senior, and a cleaner five mornings a week. One of these senior staff also undertook all the cooking and meal preparation duties except the teatime meal/snacks, where care staff prepared these. Not all staff had undertaken food hygiene training. This did not leave adequate staff available to residents and did not meet the levels previously agreed with the registration authority. There was one awake staff on duty at night, with the deputy manager, who lived on the premises, being on call. It was not possible to accurately determine if the night staffing level was appropriate for the needs of the residents, some of whom have high dependency needs. There was one fulltime equivalent care staff vacancy during the day and one at night. Advice was provided on ensuring that an agency staff member on duty alone at night would know the residents and their needs. Residents spoken with said that the staff were nice. Staff spoken with advised of a supportive staff group, with good staff morale. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 18 Two of the most recently appointed care staff had previously achieved NVQ levels 2 & 3 in Care. The deputy manager had achieved NVQ level 2 in Care. Four other staff had started NVQ to training some time back but this had ceased due to difficulties outside the home’s control. It is hoped that this will be able to recommence shortly. Two staff recruitment/files sampled did not have evidence of Criminal Records Bureau (CRB) checks. This is outstanding from the last inspection and must be addressed. One file did not have a photograph as required. Recruitment files did not evidence that the registered person had ascertained each persons right to work in this country. The recruitment file for the most recently appointed member of staff was much improved, and contained the majority of required records and checks, including an original CRB check from their previous employment. It did not contain a clear start date, or evidence of up-to-date CRB check. An induction checklist for a member of staff in post for at least five months had only been completed during the first week. The member of staff had previous experience and had attended some training courses, which they confirmed had now expired. The member of staff confirmed that they had not had any formal training, except fire training, in the five months that they had worked at Manor Rest home. The deputy manager confirmed, that while the home had its own moving and handling trainer, some staff had not had updated training on this issue. The home were advised to undertake a training needs assessment with each member of staff, which would form the basis for a training plan, which would feed into the homes quality assurance system. A training matrix was also advised to help the home manage training of dates effectively. This could also be monitored in formal and recorded supervision. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 19 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, 35, 36, 37, 38 The management of this home is not satisfactory and there was little evidence that outstanding requirements from previous inspections had been addressed. Arrangements for the protection of residents, staff and visitors are inadequate placing them at risk of possible harm. EVIDENCE: It is acknowledged that the registered manager could not contribute to this inspection, as she was not on duty at the time. Evidence was therefore taken from observation, discussion with residents and visitors, from the records available and from the staff on duty at the home. Records and receipts of residents monies were maintained, which is positive. Residents’ money continued to be pooled, which is not good practice. The deputy manager confirmed that, to her knowledge, any excess amounts continued to be deposited in the homes bank account, which breaches Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 20 Regulation and did not protect residents’ rights. Each resident had the right to have an account in their own name, and from which they can earn interest. This is an outstanding issue from the last inspection. Staff confirmed that they are not provided with formal supervision. A record of visitors was not maintained as required by regulation. The registration certificate was not displayed as required by regulation. These are outstanding from the last inspection. A record of the fees charged to residents was not available. A record of the resident’s possessions and valuables was recorded on the resident’s file sampled. The staff roster did not contain the full names of staff, their designation and the hours to be worked. No risk assessment had been completed relating to Legionella and the safety of the water storage system. Information on this can be obtained on the booklets “ Essential Information for providers of residential accommodation” and “A guide for employers” on 01787 881165 or at www.hsebooks.co.uk The home can obtain advice and information on Infection Control by contacting Essex Health Protection Unit on 01376 302282. Most of the staff spoken with confirmed that they had undertaken health and safety training in safe working practices. Evidence of regular servicing of equipment was not available during the inspection together with risk assessments relating to the premises. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 21 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 2 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 2 3 2 3 3 2 1 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 1 x x x 2 1 1 2 Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 22 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. 2. 3. Standard 1 2 7 Regulation 4 5(bc) 15(1) Requirement The statement of purpose to be updated and a copy sent to the commission. All residents must be provided with a written contract Each resident must have a written care plan that includes detailed information for staff to follow to meet and manage all aspects of the residents needs in terms of health and welfare. This needs to include the involvement of the resident were possible. All care plans must be reviewed regularly and as necessary to match changes in the service uses needs. The person registered must ensure that detailed risk assessments are carried out for all residents to identify their needs and support the plan of care. (Previous timescale of 21/01/05 not met) The registered person must make arrangements for the safe recording, handling, keeping and administration of medicines received into the home. Timescale for action 15 September 2005 15 September 2005 15 September 2005 4. 7 15(2b) 15 September 2005 15 September 2005 5. 8 13(4)&Sc h3(3n)17( 1a) 6. 9 13(2) 01 September 2005 Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 23 7. 9 13(2) 18(1ci) 8. 12 16(2n) 9. 19 23 13(4) 10. 20 16(2c) 11. 25 13(4a&c) 12. 