This inspection was carried out on 16th September 2009.
CQC has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC 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.
Random inspection report
Care homes for older people
Name: Address: Reuben Manor 654 Yarm Road Eaglescliffe Stockton on Tees TS16 0DP new service which has yet to be given a quality rating The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jacqueline Herring Date: 1 6 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Reuben Manor 654 Yarm Road Eaglescliffe Stockton on Tees TS16 0DP Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Julie Peyton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Silk Healthcare care home 83 Number of places (if applicable): Under 65 Over 65 0 30 0 dementia old age, not falling within any other category sensory impairment Conditions of registration: 58 0 0 The maximum number of service users who may be accommodated is 83 The registered person may provide the following category of care service only: Care home with nursing- Code N. To service users of the following gender: Either whose primary care needs on admission are within the following categories: Old age not falling within any other category : Code OP 83. Dementia Code DE 83 Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Reuben Manor is a purpose built; three storey 83 bedded care home providing both nursing and personal care. The home has seperate units, called suites for the four different categories of care. All bedrooms are single rooms. There is a good amount of communal space on all three of the floors as well as very pleasant gardens. The home is situated at Eaglescliffe, in close proximitiy to public transport and other public amenities. Care Homes for Older People Page 3 of 10 What we found:
A visit was carried out ahead of the Key Inspection as a result of a number of concerns being received by both CQC and Stockton Borough Council contracting unit. These concerns were in relation to insufficient staff on duty as such peoples need potentially were not being met, insufficient equipment to manage infection control, there there are not enough activities for some people and also some concern about the organisation and management of the home. None of the concerns raised were upheld. Choice of Home Care records for people living at Reuben Manor were looked at. They contained a copy of the pre admission assessment that had been conducted by the home manager. There was a good level of information contained within the assessments. There was discussion about the number of people admitted since the home opened and the process and plan of admission. It was agreed that details of this would be forwarded to CQC, however at the time of writing this report, this information had not been received. Health and Personal Care Care records of four people living at the home were looked at. The care files contained a comprehensive format for assessment and risk assessment documentation. There was some discussion with the management consultant and provider about the need to be mindful of individual specific needs, as the assessments were primarily of a tick box or numerical nature and there may be occasions when more specific information is needed. A range of care plans had been developed which were individual. The monthly evaluations are well written and contain value based information about the individual person. The daily statement of care also contained a good level of detail and were informative. In one of the files looked at the assessment contained information that this person was at risk of choking, however there was no risk assessment or care plan. It was agreed that this would be looked at immediately to ensure that appropriate strategies were in place to ensure safety and wellbeing. There was also information about GP and district nurse involvement contained within the care records. The records looked at indicated the peoples needs were being met. People spoken to felt that they were being well cared for. Visitors also were very positive about the care and services provided at Reuben Manor. Daily Life and Social Activity There is a full time activities co-ordinator employed at Reuben Manor. A copy of the activity schedule was made available and there was also discussion with the activities coCare Homes for Older People Page 4 of 10 ordinator who was enthusiastic about their job role. The care records contained a social and lifestyle assessment, which tended to be tick box and could benefit from additional details. The consultant and provider agreed that this would be beneficial. There was also a record made for all of the activities people have been involved in. A group of people who live at the home were spoken to about activities and they believed there was good opportunities for social events as well as crafts and other activities. Observations made during the inspection identified that there was a range of activity equipment in place in all of the suites. Following the inspection, on the same day a concern was raised by a relative about a new policy that had been introduced, which restricted visiting at all mealtimes. Further information has been requested regarding the introduction of protected mealtimes. Environment Reuben Manor is a new purpose built care home. It is decorated and furnished to a high standard and there is a good amount of communal space for people. Concerns had been raised that there was insufficient equipment to manage cross infection and that there were also insufficient housekeeping staff. Discussion took place with the head housekeeper, who confirmed that there was sufficient housekeeping equipment and sufficient housekeeping staff. They described the different coloured mops for the different areas in the home. A cleaning trolley was observed and there was a good range of products available. Gloves and aprons were observed in areas throughout the building and staff spoken to said that these were always in plentiful supply. Staffing Concern had been raised that there was insufficient staff on duty to meet peoples needs. The duty rota was looked at and it was somewhat difficult to determine staff on duty. The management consultant said that the rota in use was the initial rota and that there was now the need to move on to the other rotas, that had been developed. It was agreed that the new rota separately detailing all of the suites should be introduced. People living at Reuben Manor said, There are sufficient staff to support you. Staff said that they generally believed there was sufficient staff on duty. One person said that it needed to monitored as they were admitting new people all of the time. Another person said that the staffing levels within the EMI nursing unit was being looked at and that they could do with some extra staff. From observations that took place, records looked at and discussion that took place with people living at the home, relatives and staff, it was confirmed that there were currently sufficient staff available to meet the needs of the people living at Reuben Manor. The structure of the home was discussed and currently there is a manager who is registered with CQC. A deputy manager has recently been appointed, who is in the process of developing their knowledge. It was however agreed that additional senior staff were needed within the structure, however recruitment is already underway. Care Homes for Older People Page 5 of 10 There was also discussion about the skill mix in relation to the qualified nurses as there are occasions when there is no RMN on duty or during night duty there is only one qualified nurse, either an RMN or an RGN. There is the need to ensure that the qualified nurses have the required experience, knowledge and skill to meet the needs of the people living on both the general nursing suite and the emi nursing suite and evidence of this needs to be available within their recruitment and training records. Management and Administration Concern had been raised that Reuben Manor was not as organised or well run as it should be but no specific details were given. From this visit, it was shown that there is a good management structure in place. As well as there being a registered manager who now has a deputy, the provider is also always available within the home. Staff spoken to said that there was a lot of support from management. One staff member said, Management are really there for the staff, I feel listened to. Another member of staff said, We are just finding our feet, but the home is well organised and well run. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2.
Care Homes for Older People Page 6 of 10 Care Homes for Older People Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 27 The duty rota should to be updated and the skill mix of staff needs to remain under review to ensure that there is an appropriate amount of skill mix to meet the needs of people living at the home. The qualified nurses should have the experience, skill and qualifications to meet the needs of people living on both the general nursing and EMI nursing suites and evidence of this should be contained within their staff files. 2 27 Care Homes for Older People Page 9 of 10 Reader Information
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