Inspection on 12/02/08 for Manton House

This inspection was carried out on 12th February 2008.

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

Manton House 02/03/09

Manton House 30/04/07

Manton House 03/05/06

Manton House 15/11/05

Manton House 14/04/05

Manton House 18/11/04

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 Manton House Nursing Home 5 Tennyson Avenue Kings Lynn Norfolk PE30 2QG Lead Inspector Mrs Geraldine Allen Unannounced Inspection 12th February 2008 09:10 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 Manton House Nursing Home DS0000061111.V359712.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. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manton House Nursing Home Address 5 Tennyson Avenue Kings Lynn Norfolk PE30 2QG 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) 01553 766135 01553 766135 Mr Raju Ramasamy Mr Inayet Patel Mrs Margaret Anne Beale Care Home 22 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (22) of places Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Twenty-two (22) Older People, not falling into any other category, may be accommodated. Two (2) Service Users, over the age of 65 years, who have dementia may be accommodated. Total number accommodated not to exceed twenty-two (22). Date of last inspection 30th April 2007 Brief Description of the Service: Manton House is a care home, providing nursing and residential care for up to 22 older people, two of whom may have dementia. Mr Inayet Patel & Mr Raju Ramasamy have owned the home since October 2004. The home is located near to the centre of King’s Lynn and is close to all local amenities including shops, pubs and post office. The building is a large end of terrace house of traditional design. The accommodation is on the ground and first floor. There is a small garden at the front of the home, and a lawn and car park at the rear of the home. Eleven bedrooms are single, 3 of which have en-suite facilities and 4 are double occupancy rooms, 1 of which has en-suite facilities. The bedrooms are located on the ground and first floor. Ms Frost said the service currently uses the Social Services fee rates and additional charges are recorded in the contract of residence. People are advised about the relevant fee payable verbally at the time of their initial enquiry. People need to apply to Ms Frost to obtain the relevant fee rate. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during the day of 12 February 2008. Information was obtained from various sources. Before the inspection took place the manager, Merylin Frost, completed and returned an Annual Quality Assurance Assessment (AQAA). This gave information about the day-to-day running of the service and also the areas identified where improvement has taken place or is needed. Only one resident and one relative completed and returned a questionnaire sent out by us. The views expressed in the questionnaires are reflected in the report. On the day of inspection, various records were looked at. These included three care files, three staff files, medication records and records that showed how the service protect people from accidents and abuse. We also spoke with residents in private, staff who were on duty and Ms Frost. Observations were made discreetly throughout the day. A tour of the premises was completed with Ms Frost. Ms Frost took up her post as manager in October 2007. She spoke about how she wants to develop the service so that people receive high quality, person centred care. She acknowledges that there is work to do to achieve this and it was apparent that she has already identified the issues contained in this report. Ms Frost referred to the importance of a good professional relationship with staff in order to move improvement forward. There was evidence through conversation with staff that she is making good progress towards achieving her goal. Staff clearly appreciate Ms Frosts’ approach and this is positive for the future. The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes. In total, nine requirements and six good practice recommendations have been made. What the service does well: People receive good health care that is provided in a timely way. Evidence was seen that advice is sought from other health professionals when necessary. People are cared for by staff who are motivated and work hard to provide good care. People living at the home spoke affectionately about the staff and appreciated their efforts and voiced concern about how hard they work. One person spoke about “loving care” and “everything is done in the way of caring”. Staff were described as “kind and caring”. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 6 The service has a complaints procedure in place that is clearly displayed in the home. People said they would be confident about speaking to Ms Frost if they had worries or concerns. 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 Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Manton House Nursing Home DS0000061111.V359712.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 Manton House Nursing Home DS0000061111.V359712.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): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People have an assessment of their needs completed before they move into the home but it does not give sufficient consideration to all the person’s individual needs. The aims and objectives of the service are clearly displayed. EVIDENCE: A copy of the service Aims and Objectives was clearly displayed in the entrance hall. Ms Frost said the service currently uses the Social Services fee rates and additional charges are recorded in the contract of residence. People are advised about the relevant fee payable verbally at the time of their initial enquiry. The scale of additional charges is not currently within the service user guide and Ms Frost is aware this document needs to be updated to include them. