Inspection on 27/06/07 for Tuxford Manor Care Home

This inspection was carried out on 27th June 2007.

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

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

Other inspections for this house

Tuxford Manor Care Home 11/07/06

Tuxford Manor Care Home 21/11/05

Tuxford Manor Care Home 13/06/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Tuxford Manor Care Home 143 Lincoln Road Tuxford Newark Nottinghamshire NG22 0JQ Lead Inspector Steve Keeling Key Unannounced Inspection 27th June 2007 09:00 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 Tuxford Manor Care Home DS0000063842.V340249.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. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tuxford Manor Care Home Address 143 Lincoln Road Tuxford Newark Nottinghamshire NG22 0JQ 01777 872555 01777 872666 linda.sumner@hallmarkhealthcare.co.uk 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) Hallmark Healthcare (Tuxford) Ltd Mrs Linda Sumner Care Home 45 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (19) of places Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users shall be within categories OP (19) or DE/E (26) within a total registration of 45 11th July 2006 Date of last inspection Brief Description of the Service: Tuxford Manor Residential Care Home is a 45- bedded home that provides long term, short term and respite care to ladies and gentlemen requiring residential and dementia care. The home is situated on the outskirts of the town, close to a local public house although transport would be required to access the nearby shopping areas. The accommodation is provided on two floors with a passenger lift to enable easy access for people with restricted mobility. All ground floor and garden areas have level access. The facilities within Tuxford Manor are suitable to achieving independence for the residents at the home. Wheelchairs access is available all areas within the home, appropriate mobility aids are available such as hoists, transfer belts and strategically placed hand rails. The provider makes the statement of purpose and service users guide available to all residents or their representatives. Which provides comprehensive information relating to the facilities at the home. A copy of the last report from Commission of Social Care Inspection (CSCI) is also available in the foyer of the home. The minimum fees charged are currently £380 and the maximum are £425 per week. There is an extra charge for hairdressing and podiatry services. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One inspector conducted the unannounced visit. The main method of inspection used was called ‘case tracking’ which involved selecting two residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The deputy manager, two members of staff and a visitor to the home were spoken to as part of this visit. Documents were read as part of this visit and medication management was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken which included a sample of bedrooms to make sure that the environment is safe and homely. A review of all the information we have received about the home since the last inspection was considered in planning this visit and this helped decide what areas were looked at. A range of additional information was used to determine the outcome of this visit, which includes information received from residents and relatives in response to pre-inspection questionnaires and information provided by the registered provider within Annual Quality Assurance Assessment (AQAA), which was completed on the 18th May 2007. As part of the inspection process, the conditions of registration were reviewed with manager and the issuing of new certificate will be followed up by the Centralised Registration Team at CSCI to change the registration certificate to OP (45) DE (45) with no age restrictions, in line with the new guidance of conditions of registration. What the service does well: Information relating to Tuxford Manor is contained within the Service Users Guide (SUG), which provides up to date, comprehensive information relating to the service. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 6 A pre-admittance assessment process is performed to make sure the needs of residents can be identified and met. Care planning addresses the identified needs of the residents. Medication management is effective in promoting the residents safety and residents are afforded appropriate levels of respect, privacy and dignity. Residents have opportunities to access the local community and to maintain their links with family and friends. Routines are flexible and residents are given choices in their lifestyle and social activities. Residents also benefit from a varied menu. Complaints and concerns are effectively managed. Residents benefit from a safe, well-maintained environment which is a pleasant, comfortable and clean throughout. Resident’s needs are met by the number of staff employed at the home. Staff recruitment practices are effective in promoting the residents safety, and staff have received training to safely perform their duties. Residents live in a home, which is run and managed by a person who is fit to be in charge and residents’ financial interests are safeguarded. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 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 Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information relating Tuxford Manor is contained within the Service Users Guide (SUG), which provides up to date, comprehensive information relating to the service. People have assessments performed prior to moving into the home, to make sure their needs can be met. Residents are provided with the opportunity to visit the home if they wish. EVIDENCE: The resident’s pre inspection survey asked residents, “did you receive enough information about this home before you moved in, so you could deicide if it was the right place for you?” 80 of the responses received by the CSCI stated, “yes”. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 9 A service users guide is available to all potential residents or their family and friends. The guide is comprehensive and clearly sets out the objectives and philosophy of the service, the qualifications and experience of staff, and information relating to how to make a complaint. Comments made within the residents survey said “the manager and a care assistant came to my house and discussed everything with me, which was a very nice thing to do”. Records showed that need assessments are performed prior to people gaining residency, which identifies physical, psychological, social and cultural needs and preferences. Additional professional assessments are also used when available, which includes assessments from Social Services departments. Intermediate care services are not provides at Forest Manor Nursing Home Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 10 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. Resident’s health care needs are recorded and resident’s needs are met. Medication is well managed and residents are afforded appropriate levels of privacy and dignity. EVIDENCE: The pre inspection survey asked residents “do you receive the care and support you need?” 60 of the responses received by the CSCI stated, “yes”, with 20 stating “usually” and 20 stating “sometimes”. Records showed that care plans are developed to address the identified needs of the residents and are re-evaluated on a monthly basis. Staff are encouraged to report any concerns or developments to the senior staff, to ensure the residents care plans are up to date. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 11 Residents or their relatives are involved in the formation of care plans, and have signed consent to the content of the plans. Residents have access to the District Nursing team, General Practitioners and Chiropodists and residents spoken confirmed that that staff at the home always responded quickly to requests to see general practitioners. A senior carer responsible for the administration of medicines was observed to administer medication in a safe manner and she confirmed has received training in medication management. Medication, which requires refrigeration, was stored within a secure fridge in the medication room and the temperature within the refrigerator is maintained within acceptable parameters. The resident’s pre inspection survey asked residents “do staff listen and act on what you say?” 80 of the responses received by the CSCI stated, “yes”. A resident spoken with said, “The staff are wonderful and caring, my respect and dignity is always promoted, staff respect my wishes and I can spend the days as I please. I can retire to bed when I wish and get up when I want to, I have no concerns at all”. Two visitors confirmed that the staff are welcoming and respectful at all times, and that they had never witnessed anything that gives them concern. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. Residents have the opportunity and choice to participate in social activities and are encouraged to maintain appropriate personal relationships within the home and within the broader community. Residents benefit from the provision of an appealing balanced diet and are able to have snacks and drinks as they wish. EVIDENCE: The pre inspection survey asked residents “ are activities provided at the home which you can take part in?” 20 of the responses received by the CSCI stated, “always”. 20 said usually and 60 said sometimes. A Social Activities Coordinator (SAC) is employed, five afternoons per week, Monday to Friday. She said that social activities such as painting, card Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 13 making, dominoes, and board games are provided at the home together with religious services, which are also provided on a bi-monthly basis. Residents also said that the activities take place within the home but raised concerns in relation to the lack of trips out. Information provided within the Annual Quality Assurance Assessment highlighted the shortfall and it was recorded that the trips out will be improved. The deputy manager said that an open door policy is promoted at the home to encourage friends and relatives to visit the home. Two visitors to the home confirmed this. The pre inspection survey asked residents “ do you like the meals at the home?” 40 of the responses received by the CSCI stated, “always”, 40 said “usually” and 20 said “sometimes”. Residents said “the food is fantastic and lots available” and “a choice is always available and I always enjoy the meals, its something to look forward to”. We observed that the meals were well presented and balanced. The care staff assisted residents who require assistance to eat in a respectful manner. The dining area was clean and smelt fresh and a menu is displayed in the dining room to aid the resident’s choice. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are effectively managed and staff have received appropriate training in relation to the Safeguarding Adults. EVIDENCE: The pre inspection survey asked residents “do you know how to make a complaint?” 100 of the responses received by the CSCI stated, “yes”. The survey also asked residents “do staff listen and act on what you say?” 80 of the responses received by the CSCI stated, “yes”. A complaints procedure is on display in the foyer of the home and residents or their representatives are given the complaints procedure within the service users guide. A case tracked resident stated “ I would make a complaint to the manager but I have nothing to complain about”. Residents spoken with said they felt safe in the home and that the staff are receptive to their needs and wishes. Visitors to the home also said that they felt confident that should they highlight and concerns to the manager she would deal with them straight away. