Inspection on 28/02/09 for The Manse Residential Home

This inspection was carried out on 28th February 2009.

CSCI found this care home to be providing an Good 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

Similar services:

Abbey The

Snydale Care Home

Hawkhills

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Beeches The - North Yorkshire County Council

The Grove Waltham

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Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for older people Name: Address: The Manse Residential Home The Manse Residential Home Ropewalk Knottingley Pontefract West Yorkshire WF11 9AL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Stephen Robertshaw     Date: 2 8 0 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: The Manse Residential Home The Manse Residential Home Ropewalk Knottingley Pontefract West Yorkshire WF11 9AL 01977677955 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sarah Jane Slack Name of registered manager (if applicable) Deborah Milton Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 16 16 Over 65 0 0 Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The site visit to the service took place on the 28th February 2009. The visit was unannounced and the Commission were at the home for approximately six hours. The information in this report was also supported by the homes Annual quality Assurance Assessment and interviews with the people that use the service and the care staff and management working at the home. This report has been delayed due to technical problems with the Commissions IT equipment. At the time of the site visit the service was rated as a 2* star good service. Care Homes for Older People Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 6 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 7 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that the people that use the service can be confident that The Manse can support them. This is because they have had a clear assessment of their needs completed before they made a decision to live at the home. Evidence: The Commission spoke with people that use the service and with the care workers and management that work at the home. All of these discussions supported the evidence that the care home can meet and support all of the personal and accommodation needs of the people that use the service. We case tracked two of the people that use the services of the home. This included Care Homes for Older People Page 8 of 24 Evidence: looking at all of the information that was recorded about their care at the home. Both of their care files included the homes pre-admission assessment of need an an assessment of need that had been completed by the funding care management teams. The care management assessments were very basic and therefor did not give clear indications of how the hoes care plans should develop to support the needs of the individuals that they involved. The manager of the home confirmed to the Commission that no one is admitted to the home until a full needs assessment has been undertaken by the home. This is to make sure that the home has the range of skills and knowledge to be able to deliver care and supported to the people that are requesting it. Staff training records also supported the evidence that the home has the capacity to meet the needs of the people that use the service. One person said to the Commission Its great here, I am well looked after and dont need anything else. The service does not accept new admissions to people that have intermediate care needs. Care Homes for Older People Page 9 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that the health, personal and social care needs of the people that use the service can be supported by staff at the home, and their needs are clearly recorded in a plan of care. Evidence: As part of the inspection the Commission looked at all of the care plans for two of the people that use the services of the home. These all included clear information in relation to the personal and health care needs of the people that they involved. This included specialist health and dietary requirements of each person. The care plans contained information that related to individuals social, personal, mental and psychological care needs. There was evidence to support that the care plans in the home had improved since the last inspection and now were based on a more person centered approach to care. This means that the people that use the service are more Care Homes for Older People Page 10 of 24 Evidence: likely to have their needs met in a way that is acceptable to them and in a way that they had agreed to. Individual care files showed that the people that use the service are registered with a GP and the records also provided evidence of the involvement of other health care workers supporting their needs at the home and the records confirmed this. This included people having access to hearing and sight tests, chiropody and dental treatments. The homes medication systems were up to date and were accurately recorded. The home is moving to a new provider for their medication towards the end of June 2009. The new provider has given the home a new medication fridge and a new medication trolley. A photograph of each person that is prescribed medication is held with their medication record sheets. This is good practice and helps to make sure that the right person receives the correct prescribed medication for them. The home has clear arrangement for the security of prescribed controlled medication. The Commission observed people being supported to take their prescribed medication and all good practice and legal guidelines were adhered to, while at the same time maintaining the dignity and respect of the people that were receiving the medication. One person said I cant remember when to take my medicine that is the staff give it to me. Direct observations supported the evidence that the atmosphere in the home was very relaxed and there were good interactions between the people that use the service, their peers the care staff and management of the service. The staff interactions with the people that live at the home were seen to be very attentive and were positive. The relationship between the care staff individuals in the home were very good and all of the people seemed to have the confidence to talk and joke with the staff. One person said the girls are very busy, but they always have time for you. Care Homes for Older People Page 11 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that people that use the service and encouraged and supported to develop and maintain their personal lifestyles while living at the home. Evidence: Direct observation carried out by the Commission showed that activities are made available to people that use the service. The activities are advertised on the homes notice boards and the staff staff were observed asking people if they wanted to be involved in any activities. One person said Ive come in here for a rest I dont want any activities. Another person said Id like to do a little bit more but the staff are too busy and you dont want to disturb them. People living at the home are supported and encouraged to have their families and friends visit them at any reasonable time. One visitor told us I am always made welcome and it is always friendly here. The staff work very hard but nothing is ever too much for them. Care Homes for Older People Page 12 of 24 Evidence: Care staff working at the home said that people are supported to maintain contact with their families and friends that live outside of the home. The menus for the home were observed by the Commission and seen to be varied, balanced, nutritional and provided a choice. of food. We ate lunch with some of the people that use the service and observed other people being supported with their meals. The meals were well presented and people were offered support in a manner that was respectfully and supported the persons dignity. The kitchen area of the home was clean, tidy was well organized. Care Homes for Older People Page 13 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that us the service are protected from abusive situations. Evidence: The home has a clear complaints policy and procedure. This is clearly written and is easy to understand. The manager of the service confirmed that the service had not received any formal complaints since the last inspection. All of the people spoken to by the Commission knew how to make a complaint if they wanted to, however they all said that the need has not arisen yet. One person said the girls are sometimes too busy, I wouldnt complain about this as some times they may be busy with me making them slower to other people. The policies and procedures for Safeguarding Adults were observed and the care staff that were interviewed had an understanding of their roles and responsibility in relation to the safeguarding of the people in their care. |they were also aware of the policies and procedures for reporting suspicions of abuse. Staff training records also showed that they receive safeguarding audits training. Care Homes for Older People Page 14 of 24 Evidence: Staff stated to us that they understood what would constitute a concern in relation to safeguarding adults. