Inspection on 09/01/06 for Manor Road, 2

This inspection was carried out on 9th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Manor Road, 2 04/04/08

Manor Road, 2 04/04/07

Manor Road, 2 07/06/05

Manor Road, 2 07/02/05

Manor Road, 2 20/09/04

Manor Road, 2 16/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Manor Road, 2 2 Manor Road Tynemouth North Shields Tyne & Wear NE30 4RH Lead Inspector Jim Lamb Announced Inspection 9th January 2006 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.V259296.R01.S.doc Version 5.0 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.V259296.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Manor Road, 2 Address 2 Manor Road Tynemouth North Shields Tyne & Wear NE30 4RH 0191 2574519 0191 2574519 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 Mr Richard Heysham Collins Care Home 24 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (19) of places Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 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. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection lasted three and a half hours and involved discussion with the homes registered manager, deputy manager, proprietor, one relative and five service users. Three service users care records were inspected together with other records relating to the running of the home. What the service does well: What has improved since the last inspection? The homes statement of purpose is now available in large print and on audiotape. The staff team receive regular supervision sessions. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 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 the following standard(s): 15 The service users needs are fully assessed before moving into the home, all prospective service users have the opportunity to visit the home prior to moving in. The homes statement of purpose is available in large print and on audiotape. EVIDENCE: Details of the extra charges and what these are for, are in the contract given to service users and are agreed prior to their admission. The homes Statement of Purpose and the Service Users Guide both contained the full range of information required. Two service user interviewed confirmed they had been given a copy of the guide. The service users guide is available in a range of formats: large print and audiotape. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 9 The 3 service user plans checked by the inspector were comprehensive, and listed details of service user’s needs and actions taken by the staff to meet these needs. The service users interviewed said their needs were met and they were happy with the care offered to them. Staff had had a range of relevant training and experience. The home has detailed admission procedures in place; prospective service users are invited to visit the home to meet other service users and staff before they make a decision to stay. If appropriate overnight stays can also be arranged. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 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 the following standard(s): 7 8 9 11 The service users health, personal and social care needs are met. The medication systems are well managed. Appropriate systems/procedures are in place for ageing, illness and death. The risk assessment format currently in use does not have enough scope to clearly record the identified risks or how these would be managed. The social care plans need to be developed further. EVIDENCE: There is evidence of a comprehensive assessment in the service users’ care plans. The homes risk assessments need to be developed further in order to describe in detail the identified risk, and strategies to minimise and manage the risks, Once agreed, the service users or their representatives should sign the risk assessments. There was evidence of advocacy arrangements, as well as family input. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 11 Each service user has an allocated key worker. Care plans are drawn up with service users. There is evidence that plans are amended and reviewed on a regular basis. The service users social care plans need to be developed further, the manager will ensure these are completed within the next few weeks. Detailed procedures were seen to be in place regarding the care and comfort given to service users who are dying, and these ensure that their death is handled with dignity and respect. Each service user receives support from staff to manage their finances. Service users’ all indicated that they are able to make decisions for themselves. The service users informed the inspector that the home continues to meet their individual care needs. They said that the staff were caring, kind and very supportive and respectful. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 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 the following standard(s): 12 14 There was evidence that service users social and personal needs are met, it was agreed that social care plans need to be developed further. The service users confirmed that they are able to make decisions for themselves. EVIDENCE: There was evidence that each service user has the opportunity to participate in community-based activities such as luncheon clubs, pubs, visits to local shops and outings. If service users prefer, they can access to a local enabling/befriending service that will provide one to one social outings. (This will incur an additional charge) All service users are supported to maintain very close links with their families. All are able to choose who they want to see and when. On the day of the inspection, a relative informed the inspector that the service and care provided was “first Class” Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 13 There was evidence that daily routines promote independence and maximise their capacity to exercise personal autonomy, choice and freedom of movement. The inspector observed staff interacting in a sensitive and respectful manner with service users. The Home’s menus are based on the known likes and dislikes of the service users. At least three hot meals are provided on a daily basis. The service users said that the food was very good. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 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 the following standard(s): 16 17 18 Adult protection is well managed, service users are safeguarded from abuse, and staff have undertaken POVA training. The service users were fully aware of the homes complaint procedures. EVIDENCE: The home does have a complaints procedure, which the inspector saw. It contains details of how to contact the CSCI to make a complaint, and is written in a way to ensure that service users fully understand its contents. Two service users interviewed confirmed that they had been given copies of the procedure and that staff listened to their complaints and dealt with them fairly. The home does keep a record of complaints, since the last inspection visit there have been no complaints received. The service users legal rights are protected. The home has a Whistle Blowing policy procedure as well as, the Local Authorities Vulnerable Adults procedures. The home also has a copy of the D.H. “NO SECRETS” for further information. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 15 The Home maintains detailed financial records on behalf of the service users; each has an individual bank account. There was evidence of personal spending and receipts are kept. The cash balance held for safekeeping was checked for two service users, both were found to be correct. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 16 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 the following standard(s): These standards were not inspected during this inspection visit. EVIDENCE: The environment standards were all met at the previous inspection carried out on 7.6.05. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 29 30 Appropriate staffing levels are being maintained. Robust procedures are in place for the recruitment and selection of staff. Staff have a range of skills and experience necessary to meet the needs of the service users. EVIDENCE: Staff levels on the day of the inspection continue to meet the agreed level. Samples of 4 weeks’ rotas were checked and these stated the required numbers of staff were on duty: 3 staff between 7am and 9pm, with two staff between 9pm and 7am. The service users interviewed said that staffing levels were appropriate. All the staff were over 18 years of age and those left in charge were at least 21. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 18 Training needs of staff are identified via supervision and appraisal sessions. The training programme meets The National Training Organisation requirements for the first six months, since the last inspection visit there have been no changes to the staff team. Staff receive three days paid training. The home operates a thorough recruitment and selection process based on equal opportunities and ensuring the protection of the service users Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 34 35 38 The home operates a very good quality assurance system. The service users financial interests are safeguarded. The health, safety and welfare of the service users continues to be promoted and protected. EVIDENCE: Service users are informed when inspections take place and have access to inspection reports. These are also summarised and discussed in service user meetings. Copies are available for relatives/others to see The organisation has developed a range of new policies and procedures which have been linked to the National Minimum Standards. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 20 The home operates a very good quality assurance system based on the views of service users, there relatives and professionals involved in the home. A very detailed annual development plan was evidenced. The records inspected were found to be appropriately completed, these included the fire log book, accident records, personal allowance records, Health and Safey manual, and there was information which verified that appropriate maintenance contracts for the home are in place. Water storage tanks, gas and electrics are checked annually. Finance records have previously been forwarded to the CSCI to verify that the home is viable. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X X X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 X X X X X X X X 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 X X 3 3 3 X X 3 Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 22 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 2 Refer to Standard OP7 OP7 Good Practice Recommendations Continue to develop the service users social care plans. Consider using a different risk assessment format for recording service users identified risks. Manor Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Road, 2 DS0000000354.V259296.R01.S.doc Version 5.0 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!