Inspection on 13/11/08 for The Manor House Nursing Home

This inspection was carried out on 13th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Manor House Nursing Home 17/01/08

The Manor House Nursing Home 14/02/07

The Manor House Nursing Home 20/03/06

The Manor House Nursing Home 20/12/05

The Manor House Nursing Home 20/01/05

The Manor House Nursing Home 08/07/04

The Manor House Nursing Home 12/03/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

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Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Manor House Nursing Home 127 Wakefield Road Lightcliffe Halifax West Yorkshire HX3 8TH     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paula McCloy     Date: 1 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Manor House Nursing Home 127 Wakefield Road Lightcliffe Halifax West Yorkshire HX3 8TH 01422202603 01422204113 oliverjamesthomas@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Angela Charlesworth Type of registration: Number of places registered: Mrs Jean Thomas care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Elderly patients over 60 years of age Date of last inspection Brief description of the care home The Manor House Nursing Home is a comfortable home providing nursing care for up to 31 older people. It is set in its own attractive, well kept grounds with pleasant outside seating for people to use in the better weather. There is plenty of car parking and the home is on a bus route. The bedrooms are a mix of single and shared rooms and the communal rooms are spacious and attractive. The home is well furnished and kept in reasonable decorative order. 0 Over 65 31 Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that people using the service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The weekly charges at The Manor House Nursing Home range from 456.00 to 500.00 Care Homes for Older People Page 5 of 27 pounds per week. additional charges are made for hairdressing, chiropody and newspapers. The last key inspection took place in January 2008 when the home was assessed as being a 1 star, adequate service. This inspection was carried out to assess the quality of care provided to people living at the home and to see what improvements had been made. The inspection process included looking at the information we have received about this service since the last inspection as well as a visit to the home by two inspectors. The visit lasted 7 hours. During the visit we talked to 7 people living at the home, 3 members of staff, 2 relatives and the manager. We also observed staff delivering care, looked at various records and looked around the home. We sent comment cards for people living in the home, staff and health care professionals to the manager for her to give out. We did not receive any replies. These cards should provide people with the opportunity to share their views of the service and we can use information without identifying where it came from. What the care home does well: What has improved since the last inspection? What they could do better: Make sure that people are consulted about their care, support and about their preferred routines. This will make sure that people get the care and support they want. Make sure that all staff have received adult protection training, know about the different types of abuse and the reporting procedures. This will make sure people living in the home are kept safe. Make sure there are enough staff on duty to make sure people can follow the routines they want to and that staff have time to spend with people other than when they are delivering personal care. Care Homes for Older People Page 7 of 27 Make sure that staff have all of the basic training so that they are working safely and using the correct moving and handling techniques. This will make sure that no one is at risk of being injured. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they move in to make sure that home can meet their needs. They can visit the home to see for themselves if they think it is suitable. Evidence: There is a copy of the homes Service User Guide in every bedroom. This document also contains a copy of the homes contract statement, which gives people information about their rights and responsibilities. Staff from the home make sure that anyone thinking of moving in is assessed to make sure that the home can meet their needs. The manager must make sure that she also looks at the staffing levels in the home before she offers a place to anyone. She needs to carefully consider the needs of the people already living in the home and the needs of the person moving in to make sure that there are enough staff to meet everyones needs. Care Homes for Older People Page 10 of 27 Evidence: Staff said that they encourage people to come and have a look around the home, although often it is the relatives that do this. This gives people the opportunity to see the home for themselves and decide if it is suitable. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are not enough staff on duty to make sure that peoples needs are met in an indivdulised way. Some practices are poor and leave people at risk of injury. Evidence: We looked at a selection of care plans because we wanted to see what individual needs had been identified and what action staff are expected to take to meet these needs. We looked at three care plans. We could see from these plans that people are receiving health care from a range of people such as doctors, specialist nurses and chiropodists. Details of any visits are clearly documented in the care plan together with any advice given. People looked well cared for and told us that staff look after their personal hygiene needs and make sure that they visit the hairdresser regularly. We talked to two people about their care plans. They did not really know what they Care Homes for Older People Page 12 of 27 Evidence: were or about the information they contained, even though they had both signed their plan to acknowledge they had been involved in the process. It is important that people are properly consulted about their care and support so that staff can make sure that they are getting the care and support they want. Staff are good at making sure that people do not develop pressure sores. They make sure that specialist equipment is used and people are repositioned regularly. The care plans contain very clear information about what staff need to do. The care plans all contain moving and handling assessments, that tell staff how they should support each person. We saw some very poor moving and handling practices. Two people were moved using an underarm lift. We also saw that the same size of sling was used to hoist people, which took no account of their different weights. There was no detail in peoples care plans about the type of sling to be used. These practices are dangerous and could lead to people being injured. We also saw some practices that were institutional and undignified. After lunch the two care staff on duty were very busy taking people to the toilet. People were returned to the conservatory in wheelchairs and left in them whilst staff went off to take other people to the toilet. At one point four people were sat in wheelchairs all waiting to be hoisted into the arm chairs. Some people were sitting in the wheelchairs for 45 minutes. The two care staff then came in with the hoist and everyone was hoisted , one after the other into their arm chair. There are currently 9 people living at the home who need to use the hoist for every transfer. This takes two staff members. At the moment there are only 2-3 staff members on duty, which at times means if two members of staff are assisting one person there is no staff member available to assist anyone else or supervise the lounge. During the morning we saw that the only contact staff had with people living there was when they had a task to do. For example taking round the mid morning drinks or getting people into the dining room for lunch. People who needed assistance with their lunch were given their food at 11.15am, this happens because this is when staff are available. We dont think there are enough staff on duty to provide people with individualised care. Although peoples basic care needs are being met, peoples individual preferences and preferred routines are not being taken into account. We did not observe a medication round. At the last inspection in January we were concerned that the home were producing their own medication records and not being supplied with these from the pharmacy. We found this again on this visit, however, the Care Homes for Older People Page 13 of 27 Evidence: manager told us that the pharmacy will be supplying the medication administration records in the very near future. We looked at the medication records that are in use and saw that people are receiving their medication at the right times. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not able to exercise control over their life in the home. Meals at the home are good offering choice and variety. Evidence: The care plans we looked at all contained a life history. This provides staff with valuable information about the people they are caring for. We did not find any information about peoples preferred routines. When we talked some people they told us that they had to go to bed at 8pm when the night staff come on duty. One person told us they would like to go to bed earlier but they have to wait until the night staff come on duty. Staff told us that the majority of people are up when they come on duty at 8am. People also said that they thought that this happens because there are not enough staff. It is important that people are consulted about their preferred routines and staff make a record of this in their care plans. This will make sure that people have control over their life in the home. When we arrived people sitting in the conservatory told us they were cold. They said that staff put the fan on because they are hot. Three people asked us for blankets for their knees. There were no staff around. One person said that she thought the home Care Homes for Older People Page 15 of 27 Evidence: was run for the convenience of staff, probably because there is not enough of them. People told us that they only see staff at meal times or when they come to take people to the toilet or bed. They said this was because they are busy running round doing things. People living in the home told us that there were some activities on offer. People said that one member of staff plays dominoes with them in the evenings and sometimes staff organise something in the afternoons, if they have time. People said that they enjoy the visiting entertainers. We spoke to some relatives who told us that staff make them feel welcome when they visit. Everyone we spoke to said that the meals are good and that there is a choice available for every meal. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home know who to talk to if they are unhappy or want to make a complaint. Evidence: The home has a complaints procedure. It is in the Service User Guide and on display. People we spoke to said that if they had a problem they would go to the manager or owner. The home has a complaints log, where they would record details of any complaint they received. No complaints have been recorded since the last inspection in January. We spoke to two members of staff about adult protection. Neither of them have received any training about the different types of abuse. It is important that staff receive this training so they are aware of the different types of abuse and know about the reporting procedures. This will make sure that people are kept safe. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, well maintained and comfortable home. Evidence: The home is in Lightcliffe and is set in its own extensive, well maintained grounds. There is plenty of car parking and it is on a bus route. The kitchen was awarded 4 stars for hygiene at the last inspection by environmental health. The home is clean, comfortable and tidy. People told us this is always the case. People told us that their clothing is well laundered. There are infection control policies and procedures in place. There have been no outbreaks of any infectious disease since our last visit in January. Care Homes for Older People Page 18 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are not enough staff to make sure that people can live the life they choose. Staff are being recruited properly, this means that they are suitable and safe to work with older people. Evidence: At the time of this visit there were 18 people living in the home. The duty rotas showed that during the day there is one nurse on duty with two care assistants until 5:30pm. An additional carer is on duty between 11am - 12pm. From 5:30-8pm there it is just one nurse and one care assistant on duty. The manager told us that these staffing levels are adequate to meet the needs of the people living in the home at the moment. We saw that staff had little time to spend with people unless they were providing direct care. We also saw that people had to wait a long time to be attended to. We also felt that some of the routines that have been adopted for example some people having lunch at 11.15am is because there are not enough staff. Staff told us that all of the tasks get done but they do not have a lot of time to spend with people, two said that they thought it would be better with more staff. New staff are being recruited properly and all of the necessary checks are being completed. This means that they are suitable and safe to work with older people. Care Homes for Older People Page 19 of 27 Evidence: There are 10 care staff working in the home. Five of them either have or are working towards their National Vocational Qualification in care. This means they are or will be trained and competent to do their job. Care Homes for Older People Page 20 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of staff training is putting the health and safety of people living in the home at risk. There are no formal systems in place to make sure people are consulted about the way the home is run. Evidence: The registered manager is a nurse. She takes responsibility for the management of the care and works in a very hands on way with the people living in the home. She is supported by the owner and management team, who also work at the home. We looked at the fire test records and the service records for the lift. Both were up to date. This means that checks are being made to make sure equipment and systems are working properly. When we inspected the home in January we found that there were no formal quality assurance systems in place. The home have some questionnaires that they are going Care Homes for Older People Page 21 of 27 Evidence: to send out to try and get peoples views about their service. They also need to think about holding resident and relatives meetings, which would give people a forum to give their views about the home. We found people living in the home very forthcoming with their views staff need to listen to what they are saying in order to improve the service they get. Staff do not hold any money for safekeeping for people living at the home. People are invoiced separately for any additional services they have such as chiropody and hairdressing. We could see from the training records that all staff have received fire safety training. Two of the care staff we spoke to have not received the other mandatory training in moving and handling, infection control, food safety, health and safety & first aid. It is important that all staff have this training to make sure they are working safely. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 People must be consulted about their care plan. This will make sure that people get the care and support they want. 26/12/2008 2 7 13 Moving and handling assessments must contain details of any equipment that is needed to move people safely, including the size of sling to be used for people who need to use the hoist. This will make sure people are moved safely. 05/12/2008 3 10 12 The routines in the home must be reviewed to make sure that people are treated as individuals. This will make sure that people are treated in a dignified way. 19/12/2008 Care Homes for Older People Page 24 of 27 4 12 12 People must be consulted about their day to day life in the home and their preferred routines. This will make sure that people maintain control over their life. 26/12/2008 5 18 13 All staff must receive adult protection training. This will make sure that people are kept safe. 09/01/2009 6 27 18 Staffing levels must be 19/12/2008 reviewed to make sure there are enough staff on duty at all times to meet peoples needs. This will make sure that people can get the support they want and follow their chosen routines. 7 33 24 The quality assurance questionnaires must be sent out to get peoples views of the service. This will make sure that people are consulted about the way the home is run. 30/01/2009 8 37 13 All staff must receive training in: Moving and Handling Health and Safety Food Hygiene First Aid infection control This will make sure all staff use safe working practices. 27/02/2009 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 Staff need to make sure they are following peoples moving and handling plans so that they do not injure either themselves or the person they are moving. Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!