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 10 People have an assessment of their needs completed before they move into the home. However, the standard of completion is variable and in some cases insufficient information is obtained. There is no consideration about the social, emotional and spiritual needs of the person. There appears to be heavy reliance on the assessments completed by Social Services and hospital staff. The pre-admission assessment needs to be completed with full details so that meaningful interim care plans can be developed for when the person enters the home. Manton House Nursing Home DS0000061111.V359712.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 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People have an individual plan for their care that is not holistic and considers only their physical needs. People have access to health professional support as necessary. There are safe practices in place regarding the control and administration of medicines although storage needs to be improved. People receive personal care in private. EVIDENCE: Three care files were looked at in detail. Ms Frost said she wanted to improve the information within the files and the following observations were made. The files give reasonable information about the physical care needs of each person. However, the information in the care files should be more holistic so that staff understand the full range of the person’s needs and not just the physical needs. The pre-admission assessment should be fully completed so that meaningful interim care plans can be developed for when the person Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 12 enters the home. Assessments completed after the person has moved into the home should also include the social, emotional and spiritual needs of the person. This will help staff to ensure that people have social and spiritual experiences that are important to them. The care plans need to provide more detail for staff about how needs should be met and by whom. The daily progress records are task orientated. They need to be completed daily and to include information about how the person has spent their day. This will mean that they consider and record the important daily events in the person’s life. People need to be involved in developing their care plans and this should be recorded. The files are in need of tidying so that conformity and chronology are maintained. People receive timely health care support. The records of health interventions were good and gave clear information about treatments and any follow up. The reports were cross-referred to the daily progress sheets. The medication arrangements were discussed with the nurse on duty and administration discreetly observed at lunchtime. The home uses the Boots Monitored Dosage System. Good practice was seen and the regular audits conducted by Ms Frost and the nursing staff are regarded as good practice. The last audit was seen and had been well completed, with an action plan for continuous improvement. The room where medicines are stored is very small and not very well organised due to lack of storage space. Ms Frost described her plans for addressing the situation in this room and it is anticipated that better storage will significantly improve the situation. Medications were safely and properly stored. The controlled medicines held were checked against stock held and this was correct. Staff must always use a full signature when signing the controlled medicines register. The requirement made at the last inspection about medication practice has been met. Residents were given personal care in private and behind closed doors. At no time were staff overheard discussing specific residents and their needs. Residents said staff tried to provide care when they needed it although they had to wait when staff were particularly busy. Manton House Nursing Home DS0000061111.V359712.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 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A person’s preferred lifestyle and their social and spiritual needs are not clearly established and recorded. People are supported to maintain contact with their relatives. People have some control over their day-to-day choices but these are not always respected when insufficient staff are on duty. People have a varied, choice based diet. EVIDENCE: Ms Frost said she is trying to establish good relationships with local churches, schools and clubs as she intends the service will be part of the local community. The local church visited and sang carols before Christmas and communion has been established on a regular basis. Contacts have been made with other denominations so that people can receive spiritual support if they wish. Most residents were seen and spoken with briefly although three residents were seen in private and spoken to at length. One resident said she was happy at the home and enjoyed the food most days although she said it could Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 14 be “variable”. She said there were choices available at each meal and described some of them for teatime. The resident said that sometimes there were not enough staff and they then get told they will be given their meals where they are, for example her bedroom. The resident spoke about activities available and said she liked to read, play dominoes and bingo. She likes to join in with the activities taking place. Another resident was in her own room and said this was where she liked to spend the day although she could go to the lounge if she wished. She preferred her own room because she could watch what she wanted on the television. She said staff do not visit her to chat very often because they were “too busy”. She also said she did not see Ms Frost much for the same reason. She