Inspection on 06/09/05 for The Manor House Nursing Home

This inspection was carried out on 6th September 2005.

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

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

Other inspections for this house

The Manor House Nursing Home 21/11/07

The Manor House Nursing Home 08/11/06

The Manor House Nursing Home 07/03/06

The Manor House Nursing Home 15/12/04

The Manor House Nursing Home 13/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Manor House Nursing Home Bridge Road Chatburn Nr Clitheroe Lancashire. BB7 4AW Lead Inspector Jane Craig Announced 06 September 2005 09:00 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 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 Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Manor House Nursing Home Address Bridge Road Chatburn Nr Clitheroe Lancashire BB7 4AW 01200 441394 01200 440507 info@manorhousechatburn.co.uk Mr Chris Harrison Mrs Janet Harrison Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Home with Nursing (N) 31 Category(ies) of Physical Disability (PD) 19 registration, with number of places Old age, not falling within any other category (OP) 31 The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Under Annex 2, a max of 19 service users requiring Nursing Care who fall in the category of either OP or PD. 2 A maximum of 31 service users requiring personal care of the category of OP. 3 Staffing for service users requiring nursing care will be in accordance with the Notice issue dated 3 August 2001. Date of last inspection 14 December 2004 Brief Description of the Service: The Manor House Nursing and Residential Home is privately owned by Mr and Mrs Harrison. The home is registered to provide long or short term care for up to 31 residents, nineteen of whom may have nursing needs. The Manor House is a converted 17th Century property situated in the village of Chatburn. It stands in large, well maintained gardens with patio areas. There are parking spaces in the grounds. The home is close to local amenities such as the Post Office, village hall, churches and pubs. The local bus service to Clitheroe is nearby. The home comprises two floors. There is a passenger lift and a stair lift providing access to bedrooms on the upper floor. Other aids and adaptations are available to assist service users to move around the home independently. There are twenty eight single bedrooms and two shared rooms. Twenty rooms have en-suite facilities. There are accessible bathrooms and toilets on both floors. There are three lounges, a large conservatory and two dining rooms. The communal spaces are furnished in a homely way and to a good standard. Website Address: www.manorhousechatburn.co.uk The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which meant that the residents and staff were told beforehand when the inspector would be arriving. The inspection took place over one day. At the time there were 29 residents accommodated in the home. The inspector met most of the residents. Eight residents agreed to talk about their experiences of living in the home and their views and comments form part of this report. Six residents completed comment cards before the inspection. Discussions were held with the registered person, two other members of the management team and seven members of staff. Five relatives had returned comment cards and the inspector spoke with two visitors at the home. A partial tour of the premises took place and a number of documents and records were viewed. Detailed notes were taken, which have been retained as evidence of the inspection findings. What the service does well: Residents said they liked living at the home. They got on with the staff and said they were “kind” and “friendly”. A visitor to the home talked about the good atmosphere and said the staff were, “so kind and caring, every single one.” There was a programme of morning and afternoon activities. Residents said that there was plenty going on and always something to do if you wanted. Residents had opportunities to make their views about the home known. They said that their suggestions were acted upon by the staff. None of the residents had any complaints but they said they would be comfortable talking to staff if they had. One said of the owner, “she would always find a solution.” Residents said they were well cared for. One resident said that she was looked after very well when she was poorly. Their care records showed that residents’ health was monitored and referrals made to doctors or district nurses as necessary. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 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 Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 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 standard(s) 3 and 6 The admission procedure was thorough and ensured that staff understood the resident’s needs and how they were to be met. EVIDENCE: All residents were assessed prior to their admission. The residents were fully involved in the assessment and where possible staff consulted relatives and other professionals. An initial care plan was drawn up and sent to the resident with confirmation that their needs could be met at the home. Staff confirmed that assessment information was discussed with them and they were encouraged to read assessments and plans before the resident came into the home. Intermediate care was not provided at the Manor House. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 Care plans were detailed and provided staff with the information they needed to understand and meet residents’ needs. Staff met residents’ healthcare needs with support from outside agencies. Care was provided in such a way as to promote residents’ privacy, dignity and independence. There had been some improvements in medication procedures and practices. However, failure to administer prescribed medication may result in harm to residents. EVIDENCE: Care plans were detailed and provided staff with clear directions as how residents’ health, social and personal care needs were to be met. A dependency profile was used to re-assess residents and highlight changes. The plans were reviewed every month and were updated when the resident’s needs changed. A visitor said that she was always consulted about any changes in her relative’s health or care. Other plans showed that residents or their relatives had involvement in care reviews. As previously required, care plans for residents who were admitted for respite care had improved. All residents had a summary of needs and interventions, with more detailed plans drawn up if necessary. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 10 Care files contained risk assessments for moving and handling, nutrition, pressure sore risk and potential risks to the individual, for example, use of bed rails. Plans were drawn up where risk was identified. Ongoing health care needs were monitored and referrals to outside agencies were made as required. Visits from other professionals such as doctors, district nurses, opticians and dentists were recorded. Residents and visitors said the care at the home was good. One resident wrote, “when I have been poorly I have been well looked after.” Another wrote that they were “very well cared for.” Comments from relatives included, “the home offers first class care,” and, “we are overall very happy with the level of care; not just physical but intellectual and emotional as well.” All previous recommendations for improvements regarding medication had been put into place. There was a complete set of policies and procedures for all aspects of medication management. Ordering, storage and disposal of medication was thorough. Improvements had been made to assessments of residents who wished to manage their own medication. However, there were some elements of administration that need to be improved. There were some gaps on Medication Administration Record (MAR) charts, creams were not always administered and one resident had not received her prescribed pain relief on 2 occasions. Throughout the course of the inspection staff were seen to speak with residents in a respectful, polite manner. All residents who returned comment cards indicated that their needs for privacy were met and residents spoken with said that staff treated them very well. One said, “they are all very sensible,” another said the staff were “all helpful and friendly.” Residents said they could go to their rooms if they wished to be private and that staff respected this. Care plans made mention of respecting residents’ privacy, dignity, choice and independence. Staff received training in core values and gave examples of how these were maintained. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12 and 15 Residents were satisfied with the lifestyle provided in the home. Most residents had access to a wide range of activities, which suited their social and recreational needs. Residents received a well balanced diet. They were satisfied with the choice and quality of the meals served. EVIDENCE: Residents were happy with the home and the routines suited them. One resident said, “I’d rather be here than anywhere else.” Another said, “ I’ve been happy here since I arrived 2 and a half years ago.” One resident said that he came for his holidays and was always keen to come back. Those residents spoken with were very happy with the morning and afternoon activities. One resident said, “they keep us busy, it’s much better than having nothing to do.” Another said “there’s never a dull moment, I don’t know how they organise it all.” Notes of residents’ meetings showed that suggestions for activities were acted upon. There was a core of less able residents who were not usually able to join in the planned activities. Staff were seen to spend time with these residents. They said that alternative activities were sometimes available but not as a matter of routine. Discussions took place with the management team as to how the social and recreational needs of these residents could be met. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 12 Residents comments about the meals were very positive. They were satisfied with the variety, choice and quality. Comments included; “beautiful food,” “plenty to eat,” “a great variety,” and “very nice, very good cooks.” The records of meals showed that residents received a nutritionally balanced diet. The dining rooms were attractively arranged with full place settings. Staff were observed giving assistance to residents and pureed meals looked appealing. Following a suggestion on a recent resident survey, there was fresh fruit in bowls around the home. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 and 18 Residents were able to raise concerns with staff and it was evident that any complaints were taken seriously and acted upon. Members of staff had a clear understanding of adult protection issues, which safeguarded residents and meant that any alleged incidents would be dealt with appropriately. EVIDENCE: There was a complaints procedure for residents to use. This was given to residents when they came to live at the home. None of the residents had any complaints at the time of the inspection but they all said they felt able to tell staff if there was anything wrong. Staff confirmed that they would try to act on complaints and always pass them on to the management team. Records in the complaints and grumbles book showed that appropriate action was taken in all cases. Adult protection issues were covered during induction training and update training was planned to commence later this month. Written guidance and policies were available to staff and management, including “No Secrets in Lancashire”, the local authority procedure. Staff showed a clear understanding of their roles and responsibilities and how to report any allegations. They were familiar with the whistle blowing policy. The registered person had exercised her responsibility in referring an ex-member of staff for inclusion on the POVA list. