Inspection on 20/02/08 for The Manor House, Seaton

This inspection was carried out on 20th February 2008.

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

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, Seaton 11/01/07

The Manor House, Seaton 03/01/06

The Manor House, Seaton 16/08/05

The Manor House, Seaton 27/01/05

The Manor House, Seaton 29/10/04

The Manor House, Seaton 18/02/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE The Manor House, Seaton Fore Street Seaton Devon EX12 2AD Lead Inspector Vivien Stephens Unannounced Inspection 20th February 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Manor House, Seaton DS0000022063.V356991.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 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, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Manor House, Seaton Address Fore Street Seaton Devon EX12 2AD 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) 01297 22433 01297 21175 hutchc@strngarm.demon.co.uk www.manor-house.freeuk.com Dr Seldon Hutchinson Curry Mrs Susan Elizabeth Celia Curry Dr Seldon Hutchinson Curry Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15), Physical disability over 65 years of age (3) of places The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 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. 11th January 2007 Date of last inspection Brief Description of the Service: The Manor House is a Grade II listed building that has been converted and extended. It is situated in the heart of Seaton with easy access to transport links, shops and the seafront. The home provides accommodation and personal care for up to 15 older people. The home does not have a through floor lift but does have stair lifts for the use of people who cannot manage stairs. Other aids and adaptations are sited throughout the home to help people remain independent. There is a ramp leading to the front door to help those people who use wheelchairs. All bedrooms are single and are situated on the ground and first floors. Communal accommodation is situated on the ground floor and consists of a lounge/dining room at the rear of the property overlooking the garden and another lounge at the front of the house overlooking the road. It is this lounge which houses the television. There is a communal bathroom on each floor and a total of five communal toilets. To the rear of the property is a small and pleasant garden with seating areas. Short term on road parking is available outside the home and there are car parks nearby. Weekly fees range from £410.00 to £450.00. These do not include the cost of such items as personal toiletries, newspapers, hairdressing and chiropody. Further information about this home, including previous CSCI inspection reports, is available from the home direct. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. Further information about this home can be found on their internet website at www.manor-house.freeuk.com Several weeks before this inspection took place the home completed an annual quality assurance assessment (AQAA) and returned the completed document to the Commission. We sent survey forms to the people living in the home and we received 8 replies. The information we received from the AQAA and from the people living in the home has helped us to form the judgements we reached in this report. On the day of the inspection there were 13 people living in the home. We arrived at approximately 10am and finished at approximately 5.30pm. During the day we talked to the owners, Dr and Mrs Curry, 3 members of staff, and 6 people living in the home (we also spoke to others, but only briefly). We carried out a tour of the premises, checking all of the bedrooms, bathrooms, toilets, lounge and dining areas, the laundry, kitchen and office. We also looked at some of the records the home is required to maintain, including assessment documents, care plans and daily reports, medication administration, menus, health and safety records, staff recruitment, supervision and training records. What the service does well: The home takes good care to ensure that people do not move in unless they have carefully assessed their needs and are certain they can meet those needs. People are encouraged to visit and get to know the home, and are given written information to help them make an informed decision about where they want to live. There was a warm and happy atmosphere at the home. The people we talked to told us about the good care they receive from the staff. One person said “This home not only offers care and support but a priceless extra – REAL AFFECTION.” We looked at the way medicines are stored and administered in the home. We found the records were well maintained and there are good systems and The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 6 training in place to ensure that all aspects of medicine administration and storage are safe. The staff told us that they enjoy providing a variety of outings, activities and entertainments for the people living in the home. We saw notices telling people about forthcoming visits from entertainers and activities organisers. We also heard about outings, religious activities, and aromatherapy massages. On the day of this inspection quizzes, games and activities were provided by the staff both in the morning and in the afternoon. Staff were seen sitting and talking to people. The home provides a good variety of meals to suit all dietary needs and individual preferences. They try to make mealtimes a pleasurable occasion in various ways, including attractive presentation, attractive surroundings, and by offering a glass of sherry before the meal to make it a social occasion. People told us that they always enjoy the meals. Good systems are in place to make sure everyone in the home is safe and protected (as far as possible) from harm. Staff have received training on a range of health and safety and prevention of abuse topics, and they have been given policies and procedures on all relevant areas. Risk assessments have been carried out on all areas and preventative measures have been taken, including the provision of a wide range of safety equipment in order to reduce the risk of any foreseeable injuries. People told us they felt confident that they could talk to the owners, who live on the premises, if they ever had any concerns or complaints and felt certain that these would be dealt with quickly and appropriately. The home is clean, comfortable and homely throughout. People have been encouraged to bring items of furniture and personal effects