did say however, that she would speak with Ms Frost if she had any concerns but that she “didn’t have any”. The resident said that staff always respond to her call bell but that sometimes she has to wait because they are so busy. Another resident was spoken to. He said staff were very kind and he had enjoyed his stay very much. He had enjoyed the food and felt his recovery was because of the care he had received. He preferred his own company and liked to spend his time in his own room. People said they could make choices around their daily living and could spend the day where they wished. However, one resident said she had not been able to eat her meal in the dining room that day because staff were too busy to take her there. No planned activity was seen on the day of inspection. Televisions were on in both lounges and the radio was also playing in the dining room adjacent to one of the lounges. Visitors were in the building during the course of the afternoon but there was no opportunity to have a discussion with them. Lunchtime was observed. No residents were seen in the dining room and they were either served in the lounge or their own rooms. Staff were asked why this was the case and they said there were not enough staff available to get people to the dining room in time for lunch. They felt it was important to serve meals when hot rather than take people to the dining room. Residents were seen eating their lunch in both lounges. A carer was feeding one resident. The carer was sitting on the arm of the armchair next to her. Although the requirement made at the last inspection has been met, another requirement has been made as a result of this inspection. The cook was spoken to. She referred to the choices available at each mealtime. She described the special diets, including diabetics, catered for. She described the arrangements for the delivery of food supplies and said “Matron expects plenty of fresh foods”. Plenty of food supplies, including fresh fruit and vegetables, where seen. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 15 Residents were seen being spoken to by staff throughout the day. There was friendly conversation and plenty of laughter. One lounge was very noisy with conversation, the television, a vacuum cleaner in use and also the radio being on in the adjoining dining room. However, this did not seem to trouble the residents and there was plenty of conversation involving the residents taking place. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 16 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 * 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. The procedure is prominently displayed. Training of staff in safeguarding people is arranged by the service. Policies and guidance are in place about safeguarding people. EVIDENCE: The complaints procedure was seen clearly displayed on the notice board in the entrance hall. The complaints procedure needs to be updated to show the correct contact details for the Commission. The Commission has received no complaints and the manager said she had not received any complaints in the time she had worked at the home. Residents said they would speak with Ms Frost if they had any concerns, but insisted they were happy. Staff have received abuse awareness training recently and were knowledgeable about these matters. One member of staff referred to the home’s whistle blowing policy and said she would not hesitate to use it if necessary. Manton House Nursing Home DS0000061111.V359712.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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and there are no unpleasant odours. Fire safety is compromised by the continuing use of wedges and other items to hold open doors. People are at risk from hot surface temperatures, as radiators are not covered. EVIDENCE: A tour of the premises took place shortly after arrival. Not all residents were up and dressed so not all rooms were entered. The home was clean and reasonably tidy, with no unpleasant odours detectable. During the course of the initial tour, doors were seen wedged open using wooden wedges, a chair and a towel. The towel was being used because the door lock had broken and the door could not be opened from the inside. This Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 18 was awaiting repair. Some bedroom doors have now been fitted with door guards but more are needed. Staff use wedges routinely to keep doors open even though some of these are clearly noted as fire doors. Ms Frost said she has already asked for more door guards and spoke again with the estates manager during the inspection to obtain them without delay. The fitting of these devices should be regarded as a priority to ensure adequate safeguarding against fire. The laundry was well equipped and all equipment was working satisfactorily. The laundry door was held open by a door guard but this needs to be closed when no staff are in there as it opens directly onto the dining room and affects the ambiance of the room. It is evident that the service is still having storage problems. Hoists, commodes, a mobile screen, wheelchairs, walking frames and a laundry bin were all stored under the staircase adjacent to room 8. Further items were stored in the assisted bathroom by room 3. This also contained a commode & laundry bin. Storage issues have been raised at previous inspections and consideration needs to be given to how the situation can be improved. Current storage arrangements have an impact on residents. For example, one resident spends the day in her room and can see the items stored under the staircase from her chair. The requirement made at the last inspection has not been met and is repeated. All areas of the building have plenty of natural light and ventilation. Supplementary lights were in use in darker corners and provided sufficient light to ensure safety. None of the radiators have yet been fitted with radiator covers. Ms Frost was advised to complete risk assessments on all radiators to ensure a programme of fitting can focus on the most urgent and high-risk areas first. Ms Frost spoke of her plans to develop the garden so that it was enclosed and provided a sensory experience for people. It is not expected that this will be completed in time for the summer. Manton House Nursing Home DS0000061111.V359712.