CARE HOMES FOR OLDER PEOPLE
The Manor House, Seaton Fore Street Seaton Devon EX12 2AD Lead Inspector
Teresa Anderson Unannounced Inspection 10:00 3 January 2006
rd 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.V264795.R01.S.doc Version 5.0 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.V264795.R01.S.doc Version 5.0 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 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.V264795.R01.S.doc Version 5.0 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. 16th August 2005 Date of last inspection 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, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two and a half hours as part of the normal programme of inspection. This is the second of two statutory inspections this year and as such, this report should be read in conjunction with the report dated 16th August 2005. During this inspection the majority of the bedrooms and all of the communal areas were seen, and records in relation to medication were inspected. The inspector spoke with approximately eight of the fifteen residents, four of whom were spoken with in some depth. She also spoke with two members of staff and with the owners. What the service does well: What has improved since the last inspection?
At the last inspection, no requirements or recommendations were made for improvements to be made. However the owners, with the help of the local pharmacy, have introduced a new system for managing medication which is considered safer. The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 Page 6 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, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 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 the following standard(s): This standard was inspected and met at the inspection in August. EVIDENCE: The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 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 the following standard(s): 9 Minor improvements to the procedures for recording medication would enhance the safe administration of medications and therefore the safety of residents. EVIDENCE: The system for managing medication has recently been changed. The system introduced is a monitored dosage system that is designed to lessen or remove the margin of error. Staff are trained in the safe administration of medication and one member of staff confirmed that she does not administer medication as she has not received this training. Records are up to date and accurate. Some residents had been prescribed medication which had been hand written onto the administration sheets. These were not signed by two members of staff as is good practice. Medicines are stored safely. Residents said they get their medications on time. The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12 and 14. Residents’ benefit from varied organised and spontaneous activities, and from an ethos that promotes their rights to have control over their own lives. EVIDENCE: Residents who could remember said that they were offered activities such as bingo and quizzes. Some talked of going out and the majority talked of the number of different carol singing groups who had come to the home over the Christmas period. Some residents said that they prefer not to join in but like to read books, work on puzzle books or watch the world go by. Some residents could not remember being involved in any activities but said they were happy. Records and discussions with staff demonstrated that these residents are offered opportunities or do join in activities. Residents also benefit from one to one interactions with staff. Those residents who have dementia type illnesses are positioned so that they can see what is happening in the home, are offered activities and have easy access to staff who demonstrated that they are generally skilled and patient with people who have memory problems. Newspapers are scattered around the living room and books are freely accessible. Residents are invited to take part in physical exercises each Monday afternoon. Residents said they spend their days doing what they like. Some spend time in their bedrooms, other divide their time between their own rooms and the
The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 Page 11 sitting room. They choose what they wear and what to eat. One resident who has advancing dementia has been supported to remain at the home and in her current bedroom as staff and relatives feel this is what she would have wanted. The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 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 the following standard(s): 16 The home has a good complaints system. However, evidence that resident’s views are listened to and acted upon could be improved. EVIDENCE: During this inspection one resident told the inspector of complaints she had made to the male owner regarding another resident. The concerns raised have been ongoing for some time, but remain an issue for this resident. This matter was discussed with the owners who confirmed that one resident had raised concerns in regard to another resident who has advanced dementia. He described the conversations he has had and the actions he has taken. His primary driver has been to ensure that the rights of each resident are upheld. The inspector recommended that these complaints and the concerns raised together with any actions taken and the rationale behind decision-making be clearly documented. The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 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 the following standard(s): 24 and 25 The standard of the environment at this home is good, providing residents with a comfortable, homely, clean and safe place to live and bedrooms that are personal to the occupant. EVIDENCE: The Manor House is well maintained and clean throughout. The furnishings are comfortable and suitable for people with mobility problems. There are two lounges, although residents tend to use one. In addition there is a dining room/area. The outside areas are well and attractively maintained and obviously enjoyed by residents who like to sit by the patio doors looking out into the garden and watching the antics of the housedog. Radiators are covered to prevent accidental scalding. Bath water was checked and found to be hot but not scalding. One resident who was asked said that her bath water was always hot enough. Many residents talked of how they like their bedrooms, which are personalised for them.
The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were inspected and met at the last inspection. EVIDENCE: The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 Small improvements to the fire safety system could further promote residents safety. EVIDENCE: This standard was not inspected by CSCI. However, a recent visit by the fire officer identified a number of small issues which require attention. The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 Page 16 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 x x x x x x 3 3 x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 2 The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 Page 17 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 OP38 Regulation 22 (4) Requirement The registered person must, after consultation with the fire authority, take adequate precautions against the risk of fire. Timescale for action 28/02/06 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 OP9 OP16 Good Practice Recommendations The registered person should ensure that hand written entries on medication sheets are signed by two people. The registered person should ensure that a record is kept of all complaints made and includes details of investigation and any action taken. The Manor House, Seaton DS0000022063.V264795.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Exeter 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
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