to make their rooms feel homely. People told us their rooms are cleaned every day. Good systems are in place to minimise the risk of any possible spread of infection. There is a stable and well-trained staff team. The owners and staff work closely together to ensure all routines are carried out smoothly. The records we saw showed that good recruitment, induction and training procedures are in place. The home has already exceeded the recommended level of staff with a recognised qualification in care, and is working towards achieving 100 of staff with a qualification in the future. The staff we talked to were enthusiastic and happy in their work and talked about the good working relationships within the home. There are good systems of communication, including handover sessions between each shift, regular supervision sessions and staff meetings. What has improved since the last inspection? The care plans have been regularly reviewed in the last year to ensure that they are now always kept up-to-date. They now provide care staff with information about all current care needs, including any recent changes. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 7 The home has, in the past, attempted to care for people until the end of life even though their care needs have increased significantly. In the last year they have reviewed this policy and have recognised that people may need to be helped to find a more suitable home if their care needs are greater that the home’s staff are able to cope with. This has resulted in staff having more time to care for everyone, rather that focussing mainly on those who have very high care needs. Laundry systems have improved to ensure that people’s clothing is always washed, ironed and repaired promptly, and to ensure that people are always dressed in a manner that respects their dignity. Staff have receive a wide range of training in the last year, including training on dementia. They have also received instruction, supervision and monitoring to ensure that staff always treat people in a dignified and respectful manner. The home’s recording systems have improved and they now keep records of the amounts of fluids given to people who need assistance with feeding and drinking. This ensures that they now can be certain that people always have sufficient to drink each day. The call bell systems have been improved by providing sufficient extension leads where necessary around the home and by constantly checking that people who have poor mobility and may need to call for assistance can do so easily wherever they are in the home. 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, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s care needs are fully assessed before they move in to ensure the home is certain they will be able to meet those needs. People are given good information and opportunities to get to know the home, enabling them to make an informed choice about where they want to live. EVIDENCE: We asked people how they had chosen to live at The Manor House. Some told us that they knew about the home through personal recommendation or from other people already living at the home. Others said they had visited or had stayed at the home for a short holiday before deciding to move in. Some said their families had chosen the home for them. The majority said they had definitely made the right choice, although one person, while they were very The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 10 satisfied with the way they had been cared-for, said they still missed their own home and hoped to return there if possible. We were told that anyone who enquires about a possible vacancy is given a copy of the home’s brochure – this gives a wide range of information about the accommodation and services. They also have an internet website. The home told us about the careful process they always follow before agreeing to provide accommodation for anyone who is thinking about moving in. This includes visiting the person to find out their needs and expectations, and by encouraging the person to visit and get to know the people and the environment before any decision is made. The home uses a commercial care planning system that is widely used in many care homes to help them gather information about the person and to help them decide if they are able to meet the person’s care needs. We looked at the assessment documents of a person who had recently moved into the home and found that the home had obtained a wide range of information about the person and had used this to draw up an initial plan of their care needs. We were told that everyone has an up-to-date contract of residence. The home does not provide intermediate care. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at The Manor House can be confident that they will receive assistance with their personal and healthcare needs in a timely and sensitive manner by well-trained staff who respect their privacy, dignity and independence. Medicines are stored and administered safely. EVIDENCE: We looked at the care plans and other relevant records (including medicine administration records and accident reports) for four people living at the home. We also talked to these people about the way the home helps them with their care needs. We checked that the care plans were accurate and provided upto-date and relevant information to the care staff. The home uses a commercial care planning system that guides them to look at specific aspects of the person’s health and personal care needs including diet, The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 12 family and friends, social activities and preferred daily routine. We could see that the plans had been regularly reviewed and updated. Potential risks to health have been assessed and preventative measures have been taken where necessary. On the day of this inspection a District Nurse and a GP visited people in the home. We saw also saw records of visits to the home by District Nurses and GP’s and the treatment given. We were given examples of how the home closely liaises with local health and social care professionals to ensure individuals receive the best possible health screening, treatment and care. The information in the care plan documents has been used by the home to help them draw up a daily task list that is kept inside each person’s wardrobe. This list gives the care staff a brief but concise guide to the person’s preferred daily routine, and how they want to be assisted. The list is easy to follow and by keeping the list in the person’s room the