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Inspection on 28/02/06 for Radcliffe Manor House Care Home

Also see our care home review for Radcliffe Manor House Care Home for more information

This inspection was carried out on 28th February 2006.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service users spoken with were very satisfied with the care they receive within the home. They also expressed satisfaction at the surroundings and the way the staff treat them. Visitors spoken with, including professional visitors, also expressed their positive views of the home, staff and care of service users. During the inspection the care staff were observed treating the service users and visitors with dignity and respect and the activities co-ordinator was working with 12 service users in the bingo session.

What has improved since the last inspection?

Care planning documentation has improved since the last inspection and these continue to be developed to improve them further. Security has been improved with the fitting of a door lock and external security lighting. The medication is now stored and administered from a lockable trolley, which is kept locked in the manager`s office. Staff files viewed showed evidence of Criminal Records Bureau checks, and two satisfactory references. They also showed evidence of staff supervision being undertaken and recorded regularly.

What the care home could do better:

The staff files viewed showed evidence of training undertaken. However, no evidence of Protection of Vulnerable Adults training was seen. To maintain the standards of care being provided the Manager and Deputy should undertake the Nottinghamshire Protection of Vulnerable Adults abuse training and organise training for the care staff to become familiar with this. The care planning documentation has improved and shows actions required to meet service user`s needs, but further development is required to include the risk assessments and actions to address the risks.