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that the environment of the home creates a homely atmosphere for the people that use the service. Peoples individual rooms are personalised, comfortable and safe for people to use. Evidence: As part of this inspection the Commission visited the home and looked around the environment. The home was found to be well maintained and was suitable to meet the needs of the people that use the service. Some extensive work has recently been undertaken at the home. This included the fitting of new fire doors in the upstairs area of the home, fitting a new and more responsive call bell system that allows for a more appropriate and quicker response from the care staff. The adaptations in the home also include the creation of several large storage areas. This means that stocks of equipment including wheelchairs can be safely stored and do not create trip hazards around the home. The upstairs area of the home was been divided in to two halves following advise from the fire department. This area has completely been re-wired and as well as the Care Homes for Older People Page 16 of 24 Evidence: emergency lighting a new system of night lights have been fitted to the corridors. It is hoped that this subdued lighting will cause less problems for the people that use the service when they are asleep. The manager stated that it motion detectors are going to be fitted to all of the bedrooms. These can be switched on and off and will only be used to safeguard people that may be prone to falls or slips in their bedrooms. Interview with the manager of the home identified that people that use the service are encouraged to personalise their bedrooms to their own tastes and preferences.the Commission were invited by three people that use the service to look at their rooms. These had all been personalised and very very clean and tidy. One person said Ive got all my things here in my wardrobe and my pictures on the walls. There is a choice of communal areas in the home provide and these were well decorated and provided a homely atmosphere. The bathrooms and toilets were very clean and tidy. There were no offensive smells in the home. One bathroom had recently been used and a block of soap and linen towels had been left in the area. This could cause a cross infection problem. When made aware of this the staff immediately cleared the items form the bathroom. One person that spoke to the Commission said the home is always very clean and comfortable. Laundry facilities are positioned so that soiled articles, clothing and infected linen are not carried through areas where food is stored, prepared, cooked or eaten. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that the care staff receive the correct training and supervision to keep people safe and make sure that the care staff are appropriate and are suitable to care for them Evidence: The Commission looked at the information in the home that related to three of the people that work at the home.Their records showed that their recruitment procedure was based on equal opportunities and appropriate safety checks were undertaken before they were employed to have contact with the people that use the service. The homes staff rotas show how the home is staffed. This shows particular attention being given to busy times of the day. People that use the service said that the staff were always very busy. One person said the staff are very friendly and help you as much as they can. Staff training records showed that the training they received was based on delivering Care Homes for Older People Page 18 of 24 Evidence: good quality outcomes for the people that use the service. This was evidence was confirmed to the Commission through our interviews with the care staff and the management of the home. Staff training included all of the mandatory areas such as health and safety, fire safety, movement and handling, safeguarding adults and food hygiene. They also receive training in relation to the specific needs of the people that use the service including dementia care. The staff records show that induction procedures are in place and that new staff receive the new induction in common standards in line with the Skills for Care Council. The staff training records also identified that National Vocational Qualification (NVQ) training is undertaken by the care staff. 72 of the care staff have achieved at least a minimum of NVQ 2 in care. The manager of the service stated that some of the staff are now enrolled on NVQ3 in care. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The service is well led and is managed appropriately. This means that the people that use the service can be confident that the home works in their best interests and promotes their health, safety and personal welfare. Evidence: The Manager of the home has been in position since 1999 and has completed a National Vocational Qualification 4 in care. She also has qualifications in supervisory management and small business management. The owners of the service visit the home on a daily basis to offer support to the manager and the care staff that work at the home. One of the proprietors has also been responsible for all of the recent adaptations to the home and its facilities. Care Homes for Older People Page 20 of 24 Evidence: The records in the home showed that the staff undertake routine health and safety checks around the home. This was also confirmed to the Commission by the manager of the home. This included regular temperature checks on th hot water outlets to help to protect the health and safety of all of the people that live or work at the home. There was some evidence to show that the home has a quality assurance and quality monitoring system which is based on the views of people that use the service and their families. This needs to be expanded to get a wider range of views including how other outside professionals view the services that are provided by the home. This will help to identify any areas of service that need improving or identify good practice that needs to be supported. Staff records show that the care staff receive formal recorded supervision. However they did not receive the minimum amount of recorded supervision since the last inspection. The care staff and management confirmed this in their interviews with the Commission and both said that although the formal supervision was as regular as it should be informal supervision was always available and happening. Staff spoken to by the Commission were aware of the areas that their supervision should cover. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 The registered person should try to obtain clearer assessment information from the contracting authority to make sure that the home can safely care for the prospective new users of the service. The registered person should make sure that blocks of soap and linen towels are not left in bathrooms. This will help to prevent cross infection and support the health and safety of the people that use the service The registered person should make sure that a wide range of people are consulted for their quality assurance programme. This will help to identify any areas of service that need to be improved to create more positive outcomes for the people that use the service. The registered person should make sure that all of the staff working in the home receive the recommended minimum of six formal recorded supervision periods per year (pro-rata). This will help to make sure that the staff have all of the necessary knowledge and skills to care for the people that are living at the home. 2 21 3 33 4 36 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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