CARE HOMES FOR OLDER PEOPLE
Manor Way Centre Manor Way Crewe Cheshire CW2 6JS Lead Inspector
Val Flannery Announced 19 July 2005 9:00 am 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 Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Manor Way Centre Address Manor Way Crewe Cheshire CW2 6JS 01270 255248 01270 250 638 heather.simpson@clsgroup.org.uk CLS Care Services Limited 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 Heather Simpson Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1 A maximum of 41 service users in the OP category may be accommodated. Within that number I named service user may be (DE). When the home no longer cares for this service user registration reverts to 41service users in the OP category Date of last inspection 07/10/04 Brief Description of the Service: Manor Way Centre provides care for forty one older people. Located on a residential estate in Crewe the home is within reach of local facilities such as a shop, pub and is on the bus route to the town centre. Access between the ground and first floors of the two storey building is by a passenger lift or stairway. All the bedrooms are single and contain hand washing facilities. There are sufficient toilets and bathrooms to meet the needs of residents. There are a variety of aids and adaptions around the building to help residents with mobility problems. A dining area is provided on the ground floor; there are a number of communal lounges located on both floors. Residents have access to the garden to the rear of the home as well as a verandah area on the first floor. Staff are on duty twenty four hours a day to deliver care to residents. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over eight hours and was carried out as part of the yearly inspection process. One hour was spent planning the inspection. This included reading the previous inspection report and reviewing the service history for the home. During the inspection eight residents, five staff and three relatives were spoken with. Six residents care files as well as a number of the homes’ records were seen. A partial tour of the building was carried out. Three relatives/visitors and one care manager comment card were returned before the inspection was carried out. What the service does well:
A copy of the statement of purpose and service user guide as well as a copy of the previous inspection report are on display in the home. Residents said staff visited them before they came to live the home and asked them about their care needs. Relatives said they were able to visit the home on behalf of the resident and before making a decision about moving in. They said they were given information about the service offered by the home. A list of organised activities was on display in the home. Residents said they are asked about their preferences regarding activities. They also said they are visited by doctors and nurses if they are unwell. Relatives said they are able to visit the home as they wish and are made very welcome by staff. They also said they are kept informed of events that affect their relative. A well-balanced menu is offered to residents that includes choice and variety of foods. Procedures are in place that ensure the protection of residents and enables them to raise issues of concern. Residents live in a safe and comfortable environment that is homely and offers single bedrooms and a variety of communal areas- both inside and outside the home. Staff are encouraged to develop their caring skills through training opportunities and supervision/ support from senior staff.
Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 6 The comment cards included the following ‘Very pleased with all aspects at Manor Way. Excellent food. A very caring and most competent staff and management’ ‘Very happy with the care’ ‘Staff are always available to give assistance. Over mum receives an excellent level of care. All staff are very friendly and helpful’ 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. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1/3/4/5 Residents and relatives are provided with information about the service offered by the home. They are also able to visit the home before making a decision about moving in. EVIDENCE: A copy of the statement of purpose and service user guide was on display in the entrance area of the home. Also on display was a copy of the most recent inspection report. One of relatives spoken with said they were given a copy of the statement of purpose and service user guide when they first visited the home. A number of residents’ files were seen during the inspection, these contained a pre-admission assessment of need which was carried out by staff from the home. Also available were copies of the standard assessment documentation provided by the placing authority. The residents and relatives spoken with said the service offered by the home is what they expected. Some of the residents said they were unable to make a
Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 9 pre-admission visit to the home because of their circumstances, however relatives or friends were able to visit on their behalf. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7/8/9/10/ Residents’ health and personal care needs are set out in their plans of care. Residents are treated with respect and their dignity, on the whole, is upheld. EVIDENCE: Six residents’ plans of care were seen during the inspection. These showed that residents’ health, personal and social care needs have been identified; also included were details on how their needs were to be met. Residents said their health care needs were discussed with them before they moved into the home. Residents, and relatives, said they are able to request visits from doctors, nurses and other health professions. During the inspection a district nurse was seen visiting residents. Care plans showed residents receive visits from healthcare professionals, also included was the reason for the visit and the recommended treatments. An activities co-ordinator is employed by the home for twenty five hours per week. A list of activities was on display in the home. The registered manager said activities are arranged for groups and individual residents. Residents
Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 11 spoken with said their preferences with regard to activities are discussed with them. During the inspection staff were seen administering medication to residents. One resident, who was sitting in a wheelchair, was tipped backwards in the chair by the staff member when she received her medication. The reason for this action was to help the resident swallow her medication. There was no evidence in the residents’ plans of care to show this practice was followed by other staff. Neither was there any evidence to show that a risk assessment was carried out or that advice/guidance had been sought from health professionals. Other care team leaders spoken with said the resident would normally sit in an easy chair and tip her head back which helps her swallow the tablets. The practice of tipping the wheelchair is considered a danger to the resident and staff (See Requirement Number 1) Residents and relatives said staff are ‘kind and caring’ and ‘do their best to care for us’. During the inspection staff were observed helping residents with personal care, for example, using the bathroom, dressing and eating their midday meal. These tasks were carried out in a sensitive manner and with respect for the residents’ dignity. Residents also said staff spend time talking to them and reassure them if they have worries or concerns. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12/13/1/4/15 Meals are well presented and offer choice and variety. Relatives and friends are able to visit the home and maintain contact with residents. EVIDENCE: A number of residents spoken with said staff help them to exercise choice over their daily lives. For example, they are able to choose when they get up and go to bed, where they spend their leisure time, who they mix with socially and where they eat their meals. Relatives said they are able to visit the home as they wish. They also said they are given information on maintaining contact with residents. This is included in the statement of purpose and service user guide. Plans of care also contained details on family background and involvement. Residents said the food ‘is good’. They also said they are offered a choice for each meal. The menus showed that residents are offered a variety of food, for example, on the day of the inspection curry was one of the choices for lunch. Also residents said they were offered salmon the day before. Residents spoken with said that although it’s ‘not like their own home’ they are ‘well looked after’ and feel ‘safe because there are always staff around’
Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 13 Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16/18 Satisfactory arrangements are in place to respond to complaints and adult protection issues. EVIDENCE: A comment and complaints procedure is on display in the entrance area. Comment cards are available which allow residents and visitors the opportunity to raise concerns. The complaints procedure includes details on how to contact the Commission for Social Care Inspection. According to the manager the home has not received any complaints since the last inspection. CSCI has not received any complaints about the home. Since the last inspection two adult protection issues have been addressed via the Adult Protection Procedure. As a result one member of the domestic staff was dismissed. Staff were aware of the complaints and adult protection procedure and what action to take if they had any concerns. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19/20/21/22/24/25/26 The home provides a safe and comfortable standard of accommodation for residents. Single bedrooms are provided which meet the needs of residents EVIDENCE: Since the last inspection the manager and staff have re-decorated the corridors and lounge. New lights have also been installed on the downstairs corridors. This maintenance work has improved the appearance of these areas. The appearance of the corridors on the first floor would be improved if the lighting was to be changed (See Recommendation Number 1) The home is well maintained and provides a safe and comfortable environment for residents. A garden to the rear of the home is accessible to residents and provides a safe and pleasant outdoor area. The balcony area, located off a lounge on the first floor, is according to the manager, to be revamped so that residents have additional outdoor space. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 16 All the bedrooms are single and contain hand-washing facilities. Sufficient toilets and bathrooms are located around the home to meet the needs of residents. A number of bedrooms were seen during the inspection, these were individually decorated and furnished. They also contained items of furniture, photographs and ornaments belonging to residents. Residents said they are happy with their bedrooms and that they are’ kept very clean and tidy by the staff’ A range of aids including bath hoists, grab rails, wheelchairs and other lifting equipment are provided for residents with mobility problems. On the day of the inspection the home was clean and free from unpleasant smells. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 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 There are sufficient staff on duty during the day to meet the needs of residents. Satisfactory recruitment procedures are in place and provide safeguards for the protection of residents. EVIDENCE: The staffing rota showed that there is normally one care team leader and four care assistants on duty during the morning/afternoon/evening. There is normally one care team leader and one care assistant on waking duty during the night. These levels have increased since the last inspection. Sufficient support staff such as domestic and kitchen staff are employed by the home. A home service manager is responsible for managing support staff and the home’s administration procedures. Three staff personnel files were seen during the inspection. These contained the required information/checks such as application form, two references and Criminal Record Bureau checks. Residents and relatives said staff are ‘kind and caring’ and ‘will do what they can to help you’. During the inspection staff were observed helping residents with a range of tasks such as using the bathroom, dressing and eating. This was done in a manner which maintained residents’ dignity and self respect. Records seen showed that staff have access to or have achieved NVQ training in caring. Also seen were records of other training undertaken by staff including fire safety, manual handling and first aid. Staff said they are
Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 18 expected to attend courses to update their knowledge in caring for older people. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 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) 31/32/33/36/38 The home is run by an experienced manager. Staff receive supervision from the manager which helps them in their delivery of care to residents. EVIDENCE: The manager has been employed by the organisation in a senior capacity for a number of years. She is in the process of completing NVQ Level 4 in management and has attended training required for the day-to-day running of the home. Residents and relatives said the manager will listen to them and act upon their concerns and worries. Staff said the manager provides support and guidance to assist them in caring for older people. Residents spoken with said they are consulted about proposed changes, for example, menus, the décor and furnishings and their personal care. Copies of
Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 20 a recently conducted resident/relative survey showed that there is an overall satisfaction with the service provided. Staff said they receive regular one to one supervision from senior staff in the home. They said personal and organisation issues are covered during these sessions. A tour of the building showed that health and safety issues are addressed. The record of fire safety procedures was satisfactory. A letter received from the Borough of Crewe and Nantwich said no major contraventions of the Food Safety Regulations were identified during their last inspection. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 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 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 3 Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 22 None Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(2) Requirement The method for assisting the resident (identified during the inspection) with her medication must be reviewed. Advice and guidance must be sought from healthcare professionals. 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 19 Good Practice Recommendations New lights in the corridors on the first floor would improve these areas. Manor Way Centre F51 F01 S6506 Manor Way Centre V231257 190705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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