CARE HOMES FOR OLDER PEOPLE Radcliffe Manor House Care Home 52 Main Road Radcliffe On Trent Nottingham NG12 2AA Lead Inspector Lee West Unannounced Inspection 28th February 2006 10:30 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 Radcliffe Manor House Care Home DS0000008736.V279681.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. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Radcliffe Manor House Care Home Address 52 Main Road Radcliffe On Trent Nottingham NG12 2AA 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) 0115 911 0138 The Trustees of Radcliffe Manor House Mrs Valerie Dixon Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th November 2005 Brief Description of the Service: Radcliffe Manor House Care Home, a voluntary organisation and registered charity is owned by the Trustees of Radcliffe Manor House. This charming care home is located in the village, on the main road, a short walk to the village centre shops, library, health care services, places of worship and other amenities. The building is a converted and extended manor house, providing personal care and accommodation for older people. All bedrooms are single, five having ensuite facilities. There is a passenger lift to the first floor, also a stair lift to aid access to the first floor in the annexe area. The extensive gardens are well maintained, with snowdrops blooming, well laid out flowerbeds and accessible by all service users. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, the second of the year, commenced at 10.30am. The Deputy Manager, Jackie Keir, assisted. The method used was case tracked where service users were spoken with about their experiences and expectations of living at the home, analysis of the records and talking with members of staff to ensure that those living at the home have their needs met and their health and welfare maintained appropriately. Visitors and visiting professionals were also spoken with during the inspection. The activities organiser was busy within the lounge area with the majority of the service users taking part in the bingo organised. In the smaller lounge area others were reading newspapers, which had been delivered, and talking with visitors and other service users. The décor and furnishings enhance the homely atmosphere within the home and individual rooms are as the service users want them, with their personal possessions. Food is wholesome and service users recommend the food as “second to none” All areas of the home are clean and fresh smelling. During this inspection the gardens, which are well maintained, had snowdrops blossoming around the areas, with evidence of daffodils beginning to shoot. The service users expressed how much they enjoyed the gardens, especially when the weather is sunny. What the service does well: The service users spoken with were very satisfied with the care they receive within the home. They also expressed satisfaction at the surroundings and the way the staff treat them. Visitors spoken with, including professional visitors, also expressed their positive views of the home, staff and care of service users. During the inspection the care staff were observed treating the service users and visitors with dignity and respect and the activities co-ordinator was working with 12 service users in the bingo session. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Radcliffe Manor House Care Home DS0000008736.V279681.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 Radcliffe Manor House Care Home DS0000008736.V279681.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): 1,3,4, New service users have the information necessary to make a choice and their needs assessed before admission. EVIDENCE: The service user files viewed had admission assessments recorded from which the care plan is developed. Service users spoken with confirmed that they had information they needed to make a choice. Relatives were also involved in the pre-admission process and given useful information. Radcliffe Manor House Care Home DS0000008736.V279681.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): 7,8,9,10,11 Care plans set out the service user’s care needs. The medication is now securely kept in a locked trolley. Service users are treated with respect and wishes upon death are recorded and respected. EVIDENCE: On admission a full assessment is carried out by the home, copies were viewed in the service user’s files and service users also confirmed that they had been asked about their needs. The plans identify actions to meet needs, but more improvement is required to help identify and action risk assessments carried out during the assessment process. The medication within the home is now kept in a locked trolley, in the Manager’s office, and wheeled to the required areas of the home. The medicines are all kept appropriately, neatly labelled and in date. The Medicines Administration Records are properly completed and this was observed during the inspection when the medication was given out during the lunchtime meal. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 10 Service users spoken with all said that they felt the staff treat them very well, they are very kind and “knock when I’m in my room.” “They always come when I need them.” Visitors spoken with during the inspection also said that they are treated with respect by the staff and “always offered a drink when I arrive.” Service users spoken with also said that the staff do meet their needs and that they would feel confident in speaking to Jackie (the deputy matron) if they had any worries about their care. Service user’s wishes upon death are identified within the files. Testimonials from relatives were seen during the inspection which showed that the home and staff do respect these significant wishes. Radcliffe Manor House Care Home DS0000008736.V279681.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 Activities are provided regularly for all service users to access and visitors are welcomed. The service users exercise control over their lives and the diet is appealing and balanced, served in pleasant dining area. EVIDENCE: All the service users spoken with expressed their satisfaction with the activities organised within the home. The organiser takes into consideration their individual interests and needs. Maintaining contact with the families is actively encouraged and visitors spoken with during the inspection said they are always made welcome and offered drinks. The staff, they commented, always treat them and their relatives with respect. The inspector witnessed staff encouraging service users to exercise choice and maintain control over their lives, during the inspection and the rapport between staff and service users was seen to be a positive one. Meals, the service users said, are an important part of the day and “I look forward to my meals” “they are excellent and if I don’t like something it will be changed,” are comments made by service users. The meals served today were presented in the pleasantly set out dining room, the food looked appetising and the portions were “big enough for me” and “if a want more I can ask”. The home has a new cook since the last inspection and the menu for Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 12 the day looked well balanced and service users spoken with all said they enjoyed the food provided. Radcliffe Manor House Care Home DS0000008736.V279681.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 Complaints are taken seriously. The staff are competent in their roles and are aware of protection from abuse but training in area is required. EVIDENCE: Service users, staff and visitors, including professional visitors, are aware of the complaints processes and all confirmed that they would firstly discuss any issues with The Manager, or Deputy and that they would be listened to and any problems dealt with. Staff spoken with were all aware of their responsibilities in respect of the Protection of Vulnerable Adults from abuse, but, there is no evidence, in any staff files viewed, of training. The Manager and Deputy have not attended training in the Nottinghamshire Protection of Vulnerable Adults Procedures, although the handbook for the procedures was seen during the inspection. The standards within the home would be enhanced by the staff being trained and updated in this area. Radcliffe Manor House Care Home DS0000008736.V279681.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): 19,20,21,22,23,24,25,26 The home has a homely atmosphere, is clean, pleasant and hygienic. All the areas are safe and well maintained, with sufficient toilet and washing facilities. The gardens are well set. The service users’ rooms are comfortable with personal possessions and suit their needs. EVIDENCE: The home is well maintained, not only inside, but in the gardens too, with spring snowdrops and daffodils beginning to bloom. The home has a pleasant, homely atmosphere, well decorated, clean and hygienic the service users spoken with said they are satisfied with their own rooms and have their personal possessions around them. The rooms seen during the inspection were warm, clean and personalised. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 15 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 staff numbers and mix on duty are appropriate to meet the service users’ needs. Staff are recruited according to the appropriate policies and staff training was evidenced. EVIDENCE: The number of staff on duty during the inspection were observed to be appropriate for the needs of the service users and the rota evidenced the shift patterns to maintain the appropriate numbers. The staff files viewed evidenced the home’s protection of service users by following the policies and procedures set down. The files each contained the appropriate Criminal Records Bureau checks and two satisfactory references, together with the other required documentation. Staff records also showed the training certificates achieved by members of staff and the home work with other agencies to achieve these. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 16 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): 31,36, The home is managed by Valerie Dixon with deputy Jackie Keir. Staff supervision is taking place regularly and all appropriate safety records are maintained. EVIDENCE: The manager and deputy, supported by the Board of Trustees, run Radcliffe Manor in the best interest of its service users. Regulation 37 notifications and Regulation 26 inspection reports received by the commission are informative and prompt. The board is also responsive to previous requirements set. Service users confirmed that they “feel safe here”. Regular staff supervision is recorded in the staff files, with input from both carer and supervisor, which also identifies areas for professional development. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 17 Required health and safety records are maintained in order and those viewed were up to date. The home provides an atmosphere where service users say they “feel of value” and also hold regular “residents meetings” to monitor standards of care. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 18 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 3 X 3 3 X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 X x Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 19 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 OP7 Regulation 15(1) Requirement Timescale for action 30/04/06 2 OP18 13(6) Ensure the service user’s plan sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met The registered person shall make 30/04/06 arrangements, by training staff, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. 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 OP18 Good Practice Recommendations The Registered Manager and Deputy Manager to attend the Nottinghamshire Protection of Vulnerable Adults training and arrange for care staff to receive training in the Protection of Vulnerable Adults. Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Radcliffe Manor House Care Home DS0000008736.V279681.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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