Inspection on 23/01/06 for The Conifers

This inspection was carried out on 23rd January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Conifers 30/03/10

The Conifers 11/02/09

The Conifers 26/10/06

The Conifers 19/07/05

The Conifers 21/03/05

The Conifers 05/04/04

The Conifers 09/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Conifers 253-255 Seymour Grove Old Trafford Manchester M16 0DS Lead Inspector Michelle Moss Unannounced Inspection 23rd January 2006 16:45 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 The Conifers DS0000005605.V275544.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. The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Conifers Address 253-255 Seymour Grove Old Trafford Manchester M16 0DS 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 881 9380 0161 881 9380 Mrs Santosh Trehan Mrs Santosh Trehan Care Home 12 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (8) of places The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. All service users fall within the category of old age and may additionally have a physical disability. A variation has been granted in respect of four named older service users who require care by reason of dementia. The home provides day care for up to three service users in a specially designated area of the home. 19th July 2005 Date of last inspection Brief Description of the Service: The Conifers provides residential accommodation with personal care for up to twelve service users within the category of old age (OP) and who may have a physical disability (PD) and four with dementia. The Conifers also provides additional day care for up to three (3) service users. On the day of the inspection there were eleven service users living at the home. The home is owned and managed by Dr & Mrs Trehan and is located in an established residential area of Old Trafford close to the village of Chorlton, close to shops, bus and train routes and other amenities. The home is a two storey Victorian property set in its own grounds and consists of 10 bedrooms (eight single and two double), one dining room and two lounges. Stair lifts are installed on both sets of stairs. The home has gardens to front and rear of the property, which are well maintained. Parking is available to the rear of the premises. The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two weekdays in January. The total inspection lasted approximately 2.5 hours. Several residents were met and one member of staff was spoken with about practices of care within the home. In addition, a selection of care plans, medication charts and health and safety records were examined. The term of address preferred by the users of the service was confirmed as “residents”. It was felt that this best reflected the function and purpose of the service. The inspection only looked at a limited number of standards, so this report should be read together with the earlier report to get a full picture of how the home is meeting the needs of the residents living there. What the service does well: What has improved since the last inspection? The monthly reviews of the care plan had improved, demonstrating good information on changes in health and social care needs. The fire safety in the home had been improved. The term “nursing” had been removed from records so as not to mislead the readers of the documents. The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 6 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 Conifers DS0000005605.V275544.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 The Conifers DS0000005605.V275544.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): NA EVIDENCE: This section of standards were not assessed during this visit. The Conifers DS0000005605.V275544.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 and 10 The residents’ care and health needs were well documented by the home. This included having a well-managed recording system in place for the care of medicines and health conditions affecting the residents. However, this good practice was slightly weakened by failures in staff signing out medication on the medication charts and some terms used in reports about the care of residents. EVIDENCE: A sample of residents’ care plans were examined. Each contained a profile of the resident, their health needs and details about their cultural and religious needs. Where required, additional monitoring sheets were maintained. For example, weight charts, of which all were found to be well maintained. In September 2005 the home had introduced a new monthly care plan review sheet. This document was examined in detail. The plan covered all essential headings linking back to the initial assessment of needs. It demonstrated where changes in health had occurred, including changes in dexterity, mobility and dietary intake to name just a few. On auditing the review sheet, evidence The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 10 could be found that each month since the care plans reviews were introduced, an updated record had been made. This included a history of the residents’ care needs, what had changed and the new steps introduced to address any concerns. At a previous inspection concerns were raised over some of the terms being used in the daily care plans to describe events in the life of a resident. On following up the requirement, a further review of the reports was made. It was noted that overall the recording made by staff was detailed and respectful of the resident. However, one entry made on the 22/01/06 made comments similar to those previously raised in the home’s last inspection. The terms included “very lazy”. After reading and seeking clarification from a staff member, it was established that the reference related to the resident’s wish not to get up in the morning. This use of language was discussed with the senior carer on duty and the need for all records to be written in a manner that preserved the resident’s dignity and demonstrated respect was stressed. A further requirement was made for staff to be instructed on the use of language. However, on a positive note the term ‘nursing’ had been removed from documentation relating to the home. A review of the medication records was completed. Overall a good audit trail could be seen. However, on 19th and 20th January 2006, 4 different medication sheets of different residents were found to have missing signatures for the medication that was to be administered at 20:00. The senior carer on duty was informed about the errors. It was noted that the home was obtaining a second label and adding it to the medication chart, when short courses were prescribed during a month. In line with current guidance, the home was advised to stop using labels on the charts and instead add the details by writing them directly on the chart. To ensure the accuracy of the information, two staff members should check the information against the instructions given by the GP. The Conifers DS0000005605.V275544.