person knows exactly what help they can expect to receive. We were told that care plans are developed with, and owned by, the person concerned. The home also told us that their key principle is to ensure that people are in control of their lives and that they direct the services. We talked to two care workers and the cook about how the way important information about care needs is shared with them. The care staff said there is a handover session at the start of each shift, and there is also a communication book that ensures they are always informed about any changes in care needs. The cook told how dietary needs are identified, and how everyone communicates where changes or adjustments are necessary (see also Daily Life and Social Activities). The care staff are expected to read the main care plans and to make daily reports to show that the care plans have been followed, and any changes. We talked to people about the help and equipment provided by the home to help them lead their lives the way they want to. The home has a good range of equipment including wheelchairs, hoists, and pressure relieving mattresses to help people move safely and to help them remain as comfortable and independent as possible. People told us about the way the owners and staff have helped them to find solutions to their mobility and health needs. We heard many positive comments from people about the care they receive. One person told us “This home not only offers care and support but a priceless extra – REAL AFFECTION.” The home uses a monitored dosage system for the administration of tablets. This is provided by a local pharmacy. All medicines are stored securely including medicines that need to be kept cool, and any controlled drugs administered by the home. We looked at the records of medicines received into the home and administered and found that they had been well maintained. We were told that staff follow safe procedures when prescribed medicines are administered. Stocks are checked weekly. We talked to care staff and saw training records to show that they have received a range of training on the The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 13 safe administration of medicines and their competency has been checked. The home has detailed policies and procedures in place covering all aspects of safe medicine administration. During the day we saw care staff knocking on doors and waiting for a reply before entering. We also saw care staff helping people in a discreet and sensitive manner. We talked to the owners and staff about how people’s privacy and dignity are maintained, including the way they make sure people’s clothing is cared for, and we heard about how the owners are constantly monitoring the way care is delivered to ensure this standard is met at all times. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Manor House has a lively and happy atmosphere where staff take a keen interest in people’s individual interests, likes and dislikes and try to make sure these are catered for at all times. People can be confident that their dietary needs will be fully met. EVIDENCE: The care plans we looked at identified the activities and interests people had before they moved into the home. We could see how the home had helped people to continue these where possible, including reading, knitting and following their chosen religion. On the day of this inspection people were involved in various activities, either individually or in groups. In the morning one person had an aromatherapy massage from a visiting professional. In the main lounge a group were involved in a quiz. A few people chose to remain in their rooms, some to watch television. There were notices on the lounge door letting people know about future musical entertainments booked with professional musicians. Once a week an activities organiser visits the home to provide a range of The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 15 activities and exercises. In the afternoon we saw staff organising further group activities including quizzes. We also saw staff sitting and talking to people. Once a month a Communion service is held in the home. The home told us they will help people to attend Church services if they wish. They have arranged for visits from different denominations of churches according to individual faiths. We looked at the garden and heard how people enjoy sitting outside in warmer weather. Pots had been planted by residents and spring flowers were bringing some early colour to the garden. We heard how people enjoy outings, either in groups using a minibus, or individually by car or by wheelchair into the town. The home is close to the shops and those people who have good mobility or means of transport can go out easily, although the home will provide advice and support if safety is an issue. People told us about how their friends and families are encouraged to visit. The staff always offer refreshment and make people feel welcomed. We also heard how the home helps people keep in touch with friends and family, and involves families (where appropriate) in the care of their loved-ones. People also told us about how the staff respect their right to live their lives as they wish. We heard examples of how staff provide help at the right times, enabling people to get up when they want, go to bed when they want, and to follow their preferred routines throughout the day. We talked to the cook about food and nutrition. Before a new person moves into the home the initial assessment covers details of their likes and dislikes and dietary needs. This information could be seen in the care plans and was also passed on to the cook who recorded it in a book kept in the kitchen. The cook told us that when the person moves in she goes and meets them to find out exactly how they like their meals and any special needs or preferences they have. We looked at the records kept of meals that have been provided over the last year and we could see that the menus have been balanced and varied, with plenty of alternatives to ensure individual likes and dislikes have been met. The owners told us that they try to make mealtimes pleasurable events, and offer a glass of sherry before lunch. The dining room was attractively decorated and tables were laid with pretty tablecloths. Although people were encouraged to eat in the dining room those who wanted to eat in their own rooms were able to do so. The cook told us that foods are puree’d separately for those people who have difficulty in swallowing. On the day of our visit we saw a member of staff sitting with a person who needed help with their meals. The member of staff was talking to the person, and was giving assistance in a sensitive and unhurried manner. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 16 The home maintains records of fluids given to people who need assistance to drink. This means they can monitor and be certain that people have been given sufficient fluids each day. A blackboard in the dining room showed the main meals for that day. People told us that they can always ask for an alternative if they do not like the main meal on offer. The people we talked to told us they were entirely happy with the standard of meals provided, and several people told us how much they enjoy the meals. The Environmental Health Officer inspected the kitchen in July 2007. We saw a copy of the report and saw that everything was found to be satisfactory at the time of their visit. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are protected from harm by robust policies and procedures and welltrained and supervised staff. People can feel confident that they can speak out if they have any concerns or complaints and these will be listened to and acted upon promptly and satisfactorily. EVIDENCE: The home told us “We have a strong belief that everyone has the right to complain without fear of retribution in any way. We feel that any complaints received can often have a positive effect in that they help us to improve our service. All service users receive a copy of our complaints procedure, it is also clearly displayed on two notice boards in the home.” Since the last inspection no complaints or concerns about the home have been received by the Commission. The home keeps a record of complaints, concerns and compliments but only compliments were recorded for the last year. We talked to people to find out what they would do if they had a complaint or a concern. They told us that the owners live on the premises and they see everyone in the home every day. People told us they felt completely confident that the owners would deal with any issues immediately they are brought to their attention. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 18 Records of staff training showed that all staff have received training on the protection of vulnerable adults and abuse awareness. The staff we talked to during our visit said there is a very open and supportive atmosphere within the home where poor practice is challenged, and staff feel able to speak up if they see something they feel concerned about. They gave examples of where issues had arisen and the owners have spoken to the member of staff concerned, and in some cases arranged additional training to help staff improve their practice. The home has a comprehensive range of policies and procedures covering all aspects of the care services, including the prevention of abuse. The policies have been regularly updated and are kept in the staffroom, ensuring that all staff have ready access to them whenever necessary. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a clean, safe, comfortable and homely environment. EVIDENCE: We carried out a tour of the home, checking every bedroom, toilet, bathroom, lounge and dining room. We also looked in the kitchen, laundry, office, staff room and garden. All areas of the home were found to be clean and free from odours, tidy, comfortable and homely. There is a pleasant enclosed patio area at the back of the home with raised beds, seating, fish pond and planted pots and tubs. Several people told us how they enjoy sitting outside in warmer weather. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 20 The owners live on the premises and work in the home each day. They told us that they keep a daily check on any repairs and maintenance needed and make sure these are carried out promptly. As bedrooms become vacant the rooms are usually redecorated and refurbished as necessary before a new person moves in. They told us they are planning to replace some of the furniture around the home in the coming year. All rooms are single occupancy. Approximately half of the rooms have en suite facilities, and the other rooms have toilets and bathrooms close by. People have been encouraged to bring furniture, picture and personal belongings to make their rooms feel like home. Most radiators have been covered to reduce the risk of accidental burns. Special taps have been fitted to prevent the risk of scalding. Lockable storage is provided in bedrooms so that people can keep cash or valuables safely if required. Since the last inspection the home has taken steps to ensure that the call bell system can be accessed by everyone. Extension leads have been fitted where necessary. During the day we heard call bells answered promptly by staff. The home has a range of equipment to help people move around safely including stair lifts, hoists, grab rails and poles, and wheelchairs. All staff have received training on moving and handling. The staff we talked to said that health and safety is given a very high priority in the home. If any equipment is needed in order to ensure staff help people to move safely it is provided immediately. At the time of this inspection the cleaner was on sick leave and the rest of the staff had covered this person’s duties. Despite these extra duties the staff had coped well and still remained relaxed and cheerful and had plenty of time to sit and talk or do activities with the people living in the home. Comments included “My room is cleaned every day.” The home told us they have a stringent infection control policy. Staff have received training on this subject. Protective gloves, aprons, hand washing facilities and hand gels are available around the home. We found that the laundry was in good working order and tidy. We heard that efficient procedures are followed to ensure that laundry is washed quickly and returned to the correct owner. Items that require ironing or mending are deal with by staff as necessary. