Inspection on 19/04/05 for Mockley Manor

This inspection was carried out on 19th April 2005.

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

Other inspections for this house

Mockley Manor 24/04/07

Mockley Manor 14/06/06

Mockley Manor 06/09/05

Mockley Manor 05/10/04

Mockley Manor 13/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Mockley Manor Forde Hall Lane Ullenhall Warwickshire B95 5PS Lead Inspector Paul Appleyard Unannounced 19 April 2005 09.30 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. Mockley Manor Version 1.10 Page 3 SERVICE INFORMATION Name of service Mockley Manor Address Forde Hall Lane Ullenhall Warwickshire B95 5PS 01564 742185 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) Alpha Health Care Ltd Mrs Tracey Maria Parkes CRH 44 Category(ies) of N 44 registration, with number of places Mockley Manor Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 05 October 2004 Brief Description of the Service: Mockley Manor is a care home providing both nursing and residential care for 44 residents. It is registered to provide care for elderly residents. They do not provide specialist services, e.g. dementia care. It is privately owned and is part of a growing care home company. It is situated in a small village on the outskirts of Stratford-Upon-Avon and Henley-in-Arden. Access is via a country lane and its location is very rural. Most bedrooms are single, (5 doubles) with views of the surrounding countryside. There are two lounges and two dining rooms available as well as extensive gardens. The buildings are a tasteful combination of old and new build. Mockley Manor Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours and was unannounced. This was the first visit of the inspection year. Half of the day was spent talking to the manager, examining records, policies and procedures. The afternoon was spent talking to residents throughout the home and observing staff working practices. Visitors were also interviewed in terms of how the home provides care. What the service does well: What has improved since the last inspection? What they could do better: At the time of the inspection the home did not have an activity coordinator in post so activities and entertainment was limited. Staff should have more structured supervision and training in protecting vulnerable adults. The bathrooms could be reviewed as part of the upgrade of the home to make them more resident user-friendly both in design and décor. To ensure the health and safety of residents the registered manager must ensure that clinical Mockley Manor Version 1.10 Page 6 waste is securely stored and the wall covering in the laundry should be improved. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mockley Manor Version 1.10 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 Mockley Manor Version 1.10 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) 3 and 5 There is a proper assessment prior to residents moving in to the service, this being the basis to assure that care needs can be met. Prospective residents and/or relatives have the opportunity to visit the home in order to assess the facilities and suitability. EVIDENCE: A detailed assessment form is available for all information required to assess all prospective residents’ needs prior to moving into the home. The care plans of the last two residents to move in were reviewed and all relevant information found to be collected. Each service user’s care plan is written using the information from the initial assessment. Service users referred by social services were noted to have summaries of care needs on file. Evidence of ongoing review was also noted. Care plans reflect the care needs of the residents reviewed. Mockley Manor Version 1.10 Page 9 The registered manager advised that trial visits for prospective service users are encouraged wherever this is possible. One care plan reflected that a trial visit had taken place. This is less likely for those who require nursing care with visits made by relatives or friends. The registered manager advised that urgent/emergency visits are not encouraged and are extremely rare. Mockley Manor Version 1.10 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) 8 and 10 The health care needs of residents are identified and met. Residents are treated with respect and dignity when their care needs are being attended to. EVIDENCE: The care plans of five residents were reviewed in respect of how health and social care needs are met. The number of residents able to maintain their own personal and oral hygiene is limited. Care staff provide appropriate support dependent on need. Care plans clearly indicate personal hygiene needs. Evidence of assessment of service users who are at risk of developing pressure sores was noted. Treatment is well recorded. It is recommended that a clear protocol be developed for all staff to follow in pressure sore treatment. The registered manager involves the local continence specialist in assessments. All residents are registered with local G.Ps who visit on request. Service users spoken to said they were happy with the G.P. It was also noted that the home has excellent pharmacist support not only in terms of medication policy and procedure advice but also in terms of best practice for residents. Mockley Manor Version 1.10 Page 11 Residents have access to hearing and sight tests. Dental care is also provided with the dentist visiting the home on a regular basis. Staff were observed undertaking their duties. It was noted that all spoke to the service users with respect and maintained their dignity. Service users confirmed to the inspector that all personal care such as nursing tasks, washing, dressing and using the toilet are undertaken with privacy in mind. The home is suitably laid out to ensure that meeting with relatives and friends can be done in private. This is usually in the resident’s bedroom but can also be in one of the dining rooms. Residents also informed the inspector that if they need to see the doctor it is always in private. Mail is delivered to the home and then distributed to the residents individually. Residents confirmed that they open their own mail. All residents have access to a telephone. All rooms have telephone points. On the day of the inspection all residents were dressed in appropriate attire. Residents confirmed that they are addressed as they prefer. Evidence of preferred first names were noted in a number of care plans. The home has a number of shared rooms. During the tour of the home it was noted all have adequate screening to ensure that residents’ privacy is not compromised when personal care is being given or at any other time. Mockley Manor Version 1.10 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 and 15 The current arrangement for activities and entertainment are limited and so therefore do not provide adequate recreation or motivation for residents. Residents are able to maintain contact with family friends and other parties as they wish. Meals are well presented, wholesome and provide residents with a nutritious and balanced diet. EVIDENCE: Many of the residents spoken to commented on how good the food was and it was what they wished to eat. Menus were inspected and found to be well balanced and varied. The inspector ate lunch with several residents and found it to be nutritious, well presented and tasty. Many relatives and friends were noted to visit the residents during the inspection, one resident commenting that “her family can come and see her every day”. The care home is in a very rural location but does have some community input, a church service held on the day of the inspection. The care home does not currently have a member of staff coordinating social and leisure activities. Some external entertainers