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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are not employed in sufficient numbers to meet all the needs of residents in a timely way. There is a good skill mix of staff on duty. The recruitment procedure meets statutory requirements. Staff receive training that is relevant to their role. EVIDENCE: The staff rota for the week of inspection was provided. This showed that Ms Frost is routinely working shifts. The staff rota also showed that a nurse is employed throughout the day and night. Three care staff are employed during the morning and three during the afternoon and evening. Only one carer is on duty with the nurse at night. These levels are below the Norfolk Health Authority minimum staffing levels as set at 04/04/2000 and to which the service must comply. These state that a home of this size must have a minimum of one nurse and four care staff between 08:00 & 15:00; one nurse and three care staff between 15:00 & 22:00; one nurse and two carers between 22:00 & 08:00. These staffing levels are in addition to the manager’s hours and do not reflect the increased dependency of residents since they were set. The requirement made at the last inspection has not been met and is repeated. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 20 Residents have commented on needing to wait for staff to give them help and support because staff were too busy. Staff also referred to leaving call bells unanswered if they were busy with a resident and said they were short staffed on some shifts. Staff also said they were too busy to take people to the dining room for lunch on the day of inspection and residents said this situation had occurred before. Three staff files were looked at and discussed with Ms Frost. She said interview notes had been made for a recently appointed member of staff but had not yet been written up. She said she had interviewed the last two appointed staff alone as both were well known to her from her previous home. Ms Frost is aware that it is best practice to have two people interviewing candidates and this will be the case for all future appointments. The staff files need to be completed more uniformly so that retrieval of information is easier. Training records were seen. These showed that Ms Frost is getting to grips with staff training. A senior member of staff has been made responsible for staff training using training packs from Mulberry. Control Of Substances Hazardous to Health training was due 26/02/08 and basic food hygiene was due to be presented within the next month. Abuse awareness, fire safety and manual handling training have been completed. There are also regular staff meetings taking place. The last staff meeting was on 13/01/08. The requirement made at the last inspection about staff induction training has been met. Ms Frost said 3 carers were doing NVQ3, some already have NVQ2 but a further 2 staff will be commencing shortly. The service does not meet the standard of 50 NVQ trained care staff at this time. Four staff were spoken to in private. One person said staff were very kind and supportive of each other and that they also had a sense of fun. Staff said Ms Frost was bringing in plenty of changes for the good of the home and residents. They were pleased Ms Frost was at the home and that she was bringing in changes that were improving things. Manton House Nursing Home DS0000061111.V359712.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, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A competent and qualified person manages the home. Quality assurance processes, including the Annual Quality Assurance Assessment (AQAA), need further development. People’s personal allowances are protected by good practice. Staff receive regular supervision. People are protected by the home’s health & safety policies, but some practices need to improve. EVIDENCE: The service registration certificate, with the name of the previous manager still shown, was seen displayed in the entrance hall, together with the public liability insurance certificate. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 22 Merilyn Frost, the recently appointed manager, was on duty on the day of inspection. Ms Frost started her employment October 2007 and said she is very happy at the home. She said she is able to discuss issues with staff and feels well supported by the senior managers. Ms Frost is a well qualified nurse. She has significant management experience and is competent to fulfil her role. Ms Frost was not aware of the Quality Assurance (QA) arrangements at this time. She is aware that questionnaires were sent out before Christmas but there had not been much response to these. The development of a formal QA process was discussed. Ms Frost is actively consulting with residents and relatives through regular meetings and is seeking their views and opinions about the service. A copy of the minutes from the meeting dated 17/11/07 was provided. Residents said that Ms Frost speaks with them individually on a regular basis. It was not possible to inspect this standard fully and it will be reviewed at a future inspection. As a result, the requirement outstanding at the last inspection will be repeated. Ms Frost completed the AQAA and this was discussed during the inspection. Areas where the information provided could be improved were agreed. The personal allowances held for one resident were checked