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People receive all the help they require from a stable, competent and caring staff team. Good recruitment and training procedures are followed to ensure people are safeguarded from possible harm. EVIDENCE: On the day of this inspection both of he owners were on duty and in addition there were 3 care staff during the day until 6pm. In the evenings there are normally 2 care staff. The owners live on the premises and are on hand to provide extra cover at night if called. A cook is employed each morning until 2pm. A cleaner is usually on duty each morning but at the time of this inspection she was off sick. Two new staff have been recruited since the last inspection and we looked at their recruitment records to ensure good procedures were followed. We found that all necessary checks and references had been taken up before the staff were confirmed in post. These procedures ensured that the staff were entirely suitable, and that people living in the home were safeguarded from the risk of possible harm or abuse. Both staff had relevant previous experience and therefore did not require comprehensive induction, although the home provided induction on any areas necessary. We were shown evidence of the The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 22 full induction training standards that will be covered for any future new staff recruited who do not have suitable experience. The owners told us about how they embrace equality and diversity in their employment policies and procedures. They told us “All applications are considered regardless of age, gender, sexual orientation, race, religion or belief. We expect our staff to have good command of the English language in order to promote communication with service users, staff and visitors to the home.” At the time of our visit 12 staff were employed. Of these, 8 already hold a nationally recognised qualification known as NVQ’s. The remaining 4 staff were in the process of obtaining these qualifications. (The Commission recommends that at least 50 of staff hold a relevant qualification – the home has already well exceeded this target.) We looked at the records of training staff have received. Individual certificates are held in staff files, and the owners have a computer record of the dates and topics of training for each member of staff. Topics covered included catheter care, diabetes, infection control, pressure sores, dementia, wound management, safe administration of medicines. We talked to three members of staff about their experience of working in the home. We found that there is a happy and supportive atmosphere where staff enjoy their work and take a pride in providing a good standard of care. The staff were positive about training and recognised the benefits of the training they had received. They talked about the good systems of communication in the home. There is a handover session before each new shift begins. All staff are given free meals when they are on duty and staff normally sit together at meal times. There is a communication book giving details of important daily events. They have regular individual supervision sessions and also regular staff meetings. The people we talked to who live in the home praised the staff team. They told us there are always plenty of staff and they never have to wait long if they ask for assistance. They told us the staff are always helpful, kind and willing to help. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed. People can be confident that the standard of services are constantly monitored and improved through a wide range of quality monitoring methods. Good measures have been taken to reduce the risk of accidents, injuries, harm or abuse. EVIDENCE: Both of the owners have completed the Registered Managers’ Award. Mrs Curry is a registered nurse and an NVQ assessor. They have run The Manor House for 12 years. They told us about some of their principles of good management The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 24 “We both believe that in order to provide a good standard of care we and our staff should always strive to work to national and internal standards, policies and procedures. We recognize that staff need expert training in order to be competent and confident in giving care and have rigorous selection, induction and ongoing training policies and procedures in place. We recognize that no one is perfect and that mistakes can be made. We have a philosophy that if a mistake is made, it is reported to anyone that needs to know (eg service user, relatives, doctor, registration officer) it is then investigated so that procedures can be put in place to try to prevent it occurring again.” In the last year the owners have looked closely at the quality of the services they provide and how these can be improved. They have sent our questionnaires to the people living in the home, and to relatives, visitors and health professionals in order to seek their views. These were available to be seen during our visit. They have also looked at all areas of the home and the services they provide to make sure they can prove to people that their service offers good value for money. They have plans in place for the areas they want to improve in the next year. During our visit we looked at the way the home handles money on behalf of four people who do not want to, or are unable to hold cash for daily purchases. Wherever possible people are encouraged to look after their own cash but in a few cases the home holds cash for people. We saw that records have been well maintained and, where possible, the person or their relative or representative has signed the records to agree the transaction and the balances held. Receipts have been kept where possible. We looked at the records they are required to maintain in respect of health and safety within the home. The fire log book showed us that all routine checks, maintenance and training have been carried out at regular intervals. We saw invoices of maintenance contracts for all equipment in the home to show that all equipment has been regularly serviced. The accident book has been completed satisfactorily and the owners have taken any action necessary to prevent similar further accidents occurring. We saw a copy of the homes’ health and safety policies and procedures. All staff have been given their own copies of these policies and they have been asked to sign a document to confirm they have received the policies. The owners told us they recognise the importance of keeping up-to-date with current good practice and do this by attending courses, reading articles, talking to and taking advice from other professionals. They also keep a regular watch on changes in national policies through the internet. The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 4 3 3 X 3 X x X 3 STAFFING Standard No Score 27 4 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 4 x 3 x x 3 The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations The Manor House, Seaton DS0000022063.V356991.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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