Inspection on 18/09/06 for The Manor House

This inspection was carried out on 18th September 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 Manor House 02/11/05

The Manor House 24/05/05

The Manor House 02/12/04

The Manor House 18/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Manor House Thurloxton Taunton Somerset TA2 8RH Lead Inspector Jane Poole Key Unannounced Inspection 18th September 2006 10.15 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 Manor House DS0000016162.V312178.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. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Manor House Address Thurloxton Taunton Somerset TA2 8RH 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) 01823 413777 Mrs Charis Ann Cavaghan-Pack Mrs Charis Ann Cavaghan-Pack Care Home 4 Category(ies) of Old age, not falling within any other category registration, with number (4) of places The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: The Manor House is registered to provide personal care to up to four people over the age of 65. The home is very much run in a family style. Mrs Charis Cavaghan-Pack is the owner and registered manager but the home is run in partnership with her husband. Both Mr and Mrs Cavaghan-Pack live on site and both are involved in the day-to-day business of the home. The home has limited care staff hours and is therefore only suitable for service users who are reasonably independent and physically mobile. The house itself is a large Grade 2 listed building set in extensive grounds, all rooms are for single occupancy and all have en suite facilities. All areas of the home are comfortably furnished and well maintained. Fees at the home range between £495.00 and £630.00 a week. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector over a 3 hour period. At the time of the inspection 3 people were living at The Manor House, the inspector was able to meet with all three. 2 service users completed questionnaires prior to the inspection. The inspector was given unrestricted access to all areas of the home and all records requested were made available. The owners of the home were available throughout the visit. What the service does well: The Manor House aims to provide a service to people who have been assessed as having low care needs and wish to maintain their independence. People are encouraged to pursue their chosen lifestyles with assistance from staff. Service users are able to furnish their rooms with their own possessions, which creates a very homely environment. All rooms have access to tea and coffee making facilities. Visitors are welcome at all times and are able to have meals in the home. There are no organised activities but transport is provided to enable service users to access local facilities. One service user said that the best thing about The Manor House was that; “You can live your own life knowing that there is always someone available if you need them.” All service users were complimentary about the excellent food in the home. All meals are home cooked using local produce where possible. Everyone stated that the staff and management were open and approachable, all stated that they would be comfortable to raise any concerns or worries. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 6 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 House DS0000016162.V312178.R01.S.doc Version 5.2 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 Manor House DS0000016162.V312178.R01.S.doc Version 5.2 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): 2, 3, 4 & 5. Overall quality in this outcome group is good. All prospective service users are able to visit The Manor House before deciding to make it their home. All service users receive a contract setting out the terms and conditions of their residency. Intermediate care is not provided. EVIDENCE: The inspector was able to speak to the two newest service users, both stated that they had received adequate information about The Manor House before deciding to make it their home. Prospective service users are able to visit the home with their representatives before taking up permanent residence. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 9 The inspector saw copies of pre admission assessments and signed contracts in service users individual files. The home is clear about the level of need that they are able to meet. For example there are no waking night staff and service users are made aware of this during the assessment. The pre- admission assessments seen by the inspector show that the home looks, not just at needs, but also at lifestyle and interests. This is to ensure that the lifestyle at The Manor House matches the expectations of service users. 2 service users completed questionnaires before the inspection both answered YES to the questions “Have you received a contract?” and “ Did you receive enough information about this home before you moved in so you could decide if it was the right place for you?” One person commented that they had been able to visit for a week to ‘try out’ the home. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 10 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 & 10. Overall quality in this outcome group is adequate. The procedure for the administration of services users medication does not promote safe practice. Service users have access to appropriate healthcare professionals. EVIDENCE: Service users felt that their privacy and dignity were respected. All service users have single rooms with sitting areas. All have personal phones. The inspector observed that post was delivered unopened to individual service users. All service users stated that they felt that The Manor House was their home and that any routines were dictated by their needs and wishes. The inspector viewed the care plans of all 3 service users living at the home. All contained a pen picture of the individual. This includes information about the needs of the service user and about their personality and interests. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 11 There are regular updates written in the care plan, which are now kept in the main part of the home and are therefore available to staff and service users. Service users spoken to on the day of the inspection stated that the homeowners assisted them to make and attend healthcare appointments outside the home. All appointments and outcomes of meetings with healthcare professionals are recorded. Both service users who completed questionnaires prior to the inspection answered ALWAYS to the question “Do you receive the medical support you need?” Service users are encouraged to take responsibility for their own medication. Two of the three service users self medicate and this is recorded in care plans. Staff administer medication for the other service user and administration practices are currently poor. One of the owners dispenses tablets into a dossett box for the week and these are then administered to the service user by a member of staff. Staff tick to state that they have given the medication. Ways of improving the administration of medication were discussed with the home-owners. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 12 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, 13, 14 & 15. Overall quality in this outcome group is excellent. The quality of the food is excellent. Service users are encouraged to make choices and decisions to maintain control of their day to day lives. EVIDENCE: Service users are encouraged to maintain their chosen lifestyles. People stated that they are able to choose when they get up, when they go to bed and how they spend their day. Service users said that they continued to be in control of their day-to-day lives. Two people living at the home have been able to bring their dogs with them and both considered this extremely important. Service users are able to bring personal possessions such as furniture, pictures and ornaments with them to the home. This gives all rooms an individual homely feel. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 13 There are no organised activities in the home and people are encouraged to pursue their own interests and hobbies. Service users spoken to stated that this was made clear to them when they moved to the home. The home assists people to access facilities outside the home such as local shops, libraries, clubs and churches. Service users stated that the home is always happy to provide transport. Newspapers are delivered at breakfast time and two service users stated that they liked to spend their morning quietly reading the paper. The home is set in extensive grounds which service users have unlimited access to. As with all previous inspections at this home, service users were very complementary about food served. Breakfast and super are served on trays in individual rooms. The main meal of the day is at lunchtime and served in the kitchen/diner. Service users stated that this is a chance for them to socialise with other service users and staff. The inspector observed lunch on the day of the inspection, the table was pleasantly laid and drinks, including wine, were available. Service users stated that the quality of the food was always good and that local produce is used where possible. There are no set menus, food is cooked according to personal likes and requests. Records are kept of all meals served and these show a wide variety of home cooked food. The two rooms on the ground floor have kitchen areas and the upstairs rooms share a small kitchen. Service users stated that staff make sure that they always have supplies of tea, coffee and milk so that they can make drinks at any time. Service users spoken to stated that there are no restrictions on visitors and that guests are always made welcome and invited to eat meals in the home. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 14 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 & 18 Overall quality in this outcome group is good. There are adequate safeguards in place to minimise the risk of abuse to service users. EVIDENCE: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. Both service users who completed a questionnaire prior to the inspection confirmed that they knew how to make a complaint. Service users spoken to stated they would be comfortable to approach the owners or a member of staff if they had any concerns or worries. All said they always felt free to voice their opinions. Due to the size and nature of the home any change in mood or behaviour, which may be indicative of a problem, would be quickly noticed and responded to. All staff working at the home have undergone an enhanced Criminal Records Bureau check. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 15 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, 21, 22, 23, 25 & 26. Overall quality in this outcome group is good. The Manor House provides comfortable accommodation that service users are able to personalise with their own possessions. EVIDENCE: The care home forms part of a larger building, which is the residence of the owner/manager. Service user accommodation is set over two floors, there are two bedrooms on the ground floor and two on the first floor. There is a stair lift between. Service users are able to bring their own furniture to personalise their individual rooms. Communal areas consist of a large kitchen/diner and a small lounge area. Outside there are extensive grounds which service users have unrestricted access to. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 16 All bedrooms have en suite facilities and aids and adaptations have been put in place to assist people to maintain their independence with personal care. Ensuite bathrooms have emergency call bells. Bedrooms on the ground floor have kitchen areas where hot drinks can be made and the two bedrooms upstairs share a small upstairs kitchen. Individual risk assessments have been completed in respect of upstairs windows, hot water and hot surfaces. In the main kitchen there is a domestic style washing machine, which is appropriate to the needs of service users. All areas seen by the inspector were reasonably clean and fresh. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 17 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, 28 & 30. Overall quality in this outcome group is adequate. Staffing levels in the home are reflective of the needs of service users. There is no training plan for staff. EVIDENCE: The home employs 3 members of staff who are responsible for all care and domestic duties. The home is clear about the level of need that they are able to meet and the home is staffed accordingly. There are periods of the day when there are no staff on duty but support is provided by the owners of the home. One member of staff also lives on the premises. Overnight there are no waking night staff but service users are able to contact the owners in an emergency. No member of staff has a National Vocational Qualification in care although one is a trained nurse. There is no training programme for staff. Service users were complimentary about the staffing; one person stated that “staff are very helpful but not intrusive.” The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 18 Both people who completed questionnaires prior to the inspection answered YES to the question “Do staff listen and act on what you say?” The staff member spoken to was able to demonstrate a good knowledge of service users and their individual needs. They appeared confident and competent in their role. No new staff have been employed since the last inspection therefore recruitment files were not viewed. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 35 & 38. Overall quality in this outcome group is good. The home is well managed taking account of the views of service users. EVIDENCE: The registered manager of the home is Mrs Charis Cavaghan-Pack. The home is very much run as a partnership between Mrs Cavaghan- Pack and her husband. Neither have a formal qualification in care or management but between them they have many years experience of working with older people. Service users and staff described the manager as extremely open and approachable. People stated that they were very comfortable to voice their opinions and make suggestions about the running of the home. The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 20 The manager does not as a financial appointee or power of attorney for any service user. There are no formal quality assurance measures in the place but service users stated that the manager continually asks for comments about the service provided. Mr Cavaghan-Pack carries out monthly safety checks in the home. The fire risk assessment was updated in March of this year and work to change all smoke detectors to a mains powered system has been completed in line with a recommendation from the fire officer. All portable electrical appliances were tested in March and the stair lift was serviced in May this year. All policies and procedures in the home were reviewed in January of this year and continue to be appropriate. As previously mentioned there is no training plan for staff. The Manor House DS0000016162.V312178.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 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 3 X 3 3 STAFFING Standard No Score 27 3 28 2 29 X 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 3 x x 2 The Manor House DS0000016162.V312178.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13 (2) Requirement Timescale for action 15/11/06 2 OP30 OP38 18 (1) [c] All medication must be administered and recorded in line with The Royal Pharmaceutical Society guidelines for care homes. The manager must ensure that 31/03/07 all staff have up to date knowledge in health and safety issues such as; manual handling, food hygiene, fire safety and first aid. 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 DS0000016162.V312178.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 House DS0000016162.V312178.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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