Inspection on 14/11/06 for The Manor House, Frenchay

This inspection was carried out on 14th November 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 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, Frenchay 18/03/08

The Manor House, Frenchay 04/03/06

The Manor House, Frenchay 25/07/05

The Manor House, Frenchay 10/02/05

The Manor House, Frenchay 29/09/04

The Manor House, Frenchay 24/03/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 The Manor House Beckspool Road Frenchay South Glos BS16 1NT Lead Inspector Paula Cordell Key Unannounced Inspection 14th November 2006 09:30 The Manor House DS0000003354.V314015.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 DS0000003354.V314015.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 DS0000003354.V314015.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Manor House Address Beckspool Road Frenchay South Glos BS16 1NT 0117 9566424 0117 9566050 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 Marilyn Joan Clarke Ms Susan Dorothy Williams Care Home 32 Category(ies) of Learning disability (32), Physical disability (32) registration, with number of places The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 32 persons aged 18 - 64 years May accommodate up to four persons under 18 years of age Date of last inspection 4th March 2006 Brief Description of the Service: The Manor House is situated in a semi-rural location in Frenchay Village within close proximity to the M4 and Avon Ring Road. There are shops and facilities within a mile of the home. The Manor House is a large detached property that is divided into two units Chestnut and Arandell, each with its own facilities including two lounges, a dining room and kitchenette. The home is registered to provide residential care and accommodation to 32 adults with a learning and physical disability. Presently the home has 24 residents. Accommodation is on three floors. There is a lift which is accessible for people with wheelchairs to access the first floor only. Over the last few years the home has been down sized to provide more single rooms with some having ensuite facilities. Several of the rooms have been modernised. The home provides some ground floor accommodation and a facility to enable four residents to live as independently as possible. Equipment and beds to meet the needs of residents with physical/mobility needs have also been provided. Manor House is one of three homes within the Manor House Organisation that provides for adults with learning disabilities and a further home is registered with the Commission for Social Care Inspection to provide respite care to children with a learning disability. There is also a day centre. Four of the services share the Manor House site. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit following the visit in February 2006. The purpose of the visit was to review the progress to the requirements and recommendations made at that inspection and to monitor the quality of the care provided to the individuals living in the Manor House. There have been no additional visits during this period. The home has been keeping the Commission for Social Care Inspection informed of incidents that affect the wellbeing of the individuals living at the Manor House and the provider has sent monthly appraisals of the service. This information was used to plan the inspection process. The inspection was conducted over a total of 5 hours. The inspector had an opportunity to meet with some of the residents, three members of staff and an opportunity was taken to speak with the registered provider on the telephone. The methodology used during this inspection included viewing care records and other relevant documents required of a care home and a tour of the home. The inspector received responses from nine relatives and five visiting professionals to questionnaires sent prior to the inspection. A pre-inspection questionnaire was completed by the manager was also received and this information assisted with the planning of the site visit. Residents were actively encouraged to participate in the process by the staff on duty. What the service does well: There is a strong commitment from the provider to meet the National Minimum Standards and to develop the service based on current good practice. The provider has developed a three-year refurbishment plan, which ensures the home will meet the National Minimum Standards and provide all single bedrooms in two groups of ten individuals. Whilst the home is registered to provide accommodation to 32 persons, it was made clear that the home would not fill the 6 vacant places to enable individuals to have a single bedroom. The home has three double rooms with a long-term plan for these to be singles. Residents are evidently treated as individuals with an individual package of care. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 6 There is a strong commitment to provide a good quality service to the individuals. Many of the residents have treated the Manor House as home for many years and are happy to continue in this view. However, there are some people that are working towards more independence. This is good practice. There is a strong commitment to ensuring that competent and trained staff support residents. There are good systems for monitoring the quality of the service provision, appraising the service and developing their own action plans. It is evident that staff are informed of changing practices in the care field. 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 summary of this inspection report can be made available in other formats on request. The Manor House DS0000003354.V314015.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 DS0000003354.V314015.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): 1, 2, 3, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have information presented to them in a way, which means they can make an informed decision on whether to move to the Manor House. Residents’ assessed and changing care needs – many of which are complex and require specialised support - are being well met. EVIDENCE: The home has a statement of purpose, service user guide and contracts of care. These met with the requirements of the legislation and have been seen on previous site visits. The assistant manager was able to demonstrate that the statement of purpose had been kept under review. The age range of individuals living in the home varies. Many have lived in the home since it was a children’s home. The condition of registration of the home includes four persons under the age of eighteen. The assistant manager stated that the youngest resident is nineteen. Presently there are no residents under eighteen and this condition of registration