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Inspection on 23/02/09 for Ringway Mews Nursing Home

Also see our care home review for Ringway Mews Nursing Home for more information

This inspection was carried out on 23rd February 2009.

CSCI found this care home to be providing an Good service.

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

Medication is well managed. Care plans are detailed and easy to read. Complaints received by the home are dealt with appropriately. Toilets on Shakleton unit had large pictorial signs on doors. This makes it easier for residents to identify where toilets are located.

What has improved since the last inspection?

A new manager has been appointed. The requirements made at the last inspection regarding medication had been addressed. CSCI have not received any complaints about this home since tha last inspection.

What the care home could do better:

Carpets on Halifax unit were in need of deep cleaning or replacing. The pictorial notices identifying toilets could be used throughout the home.

CARE HOMES FOR OLDER PEOPLE Ringway Mews Nursing Home Stancliffe Road Sharston, Wythenshawe Manchester M22 4RY Lead Inspector Sue Jennings Unannounced Inspection 23rd February 2009 12:34 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 Ringway Mews Nursing Home DS0000021656.V374134.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. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ringway Mews Nursing Home Address Stancliffe Road Sharston, Wythenshawe Manchester M22 4RY 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) 0161 491 4887 0161 428 6991 www.bupa.com BUPA Care Homes (CFHCare) Ltd Manager post vacant Care Home 150 Category(ies) of Dementia (150), Old age, not falling within any registration, with number other category (150) of places Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home with nursing - Code N to service user of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 150 Date of last inspection 16th April 2008 Brief Description of the Service: Ringway Mews is a care home providing nursing care and accommodation for a maximum of 150 older people. Within this maximum number, accommodation is provided for 30 older people with dementia type illnesses. However, one of the houses that provided nursing care was currently closed. The home is owned by BUPA Care Homes. The home is situated in the residential area of Wythenshawe, which is to the South of the City of Manchester. There is easy access to the Manchester ring road motorway system as well as easy access to public transport systems, which are within walking distance of the home. There is ample parking within the grounds of the home. Wythenshawe Civic centre is easily reached by car and there are local shops, which are within walking distance of the home. The home is purpose-built and consists of 5 separate single storey houses. Each house provides accommodation for 30 residents and stands within its own garden area. The administration area, laundry, hairdressers, and central kitchen are housed in a central building that is accessible by a covered walkway. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 5 The charges for fees range from £397-88 to £651-51 per week. There are additional charges for magazines, papers, hairdressing and Chiropody. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by us (the Commission for Social Care Inspection) in relation to this home prior to the site visit. We also looked at other information we had about the home. Before the visit the home manager was asked to complete an Annual Quality Assurance Assessment (AQAA) to provide up to date information. We sent our questionnaires out to people who live in the home, their families and staff in order to find out their views. The visit was carried out by two inspectors and was unannounced and took place over the course of 7 hours on Monday 23rd February 2009. During the course of the site visit we spent time talking to residents, the manager, visitors the administrator and 4 members of staff to find out their views of the home. Time was spent examining maintenance records and the residents and staff files. A tour of the building was also carried out. There was evidence to show that the unit managers and staff continued to work hard to develop and improve the service. Health and Safety checks take place to make sure people are kept safe and good records are kept of these. What the service does well: What has improved since the last inspection? Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 7 A new manager has been appointed. The requirements made at the last inspection regarding medication had been addressed. CSCI have not received any complaints about this home since tha 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. The summary of this inspection report can be made available in other formats on request. Ringway Mews Nursing Home DS0000021656.V374134.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 Ringway Mews Nursing Home DS0000021656.V374134.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed information about the home is made available in various formats and people’s needs were assessed before they move in to make sure they can be met. EVIDENCE: There was an information pack provided to prospective residents that gave enough information for people to make an informed decision about moving in. The information was available in large print and would be translated into other languages if the need arose. The manager or unit manager visited the person in his or her own home or in hospital to carry out a pre-admission assessment. