Inspection on 01/11/06 for The Manor House

This inspection was carried out on 1st November 2006.

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

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

Other inspections for this house

The Manor House 25/02/06

The Manor House 12/10/05

The Manor House 22/03/05

The Manor House 09/12/04

The Manor House 24/03/04

The Manor House 18/11/03

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 The Manor House 72 Church Street Market Deeping Lincs PE6 8AL Lead Inspector Mick Walklin Unannounced Inspection 1st November 2006 11:00 The Manor House DS0000002454.V317022.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 House DS0000002454.V317022.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 House DS0000002454.V317022.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Manor House Address 72 Church Street Market Deeping Lincs PE6 8AL 01778 344921 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) sylvia.welford@sense.org.uk www.sense.org.uk Sense, The National Deafblind and Rubella Association Mrs Sylvia Welford Care Home 7 Category(ies) of Learning disability (7), Sensory impairment (7) registration, with number of places The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th February 2006 Brief Description of the Service: Manor House is part of the SENSE organisation and is registered to provide care and accommodation for up to seven service users over the age of eighteen years affected by deaf/blindness caused by rubella. This home shares a site with Manor Court, another care home and within the grounds are a patio, garden, hydrotherapy swimming pool, interactive multi-sensory room and administrative offices. Service users attend a new day care facility in Bourne also managed by SENSE. Transport is provided through the use of a minibus or via a regular bus service. The home is located in the town of Market Deeping, which has a variety of facilities and services. The stated aim of the home is to provide a safe and supportive environment based on best care values for people who are deaf/blind. To promote a presence in the community by the use of local amenities and services, maintaining good relationships and promoting a positive image of residents of Manor House . The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of The Manor House, and through undertaking a visit to the home. The fieldwork visit took place over 7 hours. The main method of inspection used was called case tracking which involved selecting three service users and tracking the support they receive through the checking of their records, discussion with the care staff and observation of care practices. A tour of the building was undertaken with the deputy manager. Documents connected with the running of the care home were also inspected. The manager had not received a pre-inspection questionnaire prior to the inspection, so this information was not received. She confirmed that the range of fees charged is between £1330 and £2231 per week. What the service does well: What has improved since the last inspection? There were no issues identified at the time of the last inspection. The home continues to provide very high standards of care. The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Manor House DS0000002454.V317022.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 House DS0000002454.V317022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are good procedures for assessing prospective service users, to ensure that their support needs can be met. EVIDENCE: There have been no new admissions to the home since March 2005. The inspection at that time found that a full assessment had been carried out, and staff had visited his previous placement. There was then a planned transition, allowing the service user to spend periods of time at The Manor House before moving in. At the time, his parents described the move as “well organised”. The Manor House DS0000002454.V317022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Care plans accurately describe service users support needs. Staff encourage service users to make decisions and choices about their lifestyle, by using a range of communication methods. Service users are encouraged to develop independent living skills, whilst risks are minimised. EVIDENCE: Care plans contain excellent ‘pen pictures’ of service users, which clearly and concisely outline their support needs, and areas that they are independent in. There is good information about likes, dislikes and preferred routines. All service users have a sensory impairment, and communication difficulties. Care plans contain hearing and visual assessments, and detailed information about communication needs. It is not possible to fully involve service users in the preparation of their care plan, and the reasons for this are documented. Detailed reviews are held every six months, which include placing authorities The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 10 and parents. The care plan for one service user was found in an unlocked cupboard in the kitchen. This was moved immediately to a locked office, where care plans are usually stored. Staff were observed to use a variety of techniques to encourage service users to make choices. One member of staff said, “We have to know the guys really well. Because of their communication problems, we have to be really aware of their likes, dislikes, and how they communicate. We use observation a lot, and can spot subtle things that would be missed by someone who didn’t know them well”. Another member of staff said, “Some will sign what they want, and others will chose from a range of options we give them, or just push things away to show they don’t want it”. Staff make widespread use of ‘hand over hand’ or ‘hand under hand’ techniques to guide service users in household tasks, and to ensure that risks are minimised. One member of staff was observed to use this technique to assist a service user to chop vegetables for a meal, and another was observed helping a service user make his packed lunch for the following day. The home has a philosophy of encouraging service users to be as independent as possible. There are an excellent range of risk assessments for activities, which ensure that residents can develop independent living skills, whilst staying safe. A ‘thank you’ card sent in recently by parents said, “We were so pleased to hear of (our son’s) achievements. The effort made by you all to raise (our son’s) confidence and self esteem has worked brilliantly”. The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users have a busy and stimulating timetable. Contact with families and friends is encouraged. Catering arrangements are of a domestic nature, and are flexible to accommodate individual choice. EVIDENCE: Service users attend a Sense resource centre in Bourne during the week, and some have dedicated home days. Their timetables at the resource centre are varied, and there is a mixture of educational, vocational and recreational activities available. Activities at the home are less structured, in line with a normal home. Staff said, “Some of the guys like a structure, so one goes swimming every Tuesday, but it would throw him if we went swimming on a Friday. Most of the time we don’t really plan things – we just decide that day”. Another member of staff said, “We get out a lot – the summer was brilliant – we were out on the bus all the time”. All residents had