Inspection on 09/08/06 for The Manor

This inspection was carried out on 9th August 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Manor 05/12/05

The Manor 28/06/05

The Manor 15/12/04

The Manor 05/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Manor 75 Manor Road Selsey Chichester West Sussex PO20 0SF Lead Inspector Mrs A Taggart Key Unannounced Inspection 9th August 2006 09:00 The Manor DS0000014783.V303602.R01.S.doc Version 5.2 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 Manor DS0000014783.V303602.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 Adults 18-65. 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 Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Manor Address 75 Manor Road Selsey Chichester West Sussex PO20 0SF 01243 602828 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) Mrs Marcia Ann Manning-Smith Mr Matthew Manning-Smith Care Home 21 Category(ies) of Learning disability (21), Learning disability over registration, with number 65 years of age (21) of places The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to 21 male and/or female service users in the category Learning Disability over 65 years may be admitted/ accommodated. Up to 21 male and/or female services users in the category Learning Disability aged from 50 years may be admitted/ accommodated. A total of 21 services users may be accommodated. Date of last inspection 5th December 2005 Brief Description of the Service: The Manor is a care home providing personal care and accommodation for twenty-one older people (over 65 years) who have learning disabilities. The home is located in a quiet residential area a short distance from the centre of Selsey village where shops and other facilities are available. Service user accommodation consists of thirteen single and four double rooms. An activities centre is situated in the grounds of the home and residents access this facility on a daily basis. The activities facility is separately staffed. Mrs. M. Manning Smith owns the home. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced visit was carried out at 9.15am and lasted for 5 hours, which covered both the early and late staff working shifts. A tour of the home was undertaken during which all communal areas and private rooms were seen and the inspector saw lunch, which is the main meal of the day, being cooked and served. The inspector spent time both in the house and in the day care facility observing staff work practice and spent time talking to service users about their experiences in the home. Time was also spent talking to the staff team about their roles and responsibilities. Five care plans were tracked with any issues arising being discussed with the deputy manager or staff team, the staff files for four new staff members were seen along with a selection of training files. Records for the running of the business were seen, which included accident and incident forms, complaints, health and safety recording, medication and maintenance records and all were in good order. Prior to the visit the registered manager Mr. Manning-Smith had completed a pre-inspection questionnaire and comment cards were received from families and health professionals involved with the home. The inspector when completing the planning for the visit used the information contained in these documents and comments are included in the report. The registered manager was on holiday at the time of the visit and the deputy manager Ms. Skinner assisted with information and was given feedback. Mrs. Taggart would like to thank everyone who helped during the visit. What the service does well: The home offers a friendly, homely and comfortable environment for the people who live there and there are opportunities for access to the local community and day care facilities. Medication is well managed and residents have access to good healthcare support. The people living in the home say that the staff team are kind and caring and that they are happy with the care provided. There is a variety of fresh, home cooked meals available and special diets are catered for. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 6 Residents, families and healthcare professionals speak very highly of the commitment and skills of the manager and staff team and staff are well trained and supervised. 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. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 and 5 Quality in this outcome is Good This judgement has been made using available evidence including a visit to the service. Prospective residents and their families can be confident that current information regarding the home will be made available, their needs will be assessed and visits to the home encouraged. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed and updated to reflect the environmental changes in the home. The documents can be supplied in an accessible format using words and symbols and the admission procedure encourages visits to the home There have been no new residents admitted since the last visit. At that time pre-admission assessments and contracts were seen to be in place. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 8 9 10 Quality in this outcome is Good. This judgement has been made using available evidence including a visit to the service. Care plans detail the personal and emotional needs of each person and the staff team offer choice regarding personal care issues. EVIDENCE: There is a plan of care in place for each person living in the home and information is updated on a daily basis and reviewed monthly. A new format in use, which includes assessments of need, risk assessments, daily living plans and personal routines. The plans are very comprehensive but would benefit from being put into a more “user friendly” style in order to easily inform new staff members about the personal and background details of the people they are supporting. The members of staff spoken to showed an awareness of the support needs of residents and any changes in the care plans are communicated at shift handover times and through the daily communication book. Staff practice was observed, residents were treated kindly and with respect and staff members were heard to offer choice around personal care issues. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 12 13 14 15 16 17 Quality in this outcome is Good. This judgement has been made using available evidence including a visit to the service. There is a choice of activities available, people access the local community and are supported to keep in touch with family and friends. Residents have their nutritional needs assessed and are offered a variety of fresh, home cooked meals. EVIDENCE: There is a day-care facility attached to the home and residents can access sessions both in the morning and afternoon. People were eager to go across to the day- centre and were seen carrying out a range of activities. The day- care facility has a separate staff team. Many opportunities are in place for people to access the local community by the use of local café’s and pubs and longer days out are planned using the minibus. One person is very skilled in making model aeroplanes and has some of his craft on display at a local shop, he has also been to speak in a school and give a demonstration. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 11 There were swimming sessions recorded and two people were going out for the afternoon shopping and for tea and cakes. One resident said, “I go to the pub and to the café and I also like going shopping to Sainsbury and Marks and Spencer. Another person said they liked to go swimming. A comment card received from a member of the local church group said that they visited the home on a monthly basis and were always made welcome. There is evidence that relationships with family and friends are encouraged and supported. One family comment card said, “ We visit the home on a regular basis and are always given a warm and inviting welcome. In fact it is a very enjoyable day when we go the The Manor”. Menus show that a variety of fresh, home cooked meals are available and residents have their nutritional needs assessed by a dietician. Lunch was roast chicken, roast potatoes and two fresh vegetables, with stewed apple and banana to follow. Some residents said that they had enjoyed fresh pancakes for breakfast as a change. Special diets such as diabetic and pureed meals are available. Several residents need pureed food and this was blended separately to look attractive. Liquid food supplements are also available. A large number of people need assistance with feeding and a part of the lounge has been designated as a “quiet area” where staff can spend time assisting people with their meals in an unhurried manner. A resident said, “ The new chef does smashing food, much better than where I used to live”. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 21 Quality in this outcome is Good. This judgement has been made using available evidence including a visit to the service. Healthcare needs are met including access to a number of healthcare professionals. Medication is well managed and staff members receive relevant training. EVIDENCE: Healthcare needs are assessed and recorded in the plan of care. There is evidence from records and from speaking to the staff team that the home works with a variety of healthcare professionals including the local learning disability team, district nurses, dieticians and speech and language therapists. The district nurse team provides specialist equipment and staff awareness training and the building has been assessed by an occupational therapist. For some residents specialist beds fitted with cot sides have been provided but there were no risks assessments or signed agreements in place with regarding their use. As good practice agreements to use cot sides should be put in place with input from families and healthcare professionals involved with the individual residents concerned. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 13 Two professional feedback forms contained positive comments about the care provided by the home. One person said, “I visit this home regularly and find The Manor one of the best homes for friendliness, cleanliness and the excellent welfare of residents. Medication was safely stored and Medication Administration Sheets were current and in good order. Only staff members who have received the relevant training are allowed to administer medication and the deputy manager said that the home also used observation by senior staff and competency tests inhouse. There have been two recent bereavements in the home and the deputy manager said that a great deal of outside nursing support had been obtained to allow one person to stay in their home until the end of their life. Staff members said that at their request a future training course has been booked regarding the care of people who are terminally ill. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome is Good. This judgement has been made using available evidence including a visit to the service. Complaints are taken seriously and acted upon and working practices and staff training are designed to protect residents from risk of abuse. EVIDENCE: There is a complaints procedure in place a copy of which is included in the Statement of Purpose and Service User Guide. The complaints book showed that one complaint had been received and dealt with appropriately by the manager. There is also a suggestion box within the home to encourage comments from visitors. A resident said, “the staff are lovely and if I complained they would do something about it straight away”. The home has a “whistle blowing” policy and staff members receive training in the protection of vulnerable adults from abuse. Staff members treated residents in a kind and caring manner and senior staff on each shift carry a radiophone in order to be able to offer immediate advice and support if needed. When asked what they would do if they suspected an abuse had occurred, all the staff on duty said they would report it to the manager or senior staff straight away. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 26 27 28 29 30 Quality in this outcome is Good. This judgement has been made using available evidence including a visit to the service. The Manor provides a comfortable and homely environment for the people who live there. There have been extensive building works undertaken to enhance the facilities available and the home is clean and hygienic. EVIDENCE: The home offers a comfortable and homely environment for the people who live there. A number of improvements have been made to the building in the last year and these include the addition of eight new en-suite bedrooms, build to current specifications, all with en-suite facilities. The people who have moved into the new rooms said they were really happy with the changes, one person said, “I am really pleased with my new room, its lovely, the best thing is I have got my own shower. I like my pine furniture and went to the shop to choose it myself ”. The lounge area has been extended and is now much lighter and brighter, with a quiet area to one end. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 16 Outside a courtyard area with seating has been provided and the whole effect is pleasant and easily accessible. Building works are still underway to improve on some of the existing rooms and the whole of the house is undergoing redecoration. Specialist equipment such as baths, handrails, grab rails and easily used hand pads for new fire exits are in place and the home was clean and hygienic. One fire door was not closing completely and one door handle in a resident’s bedroom was a bit stiff, but the maintenance man dealt with these immediately. Regular maintenance checks are undertaken and advice was sought from an occupational therapist when designing the new rooms. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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 32 33 34 35 36 Quality in this outcome is Good. This judgement has been made using available evidence including a visit to the service. Residents in the home are supported by a committed, caring and well-trained staff team and recruitment records are in good order. EVIDENCE: There were four care staff and the deputy manager on the early shift and also a cook, kitchen assistant, cleaner, housekeeper and maintenance man were present. The staff working the shift matched the staffing rota for the day. There are sufficient staff to meet the assessed needs of the current service users in the home and the day care facility is separately staffed. The people on duty were kind and caring in their dealings with residents and were seen supporting people to be as independent as possible and offering choice. The people living in the home said that the staff team were kind and caring, one person said, “ I love it here, I like all of the staff, they are very kind, Today I chose to have a shower and not a bath and someone helped me”. A comment card received from an NVQ assessor said, “ I am at present taking five staff through NVQ and have the opportunity to observe their performance The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 18 and knowledge. I have every confidence in them as carers and their attitude is good.” New staff members undertake the Learning Disabilities Award Framework induction process during which time they attend mandatory training courses. A new system has been implemented where written daily plans are given to each staff member in order to highlight their duties for that day. Staff members said the system was working well and made for increased efficiency. Each staff member has a training record in place and there is evidence that a variety of courses are undertaken including the management of challenging behaviour, diabetes, epilepsy management, medication and the protection of vulnerable adults from abuse. The recruitment files of four new staff members were seen and all contained the required documentation. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 38 41 42 Quality in this outcome is Good. This judgement has been made using available evidence including a visit to the service. A confident and competent manager is in place, staff are well supported and records are in good order. EVIDENCE: The manager of the home Mr. Manning-Smith was on holiday but both staff members and comment cards were very complimentary about his commitment to the development of the home and his open management style. A member of staff said that the senior staff at the home were “hands on” and well organised. This gave a good impression and was supportive to the staff team. A family member comment card said, “an excellent and well run home with full marks for management”. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 20 Staff members confirmed that they received regular supervision sessions from either Mr. Manning-Smith or the deputy manager and records of the sessions are held on file. Staff meeting are held and the deputy manager said that during the last meeting a secret ballot box approach had been used to elicit discussion around care issues and how quality could be improved within the home. Records for the running of the business were seen including health and safety, recruitment and maintenance records and all were current and in good order. Fire records and staff training records were seen and current checks had been undertaken. As good practice the three-monthly night staff training records could be made be easier to identify. As the registered manager was on leave it was not possible to discuss finances, quality assurance or the future development of the home, however these were discussed at the last visit. As previously stated a requirement has been made in respect of plans and risk assessments with regard to the use of cot sides and a recommendation has been made regarding the care plan format. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 4 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 X X 3 3 x The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 22 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 YA6 Regulation 15. (1) Requirement Risk assessment and agreement plans should be implemented regarding the use of cot sides. Timescale for action 31/08/06 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 YA6 Good Practice Recommendations Consideration should be given to further developing the care plans to make personal information more accessible. The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 The Manor DS0000014783.V303602.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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