are used with the exercise class very popular. A number of residents reported their desire to have more activities, both to the inspector and in the home’s own residents’ satisfaction Mockley Manor Version 1.10 Page 13 survey. It was also reported by one resident that she was happy not to join in with any activities and that care staff respected this. Mockley Manor Version 1.10 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 and 18 Procedures are in place to ensure that complaints are handled in a structured manner within clear timescales and an objective response is made. An updated vulnerable adults procedure is in place, however some staff have not had update training. This potentially leaves residents who use the service at risk. EVIDENCE: The care home has a detailed complaints procedure which is accessible to staff and residents. A number of service users and relatives advised they would go to either the registered manager, her deputy or the care manager if on the residential unit. The commission has received one complaint since the last inspection. This was from a staff member regarding staffing levels and was resolved using the home’s own complaints procedure. A procedure for responding to allegations of abuse is available with clear guidance for staff to follow. A review of staff training records indicated that not all staff have had an update in the protection of vulnerable adult training, this being a requirement from the last inspection. Mockley Manor Version 1.10 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) 19,20,23 and 26 Improvements in décor have been made in the older part of the building making the residents’ communal areas more homely. Residents are encouraged to bring in personal items for their rooms to make them feel more at home. All residents have access to all parts of the home and grounds including wheelchair users. The home is clean and hygienic in residents’ areas but potential risks to health were identified in the laundry and storage of clinical waste. EVIDENCE: Since the last inspection the home has continued with improvements to the home’s décor, particularly in the older part of the building. Evidence of new furnishings, carpets and decoration was noted. The entrance hall is being developed and following this the link corridor will be improved, the woodwork being chipped and thus not creating a particularly good first impression. It is envisaged developing the home to include eight more rooms, this commencing later in the year. As part of this project a further programme of Mockley Manor Version 1.10 Page 16 refurbishment is planned. The gardens are accessible and tidy with several relatives looking forward to sitting outside when the weather is a little warmer. The home has adequate bathrooms and washing facilities but some are not resident user-friendly, both in design and décor. The majority of the rooms were visited during the inspection. It was noted that many of the service users have made their rooms very homely and taken the opportunity to personalise rooms with items from home or their family. One resident reported that this made her feel more at home. Residents who have little personal possessions have fixtures and fitting allowing them to be comfortable in their bedrooms. In terms of infection control, systems are in place to manage dirty laundry and keep the home clean and tidy. Several residents commented on the cleanliness of the home and one stated that there were always cleaners on duty. One resident advised that her clothes were “beautifully ironed”. The following areas need attention • • The wall in the laundry where the washing machines are stored must be made good and be easily cleanable. The outside clinical waste bin must be secured and kept locked. Mockley Manor Version 1.10 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 The number and deployment of staff is sufficient to meet the care needs of the residents, both on the nursing and resident floor. EVIDENCE: Staffing has stabilised over the last six months with little or no agency staff being used. Staffing is divided between the residential and nursing floors with much increased levels of cooperation since the last inspection. Staff reported that they were happy with the current arrangement including the recent change of hours. Several residents were spoken with about staffing, both in groups and individually. The general view was that needs were met with comments made that staff were “always helpful and cheerful in their work, nothing too much trouble and very caring.” One visitor felt that staffing was satisfactory and the needs of his relative were well met. Alarm calls were answered promptly during the inspection. Mockley Manor Version 1.10 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 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) 33,35 and 36 Residents are involved in quality surveys and their opinions and views used to develop the running and direction of the care home. Procedures are in place to manage residents’ monies and valuables so their interests are safeguarded. Staff supervision is provided but is not consistent or structured and therefore gives no clear picture of development or training needs. EVIDENCE: The manager was registered by the Commission in February, having been in post since late 2004. This appointment has resulted in clear leadership and direction with staff responding to change. Residents, staff and some visitors made positive comments about the team, this supported by the yearly residents’ survey. The overall findings were that the home was well run. Further information that would be beneficial to the Mockley Manor Version 1.10 Page 19 service should be obtained from other professionals that work alongside the care team, i.e. doctors, dentists, district nurses. The accounts of two service users who have monies kept on their behalf by the registered manager were audited. Both were found to tally with the amount stated in the establishment’s ledger. The care home does not pool monies; all are kept in separate packets. All monies are checked in and out by two members of staff. Any money is kept securely locked away. The process of supervising care staff has begun but is still inconsistent and not in any regular pattern. To meet the standard all care staff must have formal supervision at least six times a year. This must include all aspects of practice, philosophy of care in the home and career development needs. A written record should be kept and signed by both the supervisor and the carer. Mockley Manor Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 3 x x 3 3 x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 2 x 3 2 x x Mockley Manor Version 1.10 Page 21 No 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 12 Regulation 16 Requirement A programme of activities must be developed and implemented that matches the service users social and recreational needs and interests. All staff must have training regarding the abuse policy. All clinical waste must be kept securely locked and safe from unauthorised removal. The laundry wall must be made impermeable and be readily cleanable. All care staff must receive supervision covering all aspects of practice, philosophy of care and career development needs. Timescale for action 30.06.05 2. 3. 4. 5. 18 26 26 36 13 13 13 18 30.06.05 1.5.05 30.06.05 30.06.05 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 8 Good Practice Recommendations A clear policy on how to manage tissue viabilty issues is made available for all staff to fiollow. Mockley Manor Version 1.10 Page 22 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mockley Manor Version 1.10 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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