could be removed as the plan is for The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 9 the home to cater for adults over the age of 18. The provider is advised to write to the Commission for Social Care Inspection about this change. The inspector saw many examples of the staff team demonstrating the capacity to meet the residents’ specialised needs. The Manor House is registered to accommodate and provide personal care for younger adults with a learning disability. It was evident from care records, discussions with staff and residents, that several individuals also have complex physical, psychological and communication needs. There was evidence that the Community Learning Disability Team including the consultant psychiatrist and a behaviour team was supporting the home, staff and the individuals. This is seen as good practice and demonstrated a multi-disciplinary approach to the care of the individuals. The consultant psychiatrist commended the home on their ability to support individuals involving other professionals. Residents’ need assessments and care plans are written from a “person centred perspective” involving the individual and where relevant, relatives. Assessment information had been regularly reviewed and updated to closely monitor and reflect residents changing needs. Training will be discussed later. However, it was evident that the training was planned around the care needs of the individuals living in the home. Residents had been supplied with written terms and conditions of residency that outlined the facilities and services to be provided, personal support offered, financial arrangements, expectations and absences, and terms of contract. Residents, their representatives and the manager had signed these. The contracts were user friendly and included pictures and symbols. The inspector reviewed three of the five standards and the home has demonstrated a good understanding of the relevant legislation. The other two standards were not directly evaluated on this occasion these have been assessed as met on previous inspections. The home has not had a new admission since November 2005. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 10 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, 8, 9, 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can be assured that their care needs are clearly identified and amended as needs change. Residents are the focus of care planning. There is a good level of resident involvement and individuals are supported to be as independent as possible within a framework of responsible risk assessment and risk management. EVIDENCE: The inspector viewed three residents’ plans of care, one from Chestnut and two from Arandell the two units within the Manor House. Plans of care seen were person-centred and clearly described the support needs of the individual. There was evidence that these were being reviewed in accordance with the care needs of the residents and within the National Minimum Standards. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 11 Since the last site visit care files have been expanded to include a history of each resident, and information pertinent to the individual, which is personcentred in a separate booklet. These documents identified the individual’s aspirations and goals that they wanted to achieve and how the staff would support this. The plan included photographs and it was evident that the resident and where relevant their relative had been involved in the process. The work that has been undertaken is commended. Some of the more able residents stated that they were actively encouraged to make decisions about their care and that they were in control. Care plans included an element on how individuals make decisions, including how an individual communicates their needs. Advice on issues of consent had been sought from professionals and recorded in the plan of care. This is good practice. Residents were supported to be as independent as their abilities allowed. This was achieved through ensuring that daily living experiences were as normal as possible. An ethos that promoted independence and skills development planning was evident with the individuals living in the home. The Manor House has a self contained flat for four residents, to enable residents more independence and the home was seeking advice from a social worker to move one resident onto more independent living. Communication seen between staff and residents was positive, appropriate and inclusive. Relationships were relaxed and friendly. Staff described how residents with non-verbal communication were supported to make choices using gestures and staff observing facial expressions. Plans of care described the communication needs of individuals and the home has sought advice from speech therapists. Care plans included how staff should support with individuals “psychological” needs and how to respond if the resident is distressed or angry. The home is working closely with an external team of professionals in supporting one individual who is challenging the service. It was evident that the staff had a good awareness of the individual and were supporting in a positive way, to alleviate the individuals anxieties and stresses. Evidence was provided that residents are regularly consulted on the running of the home. A resident told the inspector that meetings are held regularly and lots of things are discussed including holidays and food. Minutes were kept of the monthly meetings. Residents are involved in the quality audit and periodically complete questionnaires on the service that is provided. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 12 Risk assessments were on file and covered a wide range of activities both in the home and the community. These had been kept under review. Information was available in the form of risk assessments where a restriction or an invasion of privacy was imposed on individuals. For example the use of monitors for individuals who have epilepsy or the use of double confusion handles on their bedroom door in respect of one individual. The documentation included the decision process and who was involved, which included relatives and other professionals. This is good practice and these had been kept under review with evidence that the home was exploring other less restrictive methods for supporting the individual. It was evident from reading the documentation that the individual’s safety was paramount. Information was held securely. Staff were aware of the need to maintain confidentiality and the home has a policy on confidentiality and data protection. These were seen at previous site visits. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 13 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 excellent This judgement has been made using available evidence including a visit to this service. Residents are supported to lead full and active lifestyles based on choice, which included activities in the home, the community and maintaining relationships with relatives. Residents have available to them a healthy and varied menu which is subject to the home’s internal audit to ensure that residents preferences are being met and the standard is acceptable. EVIDENCE: Residents expressed high satisfaction levels in what they did both in the home and the community, both in person to the inspector and via the questionnaires sent to individuals prior to the site visit. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 14 From care plans and discussions with staff and residents it was evident that individuals made choices on how to spend their time and with whom. In addition there was a commitment for individuals to be as independent as their abilities would allow. A resident described how they looked after their personal allowance and chose how to spend their money and others were supported to look after their own medication. Another person stated that they did their own laundry in a training kitchen. The inspector observed individuals being supported to access the local community with trips to the shops, supported to attend their day centres and one individual went swimming. Staff stated that all individuals are supported to go out with their key worker on a one to one basis at least once a month as well as for group activities. The staff have access to a mini bus, a car and a people carrier to enable individuals living in the home to make full use of the community. Residents have structured day care which is tailored to suit the individual and included day centres, college courses and a couple were supported by the staff in the home. Staff stated that activities are organised in the home including arts and crafts, games evenings and cooking, to name a few. Evidence was provided that the residents have theme nights for example a Halloween and fire work party and cinema evenings. In addition, residents have access to Indian massage, an aromatherapist and a manicurist. A spiritual healer visits the home on a regular basis and residents are supported to attend church if they wish. A resident said that they are supported to see home matches at the City Ground and other residents are supported to see Bristol Rovers. Residents are supported to attend an annual holiday with the home. Holidays have included trips to Devon, Butlins and Blackpool. The assistant manager stated that residents are consulted on where they would like to go and with whom. Holidays were evidently planned around the preferences and support needs of the residents. It was evident that the staff strived to give individuals normal life experiences and their disability did not deter and hinder opportunities being given. Care records included information about contacts with friends and relatives. Residents had photographs in their bedrooms of friends and relatives. Residents described how they were supported to see family and had access to a telephone to enable them to maintain contact. Nine completed relative questionnaires confirmed that they were made welcome in the home and that they could see their relative in private and were kept informed of important matters. Comments included “excellent standards The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 15 of hygiene in the home and the care of the residents” and another stated, “the relative is very happy living in the Manor House”. There were two areas of concern raised by a relative, which was the staffing levels to be maintained, and for staff on answering the telephone to give their name. The assistant manager stated that this already being addressed. In relation to staffing there was no evidence that the staffing levels were compromising residents safety or access to the community. Residents were leading full and active lifestyles and given opportunities to access the community. Additional staff have been employed on a weekend to support individuals to go out. This is good practice. Residents have a varied and nutritious diet. From discussions it was evident that they enjoyed the food offered. This was discussed at residents meetings and where requests have been made, these had been included in the menu. Residents stated that they are asked on a daily basis what they would like and that there are always alternatives to the planned menu. Residents stated that they could help themselves to drinks and snacks and there were fruit bowls strategically put in the dining rooms. Care plans included information sought from dieticians. The home completes a quality assurance audit on service provision, which includes seeking the views of residents on the food that is available to them. This is good practice. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 16 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 good. This judgement has been made using available evidence including a visit to this service. Resident’s personal and health care needs are being met. Residents are safeguarded by robust medication practices and procedures. EVIDENCE: Care plans clearly documented the personal and health care needs of the residents. Systems for monitoring an individual’s wellbeing were in place and concerns about health were quickly addressed. Residents had access to other health professionals including a GP, opticians, chiropody, dentist and the community learning disability team. The doctor visits the home on a weekly basis. Staff have attended training in first aid and manual handling. The home has developed a comprehensive planner for training to ensure that periodic updates are undertaken. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 17 Plans of care included individual assessments for manual handling. Training for staff was in place. There were clear records detailing the personal care support needs of the individual and a daily record of care given. The home has an intimate care policy. Staff confirmed that the home’s policy for female staff to support female residents is implemented. The assistant manager stated that new staff spend a period of supervised practice prior to supporting residents with their intimate care, offering individuals living in the home protection and continuity of care for individuals. Staff assisted residents in a good humoured and courteous manner, and residents and evidently built good relationships with staff. Staff on duty communicated among each other and worked well as a team. Daily activities were planned at a meeting in the morning and staff were allocated specific responsibilities during the shift. In addition staff have a comprehensive daily planner that ensures that staff complete key tasks on a daily basis. The home has robust procedures and practices on the administration of medication, including a comprehensive induction and training package for staff. Clear records were maintained. Since the last site visit the home has developed a profile on how each individual prefers to take their medication. This is in consultation with their doctor and the pharmacist. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 18 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. Residents are protected by the home’s complaint and protection procedures, which includes training for staff. It is evident that residents’ opinions are valued and acted upon. EVIDENCE: The home has a robust complaints procedure in place. Residents and relatives were confident that a complaint would be taken seriously and responded to in an appropriate manner. Information was gained from relative and resident questionnaires. Where concerns had been raised they had been investigated and appropriate action taken involving the complainant. Residents meetings also covered concerns or complaints. The home has procedures for the protection of individuals living in the home including an abuse, bullying, anti-racism, financial, gifts and a whistle blowing policy. Staff were aware of the procedures to safeguard residents. There was a strong awareness of the individuals’ rights. Training was being arranged on protection from abuse by the Organisation. A senior manager has attended a ‘training the trainer’ course on abuse. This has been cascaded to all staff. Discussion was had with the assistant manager on when this would be updated for all staff. Whilst there is no National Minimum The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 19 Standard for this to be updated in respect of Care Homes good practice would be that this was updated at least every two years. Training records provided evidence that staff attend yearly updates on ‘Nonviolent Crisis Intervention’ and this was compulsory training for all staff. Staff stated that restraint is never used. Care plans where relevant, included information on what to do if an individual becomes angry or aggressive. Records were maintained where residents have become angry and these are discussed with the appropriate professionals including the consultant psychiatrist and psychology. It was evident that the staff supported individuals in a positive manner and not in a punitive way. Finances were checked. These were satisfactory and safeguards were in place to protect the individual’s monies including regular checks, receipts and staff signatures and where possible the residents signature. However, the latter was not apparent for all financial transactions. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 20 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents live in an environment that is homely, clean and comfortable and suitable for their needs. Plans have been developed to enable the environment to meet with the National Minimum Standards with single bedrooms being provided. EVIDENCE: The Manor House is situated in a semi-rural location in Frenchay Village within close proximity of the M4 and Avon Ring Road. There are shops and facilities within a mile of the home. The home is a large detached property that does not lend itself to providing ordinary domestic style living environment, however the proprietors have addressed this by dividing the home into two sections. Chestnut and Arandell The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 21 each with its own facilities shared communal space and staff teams although staff do also work across both sections to ensure continuity. Over time the home has down sized to provide more single room accommodation and some en-suite facilities have been added. Several rooms have been modernised and comfortably furnished to provide a homely feel. Accommodation is on three floors. There is a lift to the first floor, which is accessible to wheelchairs. The home provides some ground floor accommodation and a facility to enable four residents to live semiindependently. Equipment and beds to meet the needs of residents with physical and mobility needs has also been provided. The proprietors have developed a business plan to down size the Manor House further into two units of 10 and to ensure that all residents have a single room over the next three years. Planning permission for the extensive building work has been agreed. There are three double bedrooms presently in the Manor House. No requirement has been made in light that the provider is planning to address the shortfalls. The home was clean and tidy and looked well maintained. The home addressed the requirements from the previous inspection to replace the broken tiles in the kitchen and a shower room. Two thirds of the bedrooms were seen: these had been personalised by the occupier and were furnished to a good standard. Residents had sufficient communal space, which was homely and comfortable. Residents were seen relaxing both in the lounges and their bedrooms. During the course of the inspection the home was having some refurbishment work completed on the kitchen in Arundel. The home has had an environmental health visit and a request was made for the main kitchen to be refurbished including new worktops and door fronts. The provider stated that this is being undertaken with quotes being obtained. No requirement was made at this site visit. The home has appropriate aids and adaptations to support the individuals and the staff team ensuring and promoting independence according to the assessed needs of the individual. The inspector noted that three of the wheelchairs were dirty and required cleaning. The home has a separate laundry facility and employs staff who complete the laundering of clothes and the domestic responsibilities in the home. This area was well organised and clothes appeared to be well laundered. The home is working towards a plan to ensure that it meets the National Minimum Standards in relation to the environment. This has included The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 22 consultation with the Commission for Social Care Inspection on the standards and a plan of works to be undertaken has been submitted to address the shortfalls. As yet the works have not commenced. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 23 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): 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient and competent staff support residents. There is a highly trained workforce that is supported both by the manager and the provider. EVIDENCE: Evidence at this inspection was that the home had sufficient staff to meet the care needs of the residents living at the Manor House. There was evidence that additional staff were rostered to provide residents with opportunities to go out socially. The home employs a minimum of five staff during the day and one waking and two sleep in members of staff, cover the nights on a daily basis. There was a senior carer on duty at all times. Senior carers were responsible for managing the shifts on a daily basis and administering the medication. It was evident from conversations with staff that individuals were clear about their roles and the expectations of the service. Job descriptions were in place to guide staff and have been seen on previous inspections. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 24 Staff spoken with during this inspection described a high level of job satisfaction. Staff described good support mechanisms in place from the manager and the provider enabling them to fulfil their role as carers. Training was in place including an action plan to address shortfalls and future need. This is good practice. This forms part of a quality audit and the home’s business plan identifying key targets for the year. Recruitment information was available for staff case tracked. There were good recruitment procedures in place to ensure the safety and protection of the residents, from initial advert through to interview, and ensuring all documentation is in place prior to commencing in post. Once a member of staff is employed in the home, they complete a comprehensive induction after which they will proceed onto completing an NVQ 2 or 3 in care. Presently the home has achieved 30 of the workforce obtaining an NVQ in care with a further five staff in the process of completing this. It was evident that the home was planning to exceed the 50 target. There was good rolling programme of mandatory training which was being closely monitored by the registered manager and the individual within the organisation responsible for organising the training. In addition the staff have attended training relevant to the care needs of the residents including supporting residents with autism, person centred planning and epilepsy to name a few. Records and conversations with staff confirmed this. The assistant manager commended the commitment of the provider and the manager on the training that was available. The home has good communication systems in place including daily handover records, monthly one to one meetings with staff and the manager and monthly team meetings. Staff spoken with described good support networks and a commitment to working for the organisation and the home. From discussions it was evident that a large number of staff have worked in the home for many years and they described how the home has changed, progressed and moved with the times to provide a good quality service to the individuals living in the home. Staff were seen during the inspection supporting residents in a positive manner. Staff were knowledgeable about their roles as carer and the care needs of the individuals living in the home. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 25 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. Residents benefit from a very well managed service, where there is a review of the provision of service to ensure that a consistently good quality service is provided to the individuals living in the home. There are good mechanisms for monitoring the quality of the service involving the residents, staff, relatives and professionals and their comments are valued in developing the service. This is commendable. EVIDENCE: Mrs Sue Williams is the registered manager and has been in post since April 2004. Mrs Williams is an experienced manager and has worked for the The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 26 organisation for a number of years. Mrs Williams has completed the NVQ 4 Registered Manager’s Award. There was evidence that Mrs Williams attends regular training both in care and management. The inspector observed an open, relaxed atmosphere in the home with an emphasis upon providing residents with a good standard of care and support and promoting an individual’s self worth and independence. The home is commended on the quality assurance systems in place. Audits are completed on aspects of the home including seeking the views of the residents and their relatives. In addition the provider completes a monthly audit on the home in respect of Regulation 26 of the Care Homes Regulations and sends copies to the Commission for Social Care Inspection monthly. Health and safety in the home was monitored both by the manager and an Operational Health and Safety manager. Health and safety training for staff was in place to ensure that residents are protected and supported by competent staff. Fire records were viewed and found to be satisfactory including the fire risk assessment. A fire officer has inspected the home in June 2006 and records indicated that the visit was satisfactory. The home has had a recent environmental health officer visit. This has been discussed in the environmental standard in relation to the refurbishment of the kitchen. However, the home was commended on the safe systems of work and clear records demonstrating that the home was following legislation relating to food handling. There were a number of generic risk assessments on the environment, household and care activities and accessing the community, these have been viewed at previous site visits. The home has an extensive policy file to guide staff and support the residents. It was evident that the residents were the focus of the policies. The home has recently reviewed a significant number of the policies. This inspection did not focus on the financial viability of the home. There was no evidence that the financial viability of the service was threatened in any way. The organisation has a relevant business plan. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 27 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 3 4 3 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 2 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 4 X X 3 X The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 28 No 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. 1. Refer to Standard YA23 Good Practice Recommendations Where resident’s sign for their own financial expenditure make sure that this is consistently applied/or encouraged. Where residents are unable to sign then two staff to sign for all financial transactions. The Manor House DS0000003354.V314015.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 DS0000003354.V314015.R01.S.doc Version 5.2 Page 30 - 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!