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Inspection on 09/12/09 for Manor Rest Home The

Also see our care home review for Manor Rest Home The for more information

This inspection was carried out on 9th December 2009.

It is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.

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.

Annual service review Name of Service: Manor Rest Home The The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Philippa Jarvis Date of this annual service review: 0 2 1 1 2 0 0 9 Annual Service Review Page 1 of 9 Information about the service Address of service: Bullingham Lane Lower Bullingham Hereford Herefordshire HR2 6EP 01432274732 01432761466 thebarnoffice@btconnect.com Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: Mrs Sheila May Nauth,Mr Narendra Nauth Number of places (if applicable): Under 65 Over 65 5 23 0 0 0 23 The maximum number of service users who can be accommodated is: 23 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 23 Dementia (DE) 5 Mental Disorder, excluding learning disability or dementia 23 Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service The Manor Rest Home is situated on the outskirts of Hereford with easy access to local facilities, including public transport to the city centre. Parts of the house are Annual Service Review Page 2 of 9 No Elizabethan and the building has been adapted and extended for use as a care Home over many years. In recent years the scope of care the Home sets out to provide has been narrowed and currently the Home caters primarily for people over the age of 65 who have needs relating to their mental health. Fees are individually assessed. Annual Service Review Page 3 of 9 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at the information that we have received or asked for since the last key inspection. This included - The Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is self-assessment form that focuses on how well outcomes are being met for people who use the service. It also gives us some numerical data about the service. - Surveys that were returned to us by people who live at the home, staff who work at the home and health and social care professionals. - The previous Key Inspection report that we carried out on 7th September 2007. This was the time that the quality rating of two star good was made. - The last Annual Service Review that was carried out on 4th September 2008. -What the service has told us about certain things that have happened in the home. These are called Notifications and are a legal requirement. What has this told us about the service? The manager, Julieann Minnett sent us the AQAA for the service on 30th September 2009 when we asked for it. The AQAA was well completed, clear and comprehensive. It told us about what the service does well, improvements it had made in the last 12 months and improvements they want to make over the next 12 months. The last inspection found that the home operates a person centred approach to care. In the AQAA the home confirmed that it operates an equal opportunities policy for both residents and staff. They confirmed that all residents are provided with the same opportunities to participate in planning their care and are encouraged to do this, although some choose not to. They said that all residents are provided with the same opportunities to take part in activities and where possible we strive to meet indicviduals specific requests. The AQAA contained numerical data that told us they provide a service for people of both sexes who have a range of needs arising from mental health needs and dementia. The staff group reflects the ethnic mix of the resident group which is white british. The last Key Inspection gave the service a two star good rating. The AQAA states that improvements made since that time are as follows: - We have developed our needs assessment record and our admission records in the last 12 months. All recently admitted residents will have copies of these on their files. This has enabled us to make more informed decisions in planning a prospective residents care. - The Statement of Purpose and the Service Users Guide have both been reviewed within the last 12 months. - The home has continued to provide a comprehensive induction programme and training in the care of medicines, care skills and all relevant mandatory training. We have also provided a very valuable training course in palliative care to our care staff to ensure that the service we are providing at the end of life is excellent. Annual Service Review Page 4 of 9 - Some of the female residents requested a pampering session where staff would for example spend time giving a mini manicure. This now occurs on a regular basis. Another resident requested that we have a singing machine so a karaoke machine was purchased and sing along sessions often occur. - We held a summer barbecue fpr the residnets which was very much enjoyed. - Weekly menus are placed in the dining room and daily meals recorded on the white board in the dining room. - Adult Safeguarding and Whistleblowing training have been provided in the last 12 months. - The Abuse and Protection policies have been reviewed in the last 12 months and will be reviewed again by the end of September 2009. - Risk Assessments are in place for residents who have a history of aggressive behaviour. - On-going redecoration has taken place in the last 12 months. The entrance hall and one of the lounge areas have been refurbished and redecorated. - Several bedrooms have been redecorated in line with the on- going programme. - New carpet has been laid on the main staircase and landings which has significantly improved the decor within the home. - The garden has had a new wooden gazebo built which has a seating area in it and is enjoyed by the residents. New benches have been purchased for outdoor seating. - The domestic staff induction programme has been reviewed in the last 12 months and they now have a comprehensive induction which is equal to that of the care staff. - The staff handbook has been reviewed and will be reviewed again shortly. - The training and development policy has been reviewed and is reviewed annually. - We have maintained a consistent approach to staff training attendance and this has greatly improved. -We have provided training in palliative care to an NCFE level 3 standard. This has helped our care team as we have no qualified nursing staff and guidance was needed particulalry for the new staff in end of life care. - All mandatory training has been offered to staff this year. - The home has employed an external organisation to review its