CARE HOMES FOR OLDER PEOPLE
The Manor House Thurloxton Taunton Somerset TA2 8RH Lead Inspector
Jane Poole Unannounced Inspection 2nd November 2005 10:00 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.V260712.R01.S.doc Version 5.0 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.V260712.R01.S.doc Version 5.0 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.V260712.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 24th May 2005 Brief Description of the Service: The Manor House is registered to provide personal care to up to 4 people over the age of 65. Mrs Charis Cavaghan-Pack is the owner and registered manager but the home is very much run in partnership with her husband. Both live on site and are very involved in the day to day running of the home. The home has limited staff hours and is therefore only suitable for service users who are reasonably independent and physically mobile. The house itself is a Grade 2 listed building set in extensive grounds. All rooms are for single occupancy, all have en suite facilities. All areas of the home are comfortably furnished and well maintained. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out by Jane Poole, regulation inspector, over a 1.5 hour period. There are currently three service users living at the home and the inspector was able to speak with everyone in private. The home owners were not on site on this occasion and some records could not be viewed, therefore this report should be read in conjunction with the reported dated the 24th May 2005. What the service does well:
The Manor House provides very individualised care to a small group of service users. Service users spoken to were extremely complimentary about the service. All felt that they continue to control their day to day lives and be involved in decision making. All stated that they choose what time they get up, when they go to bed and how they spend their day The home places a great emphasis on promoting independence. Aids and adaptations have been put in place to maximise independence in respect of mobility and personal care. Transport is available to assist people to access facilities in nearby areas for shopping and leisure. Service users stated that they were able to treat the home very much as ‘their home.’ Visitors are made welcome at all times and are always invited to take meals and drinks with their friend or relative. Service users stated that the management and staff were extremely friendly and approachable but respected their rights to privacy. As with previous inspections the service users were very complimentary about the staff and the food. All food is home cooked by the carers/housekeepers. Fresh local produce is used when available and records show that there is a wide of meals served. All service users stated that the main meal of the day was a pleasant social occasion. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 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.V260712.R01.S.doc Version 5.0 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.V260712.R01.S.doc Version 5.0 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): There have been no changes at the home since the last inspection, therefore the statement of purpose continues to be reflective of the services offered. EVIDENCE: No new service users have moved to the home since the last inspection, therefore no standards in this section have been assessed on this occasion. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 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): 8, 9 & 10. Aids and adaptations have been made available to maximise the independence of service users. All service users are treated with respect, and privacy is maintained. EVIDENCE: Care plans were not available at this inspection. All service users currently living at the home are fully able to verbalise their needs and wishes. The inspector spoke with all three service users in private; all stated that they were very comfortable to express their needs and views with the care staff and the owners of the home. Service users are registered with local GPs and other relevant healthcare professionals. Service users spoken to stated that staff at the home assisted them to attend medical appointments if requested to do so. All bedrooms have en suite facilities, aids and adaptations have been made available to maximise independence. Currently all service users are able to attend to their own personal care. Service users stated that their privacy is respected at all times. All service users also administer their own medication but the home retains up to date lists of the prescribed medication for each person.