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19 and 26 The home was clean and well maintained. The standard of décor and furnishings provided residents with a safe, comfortable and homely place to live. EVIDENCE: There was a programme for routine maintenance, redecoration and refurbishment. The home was well maintained and minor repairs were carried out immediately. Décor and furnishings were of a good standard. Building work had started on an extension to the home. Residents had been consulted and plans were displayed in the home. Residents were happy with the communal spaces and their bedrooms. One said, “it’s beautiful here and I have a very nice room.” The home was clean and tidy on the day of the inspection. One resident said that she had never been anywhere where the toilets were so spotlessly clean. Others commented that the home was always kept clean. Residents were satisfied with the laundry service. Staff had training in hygiene and infection control. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Staffing levels were usually adequate to meet the needs of the residents. Recruitment practices were inadequate and did not provide safeguards for residents. Staff had access to training which increased their knowledge and understanding of the needs of the residents and assisted them to fulfil the responsibilities of their roles. EVIDENCE: The day care service offered at the home had increased to 9 people per day since the last inspection. Some of the staff felt this increase had placed an extra burden on their care duties and detracted slightly from the care of the residents. Other staff disagreed. Comment cards returned by relatives indicated that they thought there were enough staff on duty. Residents confirmed this at the time of the inspection. Discussions took place as to how staffing numbers could be monitored by the management team to ensure that there were always sufficient staff to meet the needs and dependencies of the residents. There were appropriate recruitment policies but these were not always followed. Several staff had commenced employment at the home before a POVAfirst or CRB disclosure had been received. This practice must cease. Staff files seen contained evidence that other pre-employment checks were conducted and other required information was retained. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 16 Staff said there were good opportunities for training. There was a wide range of courses available and a member of staff said that they were able to find and nominate themselves for courses they were interested in. The induction course met the national training organisation specifications and included an assessment of competency. 82.5 of care staff had attained NVQ to at least level 2. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 Systems were in place to review the quality of care provided, which included seeking views of residents and their relatives. Improvements in the way residents’ finances were handled provided safeguards for residents. Policies and practices protected the health and safety of residents and staff. EVIDENCE: Residents had opportunities to make their views about the home known. A member of the local community chaired regular residents meetings. Resident surveys were sent out annually and there was a suggestions book that was used by residents. Records showed that any comments were acted upon. Staff meetings were held every six months. The staff did not handle any finances on behalf of residents. Following previous recommendations, residents or their families had ceased to pay in advance for extras. Any expenditure over and above the fees was paid by the The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 18 home and residents or their families were billed every three months. Accurate records were kept. Not all staff had received update training in food hygiene. The training records were not clear and indicated that some other training in safe working practice topics was out of date. Fire safety training was current. Each resident had an individual fire risk assessment and there was a general one for the home. Records of fire drills were kept. Fire alarms and emergency lighting were checked regularly. Servicing and maintenance of systems, appliances and equipment was up to date. Environmental risk assessments were in place. Potentially hazardous substances were assessed and stored securely. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 3 x x 3 x 3 x x 2 The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 20 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. 1. Standard 9 Regulation 13(2) Requirement The registered person must ensure that medications are administered as prescribed. MAR charts must provide an accurate record of medication given. Staff must not be employed at the home until satisfactory checks are completed. Staff must be provided with updated training in safe working practice topics. Timescale for action 30/09/05 2. 3. 29 38 19 18 30/09/05 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. 2. Refer to Standard 12 27 Good Practice Recommendations Alternative activities should be sought for residents who are unable to join the main group. Staffing levels should be reviewed on a regular basis to take into account the needs and dependencies of residents and the staff time required by day care clients. The Manor House Nursing Home F57 F07 S22504 The Manor House V240215 060905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 1st Floor, Unit 4 Calyton-Le-Moors Accrington Lancashire. BB5 5JB 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. 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