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 15 The manager was not investigating any complaints at the time of the visit and CSCI has not received any complaints relating to the service provision at the home since the last unannounced visit. The complaints file was examined and showed that two minor complaints had been made to the manager since the last inspection, both of which had been documented with actions and outcomes to resolve recorded. Training records showed that staff have received training in relation to the Safeguarding Adults and staff spoken with were able to confirm this. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 16 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): 19-26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a safe, well-maintained environment, which is pleasant, comfortable and clean throughout. EVIDENCE: The pre inspection survey asked residents “ is the home fresh and clean?” 100 of the responses received by the CSCI stated, “yes”. The homes internal environment, which included the dining room and the lounge area, is clean and fresh throughout. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 17 Resident’s bedrooms are well maintained, clean and fresh. Window restrictors and radiator guards are evident throughout the home to promote the safety of residents. Residents are very satisfied with the standard of cleanliness in the home and confirmed that their bedrooms are cleaned on a daily basis as are the communal areas. Domestic staff confirmed that cleaning products and equipment is plentiful, which includes industrial carpet cleaning equipment. A well-maintained, secure garden area is available for residents use in the summer months. The garden area is accessible to residents with impaired mobility and the area has a range of garden furniture. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by the number of staff employed at the home and staff have received appropriate training. Recruitment practices are effective in ensuring the safety of residents. EVIDENCE: The pre inspection survey asked residents “ do you receive the care and support you need, 60 of the responses received by the CSCI stated “always”, 20 said usually and 20 said sometimes. Residents spoken with said, “The staff are always present and respond to nurse buttons very quickly, there always appears to be enough staff on duty” and “they work hard and staff are always available when I need them”. The records showed that members of staff only commence employment once satisfactory Protection of Vulnerable Adult (POVA) checks and Criminal Record Bureau (CRB) checks have been obtained, together with two satisfactory references. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 19 The service has achieved the target of 50 of staff trained to NVQ National Vocational Qualification two and above to ensure a suitably qualified workforce is employed at the home. A staff-training programme is provided in relation to Moving and Handling, Basic Food Hygiene, Safeguarding of the Vulnerable Adult, Health and Safety, the Control of Substances Hazardous to Health (COSHH), Infection Control and Dementia Care. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 20 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): 31-33-35-38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run and managed by a person who is fit to be in charge. Residents’ financial interests are safeguarded and the health, safety and welfare of residents is promoted. Further development is required to ensure residents can contribute to developments within the home. EVIDENCE: A visitor stated, “I have no concerns, the manager is very good, I feel confident that she is doing a good job”. A resident said, “the manager is very good and runs the home well”. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 21 A member of staff said that she felt supported and valued by the manager and said, “ I have no concerns at all, the manager is doing a fantastic job, supportive, approachable and professional”. Policies and procedures are readily accessible to staff and information within the policies and procedures is updated appropriately. Quality assurance auditing procedures are performed to ensure that any areas of concern is identified and addressed. Staff meetings are performed on a monthly basis and the content of the staff meetings is documented. Staff supervision is performed on a bi-monthly basis by the manager or the deputy manager, to ensure that staff have the opportunity to discuss any issues of concerns relating to the service. Resident’s money is individually stored within a secure area. All transactions are recorded and receipts are obtained to ensure that residents are protected from financial abuse. The ability of residents to contribute to developments within the home is not fully encouraged. A residents and relatives meeting was last performed on the 23rd February 2007 and the event was very poorly attended. A resident confirmed that he attended the event and confirmed the poor attendance. Resident’s health safety and wellbeing is promoted by the provision of effective routine maintenance, maintenance documentation is well presented and easily accessible. Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 22 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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 3 x 3 Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 23 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. 1 Refer to Standard OP12 Good Practice Recommendations The social activities program should be further developed to provide residents with the opportunity to participate in organised trips beyond the homes immediate environment. The resident’s consultation process should be further developed to demonstrate that the resident’s views and opinions are taken into consideration in relation to any developments within the home. 2 OP33 Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. Extracts may not be used or reproduced without the express permission of CSCI Tuxford Manor Care Home DS0000063842.V340249.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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