staff contracts and handbooks to ensure they comply with employment law. They are also going to provide training in various areas of employment law. - Return to work after sickness interviews are now being conducted and we have improved our staff attendance monitoring system. Annual Service Review Page 5 of 9 - All COSHH, area and residents risk assessments have been reviewed this year. - The quality assurance system has been reviewed and new recording procedures for hospitla admissions, falls and deaths at the home are now in place as a result of this review. The AQAA tells us their plans for improvement in the next 12 months are as follows. - The Statement of Purpose and the Service Users Guide will both undergo annual review and the Homes policies on equal opportunities and equality and diversity will be included in these. - The care manager will find alternative training providers if the District Nurse is not able to support us with our training needs. - We also plan to convert one of our store rooms into a relatives room dedicated to residents families at times when they require support. This will involve redecoration/refurbishment and will be commenced as soon as possible. - We can record in the activities record book which residents have declined to participate in each activity along wih those who have participated. - Key worker monthly meetings will help establish individual interests. - Further training in the management of aggression is to be provided. - Abuse and Protection policies to be reviewed. - Two gound floor bathrooms are a priority for refurbishment and redecoration. New flooring and decoration has been agreed for these. The main downstairs bathroom is also to be refurbished this year. - A store room will be redecorated and made into an area for families and friends in need of privacy. This has been approved and work will commence within the next year. - Fire warden training is to be provided to managers and senior staff. - Senior staff to be trained in carrying out clinical supervisions with staff. This will help identify any training requirements for individual staff and therefore improve the quality of care provided. - We have provided nutrition training to senior and catering staff but this needs to be refreshed. - We aim to have a further 3 care staff trained to NVQ level 2 by July next year. - Training in epilepsy will be provided to all care staff as this is outstanding. - The Homes Business Plan will equire review. This will be carried ot by the Registered Provider. Annual Service Review Page 6 of 9 - The home has employed an outside agency to monitor and review its health and safety procedures, practices and policies in line with current regulation. This will ensure that we meet all legal requirements. Since the last inspection the home has continued to communicate well with us and kept us informed about relevant matters. This includes making appropriate notifications about events that could or have affected the health, safety and/or welfare of people living in The Manor. In the AQAA the home told us that they have received 10 complaints in the last 12 months, of which 9 were resolved within 28 days. 6 were upheld. We, the commission, have not received any complaints about the service. There have not been any changes to the management of the home since the last inspection. We sent out surveys to a sample of people who live in the home and received 11 replies. They were positive about all aspects of the home. In reply to a question asking what the home does well we received these replies. Very good food and personal care. Cooks my meals, washes my clothes. Generally looks after me very well and I am quite content. Gives me the help I need, listens to what I want. I enjoy having fun and there is always someone around to talk to and help me. I feel taken care of, people care. Does the washing for me and makes my meals. In reply to the question what the home could do better we received the following replies. Cant think of anything. More heating in my room. I asked for some changes to the menu and these have happened. We sent out surveys to a sample of staff and received 10 replies. They were all positive about the support and training they receive and about the way that information about people who use the service is provided for them. We asked them what the service does well and we received comments like: Provides an excellent service to their residents in every way possible, in particular the menu. Care for residents. Providing a place of safety yet still allowing independence. Residents come first. The food is excellent, they have a varied menu for low fat and diabetics. They have activities in the afternoon and we also provide a shop in the afternoon for those that cant go out on their own. Treats all residents and staff as individuals and always with respect. Provide homely environment. Provide entertainment and activities. They provide good care, nice environment, homely. Good up to date training for the staff. The home is always run to a high standard. Any problems that do occur are immediately dealt with and residents needs are always being met. Care for residents and staff. The communication between service users and the care staff is good. We also asked them what the home could do better and they said, I think there is always room for improvement in amy establishment but in this case I think this home provides such a good overall level of care and committment it is hard to find fault. Annual Service Review Page 7 of 9 More varied meals. More day trips. Food sometimes a little bland and boring. There is nothing from what I have seen or experienced so far. We also sent out surveys to health and social care professionals and received 4 replies. They all expressed their satisfaction with the quality of service. Having looked at all the evidence avaialble for the annual service review our judgement is that The Manor continues to provide a good quality service for the people who live there. What are we going to do as a result of this annual service review? We are not going to change our inspection plan and a Key Inspection of the service will take place before 7th September 2010. However we can inspect The Manor at any time if we have any concerns about the quality of the service or about the safety and welfare of people using the service. Annual Service Review Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a copy of the findings in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Annual Service Review Page 9 of 9 - 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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