Inspection on 03/05/06 for Manton House

This inspection was carried out on 3rd May 2006.

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 12/02/08

Manton House 30/04/07

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 Mr Christopher Handley Unannounced Inspection 3rd May 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 Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 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.V293409.R01.S.doc Version 5.1 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 Mrs Lai-Wah Collin Mr Raju Ramasamy, Mr Inayet Patel Position Vacant 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.V293409.R01.S.doc Version 5.1 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 15th November 2005 Brief Description of the Service: Manton House is a registered care home, providing both nursing and residential care. The home is a large end of terrace building 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. Nursing care is provided by the nursing staff of the home. If medical or other nursing expertise is required this is provided via the local GP service. The home is situated on Tennyson Road, which is near to the centre of Kings Lynn. There are shops and facilities adjacent to the home. The home was purchased by Mr Inayet Patel, Mrs Lai-Wah Collin & Mr Raju Ramasamy in October 2004. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection during the course of which the Inspector interviewed four residents, two visitors and five members of staff. Since the last inspection the previous Manager, Mrs C. French, has left and has been replaced by Mrs Margaret Beal, who has not yet submitted an application for registration. Mrs Beale was not in the home on the day of the inspection so the Deputy Matron Mrs Jane Daramola assisted the Inspector by providing information. A wide range of records and documents were inspected, and a tour of the home was made. What the service does well: What has improved since the last inspection? What they could do better: The management of the home needs to be strengthened so that the manager and her deputy have up to date management skills and perhaps consideration should be given to providing some clerical assistance so that there is time for the management tasks. The management of the home need to ensure that they have systems in place for monitoring the standards of cleanliness and repair in the home eg the carpet which needed cleaning on the first visit and the curtain which was held up by string. The number of staff who have an NVQ Level 2 needs to improve and staff supervision must be undertaken. The management of the home also cannot be confident that the home is run in the best interest of the residents as they do not undertake any quality assurance measures. This is now urgent and the outcomes of any surveys must be shared with the residents and the Commission. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 6 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. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 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 Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 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): 3&6 A detailed pre-admission assessment is carried out on all prospective residents. The home does not provide intermediate care. EVIDENCE: The Inspector read three preadmission assessments. The documents are comprehensive, and the content is neatly written. The Matron undertakes these assessments. The files are clearly marked “Confidential”. Based on the contents of the documents seen there is good evidence on which the home can base a decision as to whether or not it can meet the prospective residents needs. Some of the older files do not have pre-admission assessments as those residents have been in the home prior to the National Minimum Standards came into being. The home does not provide intermediate care. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 9 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 &10 All residents have an individual care plan. A wide range of health care professionals visit the home to ensure that the residents’ health care needs are met. The medicine system is safe and effective. Residents’ privacy is maintained. EVIDENCE: All residents have a care plan. Each plan has the elements of assessment, plan, implementation and review. The documents are neatly written. Each record is kept in its own file. It is recommended that residents/relatives should sign the records to acknowledge that they have been involved in reviews of care. Included in this file is a risk assessment. A Record of pressure sores is maintained. The Daily record is neatly written, but some entries could be more comprehensive, and include a brief statement on the persons mental health state. The records are tidier than when inspected at the last inspection. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 10 Trained nurses provided the nursing care required in this home. Other specialist health care providers visit the home, including the District Nurse, the Continence Advisor, Tissue Viability Nurse, the Falls Co- Coordinator, Physiotherapist, or Dietician. All residents are registered with a G.P. if needed he would refer residents to a consultant for further tests or treatment. The Manager would arrange sight or hearing tests. The home has a dedicated medicine room, which is kept locked. This room was neat and tidy. There is a medicine trolley in the medicine room, which was locked. Only trained nurses administer medicines in this home. There were Controlled Drugs in the Controlled Drug Cupboard, one of which was counted and found to be correct against the Controlled Drug Register. There are no residents who self medicate in this home. The home has a written medicine policy. The Medicine record charts have been neatly completed. If staff have concerns about the effects of a medicine they will contact the prescribing Doctor. The home enjoys a good working relationship with the supplying pharmacist. Medicines are reviewed on a regular basis and this is recorded. Privacy and dignity are provided to residents as part of their care. These two important aspects of care form part of the induction programme of staff. The Residents interviewed spoke highly of staff in these two matters, saying that staff always close the curtains when they are dealing with them, and the Inspector saw in this in practice during the course of the inspection. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 11 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 13, 14, & 15 Residents’ life style matches their preferences and expectations. Contact with family and friends are encouraged. Residents enjoy a wide range of choice in their lives. The home provides a good catering service. EVIDENCE: Residents choose what they do during the day, choose when they get up, or retire, the Senior Nurse said. They choose their meals, their dress, hair style and many other aspects of their daily lives. Representatives of religious organisations call to the home frequently and a religious service is held in the home on a monthly basis. Visitors are welcomed to the home, but are asked to avoid meal times if possible. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 12 The home has a member of staff who organises activities, and these include bingo and quizzes. Some residents read the local paper or a book, some enjoy knitting Staff interviewed were aware of the importance of activities for residents. Many residents have photographs and ornaments in their rooms. Again staff are aware of the importance of residents having personal items around them. The Inspector was shown the Menu. It appeared nutritious, varied and interesting. Special diets are provided and recorded. If nutritional advice was required then the Dietician from the hospital would be contacted. The residents spoke highly of the meals provided and the Inspector discreetly observed residents enjoying their midday meal. The cook told the Inspector that she was aware that it was important that residents liked the meals she cooked for them Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 13 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 & 18 The home has a complaints procedure which is known to staff, and residents. The home has a Policy on the Prevention of Adult Abuse. EVIDENCE: The home’s complaint procedure is displayed in the front hall. It has the name, address, and telephone number, of the Care Commission on it. The print is in a large size, which makes it easy to read for people who may have poor sight. Residents spoken to knew how to make a complaint and told the Inspector what steps they would take in such matters. In most case they said that they would speak to the first member of staff they saw. Staff also knew how to make a complaint The home has an Adult Abuse Prevention procedure, and all staff have now had training in this matter. This fulfils a requirement made about this matter in the last inspection 15/11/05 Staff spoken to are now more aware of the types of abuse, and ways in which it can take place. The Matron needs to be alert in this matter and ensure that from time to time, due to staff turnover, there will be a need to repeat this training. The Proprietors are commended for arranging this training, which helps to protect residents. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 14 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): 19 & 26 Most of the home was neat and tidy, but some areas needed cleaning. The laundry was neat and tidy. EVIDENCE: The Inspector made a tour of the home and most of it was neat and tidy. The bedrooms, which have been decorated, look very nice. However on the ground floor at the rear of the home, the brown carpet appeared stained, and gave a poor impression of that area of the home. The Inspector made a recommendation that this was to be cleaned. On visiting the home a few days later this cleaning had been done and the area looked much better. The reason for the delay in cleaning was due to the industrial cleaning machine which originally was not working, but this has since been remedied. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 15 In the double bed room at the end of the ground floor corridor there was a dividing curtain which is held up with string. The Inspector requires that the that the string be replaced with a proper dividing rail with the curtain on. The laundry was neat and tidy. There were no chemicals left out. The residents said that their clothes are always washed well. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 16 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): 27,28,29 &30 The off duty was seen and it shows a good distribution of staff. There are staff who have NVQ training but the number needs to increased. The home has a Recruitment procedure. Staff have received some training relevant to their jobs. EVIDENCE: The off duty seen showed that there were 4 care staff, 1 RGN, 2 domestic staff, 2 kitchen staff, and 1 laundry staff on duty at the time of the inspection. Manton House has historically cared for a number of residents who have a high dependency of care needs, and on the day of the inspection there appeared to be enough staff to meet the needs of residents. There was one trained nurse on duty who is an experienced nurse and is familiar with the routines of the home. The Matron needs to review the trained staffing hours during the middle of the day so that professionals, visitors and other can be dealt with without causing disruption in providing the care which requires a trained member of staff to provide, e.g. the administration of medicines. These hours include 10am – 2pm and 2pm- 4pm. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 17 Further consideration should also be given to strengthening the management of the home, to ensure that the home is effectively run and managed at all times, and that there is a senior person or deputy on duty to lead and advise staff. The senior nurse on duty has a wide range of clininical skills, but consideration needs to be given to involving her in managerial tasks and offering the appropriate training, so as to expand her skills, e.g. interviewing. The Inspector was informed that there are 3 members of staff who have NVQ II. To meet the standard required the home needs to have 8 of its staff with an NVQ II. It is required that the number of staff who NVQ is increased. Based on previous experience the Inspector is aware that the home does a written procedure for recruitment and this was confirmed by the Manager some days latter when the Inspector visited the home. The home has an Induction and Foundation training programme. Other training includes Moving and Handling, First Aid, Adult Abuse, Health and Safety, Food Hygiene, Caring for People with Dementia. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 18 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): 31,33,35,36 & 38 The home does not have a registered manager and the management of the home are not yet in a position to say that the home is operated in the best interests of the residents as there is not a Qulaity Assurance system in place. The management also do not yet properly supervise staff. The home holds residents’ monies. The home has some, but not all, of the Health and Safety Records, and documents required. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 19 EVIDENCE: The acting manager is a qualified nurse and has worked in care for many years. She was appointed in April of this year. .As yet she is not registered as Manager for this home, and needs to submit her application without any further delay. She will be required to undertake the managers award. She has a clear sense of leadership which staff and residents are able to relate to. At present staff supervision does not take place and it is required that it should be. This management development tool is very important to the development of staff and the quality of care provided to residents. Resident’s personal monies are kept in the safe. A detailed record of monies for each resident is kept. The Inspector saw the records and the monies. Numbered receipts are provided when monies are handed in. To further protect the residents monies the Inspector recommends that the home should have a written procedure for this and staff should be informed of this as part of their induction to the home. At present the home does not have a Quality Assurance System and the Manager is aware that the home is required to have one. In the inspection dated 15/11/05 it was recommended that the home should have a Quality Assurance system. It is disappointing that this aspect of the management of the home has not yet be taken care of. It is important that when the surveys have been carried out, the outcomes are shared with the service users and the Commission. The Inspector was shown some of the Health and Safety documents required by Standard 38, which are kept in the office. It is required that the home obtains all these documents, and the Inspector advises that they are kept together in a folder in the office. The Matron needs to make sure that staff have a knowledge of these documents, and their location should there be a need to refer to them. Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 20 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 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 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 1 X 2 Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 2. 3. 6. 7 8 Standard OP19 OP28 OP31 OP33 OP36 OP38 Regulation 23 19 (5)(1)b) 10(3) 24(1)(2)( 3) 18 2 38 Requirement It is required that the string holding the privacy curtain be replace with a curtain rod. It is required that the level of NVQ training be improved. to a minimum of 50 of staff. It is required that the Manager undertakes recognised management training. It is required that the home implement a Quality Assurance System. It is required that the Matron implement a system of staff supervision. It is required that the home has the Health and Safety documentation required by Standard 38 Health and Safety documentation. It is required that the manager submits an application for registration Timescale for action 25/06/06 01/08/06 01/09/06 01/12/06 01/09/06 01/09/06 9 OP31 9 01/08/06 Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 22 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 It is recommended that the resident/relatives sign the care plans to show their involvement in the care planning process. It is recommended that the Daily Record gives a brief detail of the residents mental health status. It is recommended that the mobile screens in double rooms be replaced with curtains. It is recommended that the Matron review the use of trained staff between 10AM to 12 MD and 2 PM till 4PM, to ensure the most effective use of staff. It is recommended that the Manager undertake an Audit of the training needs for trained nursing staff in order to identify and training deficits, and to establish a training programme if needed. It is recommended that the home have a written procedure for handling residents money, and that this form part of the induction of staff. 2. 3 4. OP25 OP27 OP30 5 OP35 Manton House Nursing Home DS0000061111.V293409.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. 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