against records held and were correct. The record shows full details of expenditure and income. Two full signatures need to be given for each transaction. The format needs to be turned to “landscape” to allow room for two full signatures for each transaction. This will help to safeguard against financial abuse. Ms Frost confirmed that staff supervision is taking place. The deputy manager is responsible for the clinical staff supervisions and another nurse is currently doing mentors training so that can be introduced for staff to receive additional support. Staff confirmed they were receiving regular supervision and the supervision record for a recently appointed member of staff was seen. Ms Frost confirmed that visits by the provider’s representative are taking place monthly. She also confirmed that a report is being produced after each visit, however copies of the reports are not being forwarded to the Commission every month. Ms Frost undertook to ensure they were sent as required. The requirement made at the last inspection about this has not been met in full and is repeated. The maintenance programme for 2007/2008 was seen and was up to date, with due dates for servicing recorded. The fire risk assessments were updated recently and the fire alarm and emergency lights serviced 17/01/08. Accident records were seen. The records were completed well and immediately after the incident occurred. Ms Frost confirmed that she audits the accident records to look for patterns and other concerns. Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 23 Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 24 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 2 Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 25 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. Standard OP3 Regulation 14 (1)(a) Requirement People must have a thorough assessment of all their needs, including their social and spiritual needs, before they move into the home. This will ensure that people can be confident all their needs will be properly met. People need to have care plans that reflect all their needs. People should be involved in the planning of their care and consulted about any changes to their plan. This will mean that all people who use the service feel they have choices and control about their care. Arrangements must be put in place at mealtimes so that people are able to eat their meal where they wish. Sufficient staff must be able to assist them as necessary. This will mean that people can enjoy a better dining experience. The fitting of devices to hold open doors safely needs to be completed. This will mean that DS0000061111.V359712.R01.S.doc Timescale for action 12/03/08 2. OP7 15 12/03/08 3. OP15 16 (i) 12/03/08 4. OP19 23 (4)(a) 12/03/08 Manton House Nursing Home Version 5.2 Page 26 5. OP19 13 (4)(c) 6. OP26 23 (2)(l) staff no longer use wedges and other items to hold doors open and fire safety will not be compromised. All radiators need to have covers fitted. A programme for this work should be based on risk assessments to ensure high-risk areas are dealt with first. Risk assessments must be completed without delay. This will mean that the risk of burns from hot temperature surfaces is reduced. A review and improvement of storage space needs to be undertaken so that bathrooms, corridors and lounges are not used to store items such as continence wear and wheelchairs. This will improve the homeliness of the environment for people. This compliance date of 28/05/07 has not been met. Staff must be employed in sufficient numbers to meet the needs of residents in a timely way. This will mean that people receive the help and support they need when they need it. The service providers must develop and introduce a quality assurance process that seeks the views of people who use the service, relatives and visitors to the home. An action plan must be put in place that will demonstrate improvements to this service. This requirement is repeated and will be reviewed at the next inspection. The service providers must ensure that monthly visits are carried out to the service and that a copy of the report of each DS0000061111.V359712.R01.S.doc 12/03/08 12/03/08 7. OP27 18 (1)(a) 12/03/08 8. OP33 24 12/06/08 9. OP33 26 12/03/08 Manton House Nursing Home Version 5.2 Page 27 visit is held at the home and a copy sent to the Commission. This will demonstrate that there is regular monitoring of the service. The compliance date of 25/06/07 has not been met in full. The requirement is repeated. 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 OP7 Good Practice Recommendations The care plans should include more information about the social and emotional needs of people so that staff can better understand these needs and how they can be met. Daily progress records need to include information about how the resident spends their day and with whom. This will encourage a more holistic approach to their care. Improved storage arrangements are needed in the medication room. The current arrangements are not adequate to help staff keep consistently good control of stock items. The home’s complaints procedure needs to be updated to show the correct contact details for the Commission. This will help people to make easy contact with us should they wish to do so. It is good practice to have two staff conduct new staff interviews and to keep interview records. This will help to ensure the recruitment process always reflects best practice. Two full signatures should be used for all transactions undertaken on behalf of a resident. This will help to reduce the risk of financial abuse occurring. DS0000061111.V359712.R01.S.doc Version 5.2 Page 28 2. OP7 3. OP9 4. OP16 5. OP29 6. OP35 Manton House Nursing Home Manton House Nursing Home DS0000061111.V359712.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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