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 10 Where possible a care manager’s assessment was obtained. A care plan was written using the information gathered during these assessments. There was evidence that care plans were written using a person-centred approach. A sample of assessments of four people were examined and found to contain some good information. Residents spoken to said that they were given an opportunity to visit the home before making a decision to move in. There are thirty intermediate care beds located in Wellington House. This service is offered to people who no longer require hospital care but who need additional rehabilitation. Hospital staff support the staff at the home and residents are under the care of a hospital consultant. Ringway Mews Nursing Home DS0000021656.V374134.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were person-centred and addressed people’s health, personal and social care needs. EVIDENCE: We looked at four people’s care plans and found they gave enough information about how their needs were to be met. We saw that care plans were being reviewed regularly. Risk assessments around areas such as falls, pressure areas and nutrition had been carried out. Care plans included a tick box section that asked if a Mental Capacity Assessment had been carried out. We saw on some care plans that this Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 12 assessment was not required. We did not see any evidence in the care plans to show how they had arrived at this decision. It was recommended that a care plan be written to describe the process used to arrive at their decision and who was involved in making the decision. All residents were registered with a local GP and where possible residents had retained their own GP. Records of visits from other healthcare professionals were held in each resident’s file. Medication was well managed, stored correctly and records were maintained to a good standard. Staff had received training in the administration of medication this reduced the risk of medication errors. Medication stock was adequate and a record was being made of all medication received in to the home and disposed of. Residents are encouraged to maintain contact with family, so that they continue to be part of family life. We spoke to a visitor who told us “my sister’s husband had come along to see the home before she moved here” and “we are happy with the home, the staff are helpful they work hard”. Ringway Mews Nursing Home DS0000021656.V374134.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a range of activities and a choice of home cooked meals. EVIDENCE: We saw staff welcoming visitors into the home. There was an open visiting policy and residents were able to see visitors in one of the lounges or in the privacy of their own rooms if preferred. We saw one member of staff sat in a resident’s bedroom styling her hair. Other residents were seen resting in their rooms after lunch. The menus were displayed in the dining room so that residents knew what the meal choices were for the day. One resident told us “I have just had my dinner, it was very lovely”. Menus could be improved and presented in userfriendly formats such as pictures or large print. Large whiteboards could also be used to present information and any changes. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 14 A visitor told us “we are able to come and visit at any time they don’t mind”. We saw there were a number of different in-house recreational activities on offer. An activities programme was in place that included details of activities and visiting entertainers planned for the year. We visited Halifax and Shackleton units. We saw several residents on Shackleton unit making decorations with the activity organiser for the St Patrick’s day party. Residents told us they enjoyed the painting sessions. One resident likes to embroider and the activity organiser had brought in a tapestry for them to sew. We did not see any activities taking place on Halifax unit. The manager of this unit told us that activities usually took place in the afternoons. A specific room for hairdressing was provided and this gave the impression of being in a hairdressing salon. This was a well used facility and residents were able to sit and chat whilst having their hair cut and set. Ministers from local churches visited the home on a regular basis. They told us that arrangements would be made to support residents from other religious backgrounds as and when required. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 15 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaint’s procedure is clear and accessible. People who use the service and their representatives’ feel listened to and taken seriously. EVIDENCE: There are suitable procedures in place for dealing with complaints. The complaints policy and procedure is part of the guide for the people living there. We saw that there had been 5 complaints logged at the home since the last inspection. We saw that complaints were dealt with in line with the home’s complaint policy. There are internal policies and procedures for the Protection of Vulnerable Adults (POVA) and a copy of the local procedures was also seen to be available. There have been no recent allegations of abuse. We spoke to staff that told us that they have received training that teaches them how to recognise and report abuse. One told us “I would report to the manager or a senior member of staff”. Another said “I would make sure the resident was OK then tell the manager”. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 16 Ringway Mews Nursing Home DS0000021656.V374134.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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a well-maintained and comfortable environment. Improvements are needed to the cleaning of some areas to provide an odour free and pleasant environment for people. EVIDENCE: We visited two units, Halifax and Shakleton both providing dementia care. The communal areas generally provide a comfortable and well-maintained living environment for residents. Bedrooms are individualised to resident’s preferences. Residents are able to bring personal items, including furniture, with them on admission and are able to have a private telephone line should they wish. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 18 On entry to Halifax unit we noticed a strong and unpleasant smell. This did not provide a pleasant living environment for residents. We spoke to visitors to the unit who told us ““the only thing is the awful smell it is really strong”. The carpets on this unit must be deep cleaned and if this does not eliminate the smell carpets must be replaced. We visited Shackleton unit and saw that pictorial signs were used to identify toilets. This means that residents could easily identify where toilets were located. Ringway Mews Nursing Home DS0000021656.V374134.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff was sufficient to meet the needs of the residents and staff have access to a wide range of training. EVIDENCE: Feedback about the way the staff carried out their duties was generally positive. Comments included “very good”, “the staff are very good”. We spoke to several care staff. They told us that they had access to a range of training. A training plan was seen that showed training in manual handling, medication, fire safety, first aid, and Protection of Vulnerable Adults had been provided. The manager reported that staff supervision was provided and that all staff had an induction period. Training needs were identified during supervision and the home provided ongoing refresher training. Staff have the opportunity to complete the NVQ in care and currently more than half the care staff hold the NVQ2 in care. There was evidence on staff files to show that staff were given a copy of their job description detailing their roles and responsibilities. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 20 We saw the recruitment files of the newest members of staff. These were well organised and easy to read. We saw that each member of staff had completed an application form. We saw that although a POVA 1st check had been requested there was no evidence that these checks had been completed or the results received by the acting manager. The new manager told us that the staff without POVA 1st checks would be taken off duty until the appropriate safety checks have been carried out. This was done immediately. It was recommended that in order to fully safeguard residents, there should be a system in place to make sure POVA 1st checks are returned before staff start work at the home. We saw that one completed application had a different address from the one provided as proof of address/identity. There was no evidence on file to show that this had been identified or discussed with the person. Where people live part time in two addresses both must be included in the CRB disclosure request. Two references were held on staff files but they were not always taken from the last employer. For example where one person had previously worked in a care home, references had not been requested. Another person had given a work history but had not listed their previous employers as referees. Where people do not give previous employers as referees applicants should be asked to explain the reason why and a record of the answers held on file. Ringway Mews Nursing Home DS0000021656.V374134.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems in place to safeguard and protect residents’ financial interests but the management of staff recruitment could be more robust. EVIDENCE: A new manager had started work on the day of the site visit and was having an induction. The new manager has previous experience in managing a care home. Because the home has not had a registered manager for 12 months the organisation must make application to register a manager as soon as possible. The acting manager told us that staff files had been audited recently. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 22 There is a clear and transparent system for managing and recording the personal finances of residents. The system in place is that, the resident, their family/representative or the relevant local authority is responsible for their personal finances. All transactions and documentation were regularly audited by the administrator, the manager and through the main organisation (BUPA). Health and Safety checks take place to make sure people are kept safe and good records are kept of these. Regular audits are carried to monitor the performance of the home in areas such as accident reports, staff training and Health and Safety. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 23 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 3 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 3 X X X X x X 2 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 3 X 3 3 X 3 Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP26 Regulation 13 Requirement The carpets on Halifax unit must be deep cleaned and if this does not eliminate the smell carpets must be replaced. The provider must make application to register a manager with CSCI as soon as possible. Timescale for action 23/03/09 2. OP31 19 23/04/09 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. 2 Refer to Standard OP19 OP29 Good Practice Recommendations It is recommended that the pictorial signs be used on all units where residents have difficulty identifying toilets and bathrooms. It is recommended that where people do not give previous employers as referees applicants should be asked to explain the reason why and a record of the answers held on file. Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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. Extracts may not be used or reproduced without the express permission of CSCI Ringway Mews Nursing Home DS0000021656.V374134.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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