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Inspection on 16/08/05 for The Manor House, Seaton

Also see our care home review for The Manor House, Seaton for more information

This inspection was carried out on 16th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Manor House provides or arranges for high quality, well-planned, multidisciplinary care to people who have needs relating to old age and/or dementia. The owners and staff have a sound understanding of dementia and its effects on both the individual and their family and friends. Staff relate to residents in a way that pays respect to the person. One testament to this comes from a resident with dementia who said ` there are people here who care for you` and `you get sensible answers`. This is taken as an indication that this resident feels well cared for, safe and valued. Activities are focused on the preferences, needs, abilities and previous interests of the individual resident and the home is currently working towards compiling a life story for each resident. Staff are well trained and have a sound understanding of their role in relation to the objective of the home and the ethos of care. They are well supported, trained and supervised by the owners.

What has improved since the last inspection?

Since the last inspection the staff complement has been increased in response to increased needs of some residents. New dining room tables have been purchased together with a new fridge, freezer and fryer. The hallways and landings have been redecorated together with six bedrooms, some of which have had new carpets and furniture.

What the care home could do better:

At this inspection there were no areas which were identified as requiring improvement. No recommendations or requirements were made.

CARE HOMES FOR OLDER PEOPLE The Manor House The Manor House Fore Street Seaton EX12 2AD Lead Inspector Teresa Anderson Announced 16 August 2005 10:00hrs 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 D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Manor House Address Fore Street Seaton Devon EX12 2AD 01297 22433 01297 21175 hutchc@strngarm.demon.co.uk Dr Seldon Hutchinson Curry 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 15 Category(ies) of OP Old age (15) registration, with number PD(E) Physical dis - over 65 (3) of places The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 The physical disability category PD(E) to be limited to three (3) bedrooms on the ground floor. Currently rooms numbered: G4, G5 and G6. Date of last inspection 27 January 2005 Brief Description of the Service: The Manor House is a Grade II listed building, which has been converted and extended. It is situated in the heart of Seaton with easy access to the shops and the seafront. To the rear of the property is a small and pleasant garden with seating areas. The home provides accommodation and personal care for up to 15 older people who may also have a physical disability. Bedroom accommodation for service users is on the ground and first floors. All rooms are single occupancy and nine have en-suite facilities. Three stair lifts give access to the first floor. On the ground floor service users have the use of a lounge at the front of the building, and a combined lounge/dining room at the rear of the property that overlooks the garden. There is also a small room in which smoking is permitted. There is a communal bathroom on each floor and a total of five communal W.C.s. The home has both a dog and a cat. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over approximately 5 hours as part of the normal programme of inspection. The inspector spoke with approximately 7 residents, with 5 members of staff and with the owners. 10 comments cards were received. The inspector saw the majority of the communal areas of the home and some bedrooms. Records in relation to care planning, training, fire safety and recruitment were inspected. What the service does well: What has improved since the last inspection? What they could do better: At this inspection there were no areas which were identified as requiring improvement. No recommendations or requirements were made. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 6 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 D54 D06_s22063_manorhouse_v234847_160805 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 D54 D06_s22063_manorhouse_v234847_160805 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. Residents benefit from comprehensive assessments which ensure that residents will not enter the home unless their needs can be met. EVIDENCE: All prospective residents are assessed by the home owner(s) prior to admission. Assessments include information from other professionals who have been involved with the resident prior to admission. This includes information from community nurses, social services and community psychiatric nurses. Assessments are ongoing and form the basis of dynamic care plans. The Manor House D54 D06_s22063_manorhouse_v234847_160805 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 and 10. Care planning is consistent and clear providing staff with the information they need to meet residents’ needs. Healthcare needs are well met with evidence of good multi disciplinary working. Staff have a good understanding of the residents’ support needs and meet these in a way that promotes and protects residents’ privacy and independence. EVIDENCE: Care planning for residents who live at The Manor House is comprehensive, easily accessible, clear and focused on the needs and personality of each resident. Plans detail the residents health and social history and needs and are designed so that they contain all the information a carer would need to care for the resident for a day. Care plans demonstrate that healthcare professionals are contacted in a timely manner and that advice and support are sought and followed. They are currently being further enhanced by ensuring that each resident has a ‘biography’ or ‘life story’ included in the care plan which will help staff to engage with those residents who have failing short term memories. Residents are very happy with the care they receive. They say the doctor is called when needed and that the staff always help them. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 10 A resident who has a dementia type illness said ‘ there are people here who care for you’ and ‘you get sensible answers’. This has been taken as an indication that this resident feels well cared for and valued. Staff demonstrated an excellent understanding and knowledge of residents and their needs. They were clear about their role and about how they can help residents to remain healthy and independent. They gave some lovely examples of how they help those residents with dementia to maintain their dignity and their ‘personhood’. Although a full inspection of medication was not undertaken, it is worth noting that the owners and staff at The Manor House work very hard to ensure that all residents receive medication that will enhance their quality of life and which minimises side effects. Care plans clearly demonstrated how this is achieved through close monitoring and working with healthcare professionals. The owners talked of how this can be difficult to achieve with the current medication system they have in place. The inspector has asked the pharmacy inspector to visit and advise. The Manor House D54 D06_s22063_manorhouse_v234847_160805 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) 13 and 15. Residents benefit from an ethos which encourages and promotes visitor and community involvement in the residents lives. Meals are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Visitors to The Manor House say they are always warmly welcomed and that there is ‘always a cup of tea on offer’. On the day of the inspection a donkey from the local donkey sanctuary was being escorted around the home. Residents are very complimentary about the meals served at The Manor House. There is a variety and choice and ‘good home cooked food’. The cook also bakes and on the day of inspection home cooked scones with clotted cream and jam were on offer. One resident talked of how he only chose to have a cooked breakfast on special occasions and that one day when he felt ‘down’ a member of staff offered him one to help cheer him up. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a good complaints system with sound evidence that residents views are listened to and acted upon. Residents are protected from abuse by the homes policies and procedures. EVIDENCE: Since the last inspection CSCI has received one complaint about this service. This complaint was partially upheld, however mitigating circumstances existed. Residents told the inspector that they had no real complaints but that if they did they could talk to the staff or to the owners. Residents were obviously comfortable in the company of staff, enjoying their company and responding to them positively and in a relaxed way. One resident said the best thing about living at The Manor House was that she felt safe. Care staff have a good knowledge of the issues relevant to the protection of vulnerable adults. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The standard of the environment at this home is good, providing residents with a comfortable, homely, clean and safe place to live. EVIDENCE: This home is well maintained throughout. The furnishings are comfortable and suitable for people with mobility problems. There are two lounges, although residents tend to use one, and a dining room. The outside areas are well (and attractively) maintained and obviously enjoyed by residents. The home is clean and bright and residents say it is always this way. Infection control policies are in place and followed by staff. Residents say that their clothes are well cared for. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 14 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, 29 and 30. There is a good match of sufficient numbers of well trained staff offering consistency and high quality of care. Recruitment procedures ensure the protection of the residents. EVIDENCE: Staff say they get a lot of training which helps them to do their job. Records demonstrate this includes diet and nutrition, infection control, preventing falls, caring for people with Parkinson’s Disease and dementia care. Staff say they get a lot of training which helps them to do their job. Staff are well supervised and receive annual appraisals. The duty roster shows that sufficient staff are on duty to meet residents needs, and they confirm this. Residents and visitors are very complimentary about the staff and their skills. Comments include ‘I am extremely happy with the care’ and ‘they are very caring’. Recruitment files show that all necessary checks are undertaken including Criminal Record Bureau and Protection of Vulnerable Adults checks. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 15 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 for consulting with residents are good with a variety of evidence to indicate that residents views are both sought and acted upon. Residents’ monies, their possessions and safety are protected by good systems of management and working practices. EVIDENCE: The Manor House has a strong emphasis on listening to residents and their experience of living at the home. Formal quality audits are undertaken (currently being collated) and less formal methods of day-to-day monitoring are undertaken. Residents say the home is ‘their home’ and staff say this is the way it should be. They work hard to achieve this. Sounds systems are in place to protect residents monies and safe working practices are followed. Induction, foundation and NVQ training is undertaken. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 16 Fire risk assessments are regularly reviewed and appropriate training is given. The fire log book was inspected and this is in order. The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 17 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 4 8 4 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 18 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 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 Good Practice Recommendations The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Manor House D54 D06_s22063_manorhouse_v234847_160805 stage 4.doc Version 1.40 Page 20 - 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!