CARE HOMES FOR OLDER PEOPLE
Manor Road, 2 2 Manor Road Tynemouth North Shields Tyne & Wear NE30 4RH Lead Inspector
Jim Lamb Key Unannounced Inspection 4th April 2008 09:30 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 Road, 2 DS0000000354.V361848.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 Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Manor Road, 2 Address 2 Manor Road Tynemouth North Shields Tyne & Wear NE30 4RH 0191 2574519 F/P 0191 2574519 No Email 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) Kay Care Services Limited Mrs Susan Anthea Baston Care Home 23 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (17) of places Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 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: Dementia - Code DE, maximum number of places: 6. Old age, not falling within any other category - Code OP, maximum number of places: 17 The maximum number of service users who can be accommodated is: 23 4th April 2007 2. Date of last inspection Brief Description of the Service: The home provides personal care and accommodation for older people who require long-term care. The home is located in the village of Tynemouth close to shops, pubs, the post office and seafront. There are good transport links near-by. The home has a passenger lift, and service users have access to a landscaped front garden and a paved courtyard. The majority of bedrooms have en-suite facilities, and communal areas are attractively furnished. Fees for the home are £392.00 to £414.00 per week. Inspection reports and the service user guide are available in the home on request. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes.
How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 4.4.07. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 4.4.08. During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, this method is called case tracking. Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit We told the manager/provider what we found. The quality rating for this service is 2 star this means the people who use the service experience good quality outcomes. What the service does well:
The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 6 The home makes a full assessment of a person’s needs before deciding if it can meet all those needs. The home draws up detailed plans to meet the care needs of its service users and their health care needs are also fully assessed and properly met. The home stores medicines safely, and administers them correctly. Service users say that staff treat them well and treat them with respect. The home is working hard to provide a stimulating atmosphere in the home, with appropriate social activities available. All are encouraged to keep in regular contact with family and friends, who say they are always made welcome in the home. They are also encouraged to take as much control over their own lives, as they are able, and make their own decisions. Service users are very complimentary about the food, and there is a balanced diet, with a choice included. Complaints and concerns are taken very seriously and are responded to properly. The home is kept clean, hygienic and free from odours. The home has enough staff to meet the needs of the service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is experienced and is providing very positive leadership to the home. The home is being run in the best interests of the service users. Service users’ finances are protected by the home’s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home’s policies and systems. All those service users engaged in conversation during this inspection said that they are treated with respect by the staff at all times, and said that staff are careful to protect their privacy and dignity. One service user said “The staff always have time for me, they are always kind and helpful”.
Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 7 Another said, “Being here is nothing like my own home, but it’s the next best thing, I have brought lots of personal items from home including furniture and this has helped me to settle in”. What has improved since the last inspection? 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 Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 8 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 Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 9 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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are properly assessed and are provided with enough information about the service to enable them to make a choice about where they want to live. EVIDENCE: The care records for three service users were examined. These showed that the manager makes sure that a full assessment of a new service users needs is carried out by the person’s social worker before they come into the home. The manager also carries out her own assessment, to be doubly sure that the home can meet all of the new person’s needs. More detailed assessments are carried out once the new service user has come into the home. These include assessments of risk; of nutritional needs; of
Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 10 social needs; of moving and handling needs and of behavioural needs. A dependency rating scale is also completed. As a result of all these levels of assessment, the manager can clearly demonstrate that all her service users are in a home that can give them the care that they need. All are provided with a contract explaining the homes terms and conditions, and fees. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 11 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health of the service users is met and there is good multi disciplinary working taking place. The promotion of health care is taken seriously, and service users have their personal needs met in the way that they prefer. EVIDENCE: There are comprehensive assessments in the service users’ care plans. There is also a comprehensive risk assessment of service users. There are advocacy arrangements, as well as family input to represent service users. Care plans are drawn up with service users and their relatives. Plans are amended and reviewed on a regular basis.
Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 12 There are systems in place that will ensure that the placement and the service users plans are reviewed annually. These involve the care managers and the service users representatives. The service users confirmed that their privacy and dignity are respected at all times. Service users care records showed that they have access to external health care services. G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. The medication systems were examined for ordering, receiving, administering and disposal. All were found to be well maintained. All staff has had accredited medication training. Appropriate systems and procedures are in place for the management of controlled drugs. The dispensing pharmacist offers good support and advice. Service users’ said that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. One relative said “the care provided was exceptional”, another said “I have no misgivings at all, this is a wonderful place, and the staff are excellent”. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 13 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 and 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 offered a good quality lifestyle, which includes social contact, activities and choice. EVIDENCE: Each service user has a social skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users are supported and encouraged to be in control of their own lives, to enjoy their own interests and hobbies. There are daily activities available, and entertainers frequently visit the home. All service users are supported to maintain very close links with their families. They can choose who they want to see and when. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day.
Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 14 The menus have been drawn up with help and advice from a nutrionalist, and they are varied and well balanced. All those spoken to said that the meals were very good and that they were always offered a choice. Religious service, which is open to all denominations, is held in the home every fortnight. Two service users also go to church services with their families. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 15 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 and 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 good, clear, user-friendly complaint and protection system, service users are safe and their views are listened to and acted upon. EVIDENCE: There is a complaints procedure. It contains details of how to contact the CSCI to make a complaint, if complainants are not happy with the homes investigation and response. The procedure is written in a way that ensures service users fully understand its contents. Three service users said that they had been given copies of the procedure and that staff listened to their complaints and always dealt with them fairly. The home keeps a record of complaints. The home has a Whistle Blowing policy, the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Health’s document, “NO SECRETS”. Staff are aware of these procedures and have easy access to them. Safeguarding adults training is ongoing for all staff. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 16 Service users can deposit cash for safe keeping in the home’s safe and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately recorded and had two signatures for each entry. There was plenty of evidence of personal spending. Receipts are obtained for purchases and numbered to cross-reference to the transaction. Weekly checks of balances and cash are carried out. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 17 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, clean, safe and pleasant environment for those living there. EVIDENCE: The home was clean, well decorated and well maintained. The grounds were tidy, safe, attractive and accessible. The fire service and the environmental health department had made visits to the home. Requirements made by these organisations had been met. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place.
Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 18 Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in very good condition. Lighting was bright and domestic in design. All doors have privacy locks and room sizes meet the minimum required. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Service users’ bedrooms have opening windows and restrictors are in place where needed. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. All exit doors apart from the main entrance door are alarmed. The inner lobby door leading to the main entrance can be opened by anyone, including service users with dementia. There was emergency lighting throughout the home. Water is stored at over 60°C. Valves at water outlets ensure water is provided close to 43°C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are well organised. The washing machine has the specified programme to meet disinfection standards. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good match of well-qualified staff, who are appropriately recruited and supervised and who offer consistency of care within the home. EVIDENCE: Staff levels on the day of the inspection met the agreed level. Samples of 4 weeks’ rotas showed the required numbers of staff were on duty: 3 staff between 8am and 10pm with 2 between 10pm and 8am. All the staff were over 18 years of age and those left in charge were at least 21. Training needs of staff are identified in supervision and appraisal sessions. The training programme meets The National Training Organisation requirements for the first six months. Staff receive at least three days paid training each year. The service has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment.
Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 20 The service has a good staff training and development programme in place, all statutory training was up to date and 78 of the staff team has completed NVQ level 2/3. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 21 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, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is supported by the organisation in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities, and service users best interests being promoted. EVIDENCE: The manager has the appropriate qualifications, experience and skills necessary to manage the service. Staff were clear about their responsibilities. Service users are told when inspections take place and there are copies of reports available for relatives and others to see.
Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 22 A quality system is in place to monitor the quality of the service provided. This involves gaining feedback from service users, relatives and professionals involved with the home. The outcomes will be published and made available to all prospective service users. The home is also has an annual development plan. There is a health and safety policy and a range of associated procedures. Staff receive training in health and safety and safe working practices (fire safety, moving and handling, first aid, food hygiene, and infection control). The service has an internal training officer who holds meetings to discuss issues. Servicing and maintenance agreements are in place for facilities and equipment. All fire safety checks; tests and instructions to staff are conducted at the required frequency and recorded. Water storage tanks, gas and electrics are checked annually. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 23 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 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 3 X 3 X 3 X X 3 Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP22 Good Practice Recommendations To minimise the risk of service users with dementia leaving the building alone, the inner lobby exit door should be fitted with a keypad lock. Manor Road, 2 DS0000000354.V361848.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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
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