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): 12,14 and 15 Residents were encouraged to exercise choice and control over their lives including their cultural, religious and recreational interests and needs. EVIDENCE: From talking with a group of residents during their evening meal, a range of examples about how they exercised choice and took control over their lives was provided. This included getting up and going to bed when they wanted, where they had their meals and their choice on how to spend their time during the day. Religious and recreational interests were noted to be decided by the residents. One lady resident spoke about her enjoyment at having her hair done on a regular basis. Other residents spoke about enjoying activities over the Christmas season and their love of watching the television, including many of the ‘soaps’. The evening meal was served during the inspection. This was seen to be varied to reflect the different residents’ likes. In the majority of cases residents were seen to finish the whole meal. Residents were served drinks with their meals, with further drinks offered at the end. The mealtime was The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 12 found to be very relaxed with a pleasant atmosphere and the interaction between the residents and staff was observed to be positive and respectful. The Conifers DS0000005605.V275544.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 and 18 The complaints process in the home meant that residents felt able to raise concerns. The residents’ rights were further safeguarded by the home’s vulnerable adult protection procedures. EVIDENCE: From talking with a group of residents, it was noted that they felt able to raise comments to staff and receive a respectful response. The residents were clearly able to voice their opinions about matters to do with the home, including likes and dislikes about the evening meal. The home had an established adult protection procedure in place. The Conifers DS0000005605.V275544.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 and 26 Overall, the environment was of a good standard. However, there were some safety issues that required addressing to ensure that the residents’ welfare was not compromised. EVIDENCE: The dining and lounge areas were seen and both were found to be clean. On following up some previous requirements, it was noted that a couple were still outstanding. The first related to the window panels in rooms 6 and 7, which required replacing and a safety glass assessment being carried out. Where necessary, safety film should be applied or the glass replaced to meet safety standards. The second unmet requirement concerned having a lock fitted to a bedroom and bathroom. Further clarification on the type of locks was given. This extended to installing locks that could be overridden in emergencies. The work to address these weaknesses was being arranged at the time of the inspection. The Conifers DS0000005605.V275544.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, 29 and 30 The residents’ welfare and safety was promoted by the home’s recruitment procedure and staff training. EVIDENCE: The staff file of a newly appointed member of staff was examined. This included all the required information set under the National Minimum Standards and the Regulations for Older People (2001). The senior staff member on duty had just completed her NVQ level 3 Award. A number of essential units about the welfare of the elderly had been completed. The staff member was found to be well conversant with good practices of care of the elderly and demonstrated good links with theory. The Conifers DS0000005605.V275544.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): 33,35 and 38 The management and administration procedures were effective in maintaining the best interests of residents and promoting their welfare. EVIDENCE: The senior member of staff on duty was found to be well conversant with the management systems that operated within the home. The records maintained about the welfare of residents were formatted in a manner, which demonstrated that the home operated in the best interests of residents. This view was further supported on talking with residents. The home did not take responsibility for residents’ finances. The fire records were examined and were found to be maintained regularly. A previous problem with fire doors not closing correctly had been addressed by the home’s maintenance. The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 17 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 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 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 18 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. Standard OP7 Regulation 17 Requirement The manager is required to monitor the content of all care plans. This includes staff receiving instructions on the use of language in writing daily reports about the welfare of the residents. Staff must ensure that all administered medication is correctly signed out on the medication chart. The window panels in rooms 6 and 7 must be replaced and assessments must be carried out to ensure that window panels comply with glass safety. (Not met within previous timescale 21/10/05) A privacy lock must be provided on bedroom 2 and the bathroom lock must be repaired to ensure privacy for residents. (Not met within previous timescale 21/10/05) Timescale for action 31/03/06 2. OP9 13 28/02/06 3. OP19 23 30/04/06 4. OP19 23 30/04/06 The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Conifers DS0000005605.V275544.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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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