26 16(k) (Previous timescales from 30/03/04 not met) The person registered and must ensure that the staff employed at the care home are provided with the training appropriate to the work they are to perform. This refers to medication training. The person registered must ensure that residents are given appropriate opportunities for stimulation through recreational and leisure activities, both in and outside the home, that suit their needs, preferences and capacities: consideration must be given to people with dementia or other cognitive impairment. Staffing levels need to be reviewed to ensure carers have time to do this. (Previous timescale of 01/05/05 not met) The person registered must ensure that the premises are suitable to meet their stated purpose and are well maintained, safe, and kept in a good state of repair. This refers to all the safety aspects identified as potential hazards to residents in this report. The person registered must provide appropriate floor coverings in all areas of the home. The person registered must ensure the safety of residents. This refers to the surface temperature of the radiators and the temperatures of the hot water. (Previous timescale of 23/01/05 not met). The person registered must ensure that the laundry floor finishes are inpermeable and that these and the wall finishes are readily cleanable. (Previous 15 September 2005 15 September 2005 15 September 2005 15 September 2005 15 September 2005 15 September 2005 Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 24 13. 27 18(1a) 14. 29 19 & Sch 2 15. 30 18(1) 13(5) 16. 31 10 timescale of 01 July 2005 not met). The person registered must ensure that staff numbers and deployment meet the needs of the residents. The last report requires that the agreement with the previous registering authority of four staff on duty on the early shift be implemented. Staffing levels must be reassessed to ensure that the needs of residents can be met at all times, including while care staff prepare and cook the meals. (This is a repeat requirement from previous inspections which continues not to be met). The person registered must ensure that the details of all persons working at the home include all the elements required by regulation. This includes evidence that all staff can legally work at the home, and that all staff including new staff starting work at the home have a Criminal Record Bureau check/ Povafirst check carried out. The person registered must ensure that all staff are provided with appropriate training for the work they are to perform, including induction training and for example training in moving and handling. (This is a repeat requirement from previous inspections which continues not to be met). The registered provider and the registered manager must ensure that the home is managed with sufficient care, competence and skill, and that appropriate actions are taken to address the requirements identified in this report. 15 September 2005 15 September 2005 15 September 2005 15 September 2005 Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 25 17. 35 20 18. 36 18(2) 19. 37 17(2) & Sch 4 17(2) & Sch 4 17(2) & Sch4 20. 37 21. 37 22. 23. 24. 37 37 38 19 & 2 17(1a) 13(4) The person registered must not pay money belonging to any resident into a bank account unless that bank account is in the name of the resident. The person registered must ensure that staff or provided with appropriate supervision. (This is a repeat requirement from previous inspections which continues not to be met). The staff roster must include the name of all persons working at a care home and identify the hours actually worked by them. A record of visitors must be maintained in the care home. (Previous timescale of 01/06/05 not met). A record must be kept in the care home of the care homes charges to residents, including any extra amounts payable for additional services not covered by those charges and the amount paid for by, or in respect of, each resident. A photograph must be maintained of all staff. A photograph of each resident must be available and kept in the care home. From a person registered must ensure the safety of a quick meant on the premises. This refers to a current safety inspection certificate for the fixed electrical wiring. A copy of this must be sent to the Commission. The registration certificate must be displayed in full in the care home. (Previous timescale of 01/05/05 not met). 15 September 2005 15 September 2005 15 September 2005 15 September 2005 15 September 2005 15 September 2005 15 September 2005 15 September 2005 25. 37 17(2)& schedule 4 15 September 2005 Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 26 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. 2. 3. 4. 5. 6. 7. Refer to Standard 1 3 9 9 9 15 19 Good Practice Recommendations The service user guide should be written in a format that is easy for residents to read A policy and procedure on the emergency admissions should be available in line with the information in the Statement of Purpose. Staff should have access to a current medications directory. A current sample list of staff signatures and initials should be maintained with the MAR sheets. The home should consider keeping a photograph of each resident on their individual MAR sheet. The person registered should consider arranging training on food handling for all staff involved in the preparation and serving of food to residents. The registered person should introduce a programme of routine maintenance and renewal of the fabric and decoration of the premises that is implemented, with records kept. The registered person should ensure that there are sufficient bathing facilities provided to meet the needs of the residents. This is a repeat recommendation. The registered person should ensure that all residents have access to a call bell in their bedroom. The person registered should consider having an assessment of the premises and facilities undertaken by a suitably qualified person, who has specialist knowledge of the client group. The person registered should ensure that the doors to all residents bedrooms are fitted with appropriate locks suited to the residents capabilities and accessible to staff in emergencies. Residents should be provided with keys unless a detailed risk assessment advises otherwise. The registered manager/registered person should evidence and record why linoleum flooring is used in some of the homes bedrooms. This is a repeat recommendation. The registered manager/registered person should reconsider if it is acceptable practice to use a residents bedroom as the hairdressing facility. This is a repeat recommendation. I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 27 8. 9. 10. 21 22 22 11. 24 12. 13. 24 24 Manor Rest Home 14. 26 15. 32 16. 17. 35 35 The registered manager/registered person is recommended to contact the local Environmental Health Officer or the Health Protection Unit for advice on ensuring that the homes current sluicing facilities etc. provide appropriate infection control measures. An assessment should be undertaken of staff training needs, that would inform a training plan, and a staff training matrix should be implemented to support the home in ensuring staff training remains current. Regular staff meetings should be held and recorded. This is a repeat recommendation. The registered manager/registered person should ensure that the personal allowances of residents are not pooled. This is a repeat recommendation. Manor Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 28 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-On-Sea SS2 6BG 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 Rest Home I56 I06 S15461 Manor Rest Home V238929 250705 Stage 4.doc Version 1.40 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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