a holiday in Norfolk this The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 12 year, which staff said was a great success. One service user was at home due to having been ill recently. She received 1-1 support throughout the day, and she was provided with a good range of activities to participate in. Contact with families is encouraged. Some service users go on regular visits, and others receive visits from their parents. The home has a telephone equipped with an amplifier, to assist service users in communication. Catering arrangements are of a domestic nature. Menus are prepared on a four-week rotation, and are varied, and reflect resident’s choices. Care staff are responsible for shopping and the preparation of meals, with the help of service users. Staff demonstrated a good knowledge of individual service users like, dislikes, and dietary requirements. The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users receive good support from staff. There are good arrangements with local health providers to ensure that service users health needs are met. EVIDENCE: Staffing levels allow for individualised support to be provided for service users. Information about likes, dislikes and preferred routines is contained in care plans. Staff have an excellent knowledge of service users preferences, and they communicate effectively with service users to ensure that their wishes are catered for. Each service user has a Health Action Plan, which gives a comprehensive picture of their health needs. All are registered with local doctors. Local opticians are used, and the two service users who use hearing aides attend an audiology clinic. Sense also has staff to conduct hearing and visual assessment every two years. Service users receive six-monthly dental checks, and specialist services such as psychiatry, psychology and neurology are all available. The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 14 All staff are trained to administer medication. Staff said that they receive training from Sense, and an annual refresher course. The manager will also assess them for competence. The nurse advisor provides training for more complex procedures. Two staff administer the medication, to ensure that it is administered safely. Administration records are correctly completed, and storage facilities are satisfactory. A pharmacy audit in January stated “All stock in good order”. One service user requires his medication to be crushed in his food, and this has been authorised by the GP and pharmacist. The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are effective procedures in place for dealing with complaints and adult protection issues, ensuring that service users are safe. EVIDENCE: There have been no complaints since the last inspection, and staff were clear on how to deal with complaints, should they receive one. A number of compliments had been received from relatives, since the last inspection. Staff are required to complete an annual adult protection questionnaire as part of their appraisal. This is reviewed by the training Manager to ensure that staff demonstrate an adequate knowledge of the procedures. Staff interviewed had a good knowledge of the procedures for reporting suspected abuse, and were clear about the location of policies and procedures, including the Lincolnshire Adult Protection Committee procedures, a copy of which is displayed on the notice board. SENSE East has a Protection Committee, which reviews all reports of adult abuse within the organisation. The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 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 clean, comfortable and well-decorated and maintained environment for residents to enjoy EVIDENCE: Although the building is old, it is well maintained and decorated. There is a good range of communal space, including a kitchen/diner, two living rooms and a sensory room. The home is equipped for the needs of deaf/blind people with a loop system, visual doorbells, and thoughtful use of colours. Bedrooms are well personalised, and reflect residents needs and choices. The home was clean and pleasant smelling on the day of the inspection. The Manor House DS0000002454.V317022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are clear about their roles, and well trained and supported. There are sufficient staff to ensure that service users needs are met. Recruitment and selection processes protect service users. EVIDENCE: There are usually four staff on duty during the day, with the manager working as supernumerary. Staff said that this was adequate to meet the support needs of service users, and these levels allow high levels of personal support to be offered, including individualised activities. There is some staff turnover at present due to staff retiring, or pursuing their careers. One service user has also required support whist being admitted to hospital, and staff said that although this has left them “a bit more stretched than usual”, there had been good teamwork in covering gaps. Staff complimented the training that they receive. One member of staff, talking about her induction, said, “The training is good – really thorough. It gave you The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 18 the experience of being deaf/blind, and gave you confidence before being thrown in at the deep end”. Another said, “This is a specialist area, that requires specialist skills – the training is very good”. Training records confirmed that staff had received mandatory training as well as specialist training. The files of three staff recruited since the last inspection were examined. All contained the documentation necessary to protect service users. The Manor House DS0000002454.V317022.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home is very well managed and organised. There are good quality monitoring systems, and regular checks ensure that the environment is safe. EVIDENCE: The manager has worked at the home for the past six years. She has obtained a National Vocational Qualification (NVQ) in management at level 4 and is doing NVQ 4 in care. She also holds the Registered Managers Award. Staff praised her management style, and the support she offers them. They said that they felt valued and listened to. Sense East has good systems for monitoring the quality of care provided on an annual basis. They use self-assessment questionnaires, staff focus groups and The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 20 questionnaires for staff, purchasers and parents. A survey is currently being conducted. Health and safety documentation is well organised. Sense employs a health and safety advisor who conducts regular audits, and one was occurring on the day of the inspection. Staff carry out regular checks, and maintenance and servicing records were up to date, with the exception of the gas safety certificate. The health and safety advisor was aware of this, and was chasing this up. The Manor House DS0000002454.V317022.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 x 2 3 3 x 4 x 5 x 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 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 4 x x 3 x The Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Manor House DS0000002454.V317022.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 The Manor House DS0000002454.V317022.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. 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