The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 10 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. Service users continue to have control over their day to day lives. The quality of food in the home is excellent. Friends and family are always made welcome and are invited to join service users for meals. EVIDENCE: Service users stated that they continue to be in control of their lives and dictate their own daily routines. There are no formal activities in the home and service users are aware of this at the time that they move in. People are encouraged to pursue their own interests and hobbies. All spoken to stated that transport is always provided to enable them to visit facilities and amenities in nearby areas. Service users stated that they were assisted to go shopping in the local town and to the library. People said that they had the newspaper delivered with their breakfast and one person stated that they liked to spend the morning reading the paper and completing the crossword. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 11 Two service users go to church each Sunday and transport is provided for this. Another person enjoys spending time outdoors and helping with some gardening tasks. Service users are able to furnish their own personal rooms and two people emphasised how important this was to them. One of the service users has a cat, which they bought with them to the home. At this, and every previous inspection, service users were extremely complimentary about the quality of the food in the home. All food is home cooked using local produce where available. Since the last inspection the gardener has begun growing some fruit and vegetables which have been very much enjoyed by service users. The main meal of the day is at lunch-time and people stated that they liked to eat in the kitchen/diner and enjoyed the company of other service users. Drinks, including wine, are served with all meals. Breakfast and supper is served on trays in individual rooms. The rooms on the ground floor have small kitchen areas and there is a small kitchen on the first floor for people to make hot and cold drinks. A record is kept of all food served including alternatives. The record shows that a wide variety of meals are served. Everybody spoken to stated that friends and relatives are always made welcome and always invited to have meals with the service users. One service user said that “birthday parties are wonderful.” The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 12 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. There are appropriate policies and procedures in respect of making a complaint, whistle blowing and recognising and reporting abuse. EVIDENCE: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. 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. 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. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 13 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, 20, 21, 22, 23, 24, 25 & 26. The Manor House provides a comfortable homely environment for service users. Aids and adaptations have been made available in line with individual needs. EVIDENCE: The home is set in extensive grounds, which service users have unrestricted access to. Service user accommodation is part of a larger dwelling, which is the residence of the owners. Service user accommodation is set over two floors with a stair lift between. Communal areas are located on the ground floor and consist of a large kitchen / diner and a small lounge. Two of the personal rooms have private sitting rooms, all have en suite facilities and have been fitted with call bells. The two rooms on the ground floor have kitchen areas and the two upstairs rooms have access to a small kitchen on the same floor.
The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 14 Service users are able to bring their own furniture with them and all rooms seen were extremely personal to the individual. Aids and adaptations have been made available to maximise the independence of service users. In the kitchen there is a domestic style washer drier which is appropriate to the needs of the home. Individual risk assessments have been completed for each person in respect of hot water and hot surface temperatures. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 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, 28 & 30. The staffing levels in the home are reflective of the needs of the service users. EVIDENCE: The home is very clear about the level of need that they are able to meet and the staffing levels in the home are reflective of this. Three staff are employed, one person lives on the premises. The owners Mr and Mrs Cavaghan-Pack, also work with the service users and provide on call back up. There are periods during the afternoon and evening when there are no staff based in the home but service users are able to summon assistance by using their call bell. Service users spoken to were extremely complimentary about the staff in the home saying that nothing was ever too much trouble. Staff appear confident in their roles and offer a very person centred approach to care. No staff have an NVQ in care and records of other training were not available. No new staff have been employed since the last inspection and therefore staff recruitment files were not viewed on this occasion. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 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): 31 & 38. The manager of the home is open and approachable. EVIDENCE: The registered manager of the home is Mrs Charis Cavaghan-Pack, but the home is very much run as a partnership between her and her husband. Neither has a formal qualification in care or management but both have considerable experience of caring for older people. The home does not take responsibility for the personal finances of any service user. The home-owners were not available at this inspection. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 17 Service users and staff stated that the management of the home were extremely approachable and that communication was very good. The home takes steps to ensure the health, safety and welfare of service users whilst providing a homely environment. Staff have received training in first aid and food hygiene. All accidents and untoward incidents are recorded by the staff. Since the last inspection the home has installed some mains operated smoke detectors in line with a recommendation from the fire safety officer. A requirement of the last inspection was for all portable electrical appliances to be checked, there is no evidence that this has been done. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 18 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 3 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 19 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 OP38 Regulation 13b (4) Requirement Electrical portable appliances must be tested annually. (Requirement made at previous inspection.) Timescale for action 31/12/05 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 OP7 Good Practice Recommendations Care plans should be kept in the home to ensure that they are easily accessible to staff and service users. The Manor House DS0000016162.V260712.R01.S.doc Version 5.0 Page 20 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.V260712.R01.S.doc Version 5.0 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
