Inspection on 23/10/06 for Walkden Manor

This inspection was carried out on 23rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Walkden Manor 18/02/09

Walkden Manor 15/01/08

Walkden Manor 03/07/07

Walkden Manor 26/02/06

Walkden Manor 12/05/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Walkden Manor 41 Manchester Road Walkden Worsley Gtr Manchester M28 3WS Lead Inspector Sue Jennings Unannounced Inspection 10:00 23 October 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 Walkden Manor DS0000062619.V306190.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. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walkden Manor Address 41 Manchester Road Walkden Worsley Gtr Manchester M28 3WS 0161 790 9951 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) Walkden Manor Care Home Ltd Mrs Sonia Jane Duffy Care Home 29 Category(ies) of Dementia (2), Old age, not falling within any registration, with number other category (29) of places Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 29 older people (OP) requiring personal care only may be accommodated. Within the overall numbers two (2) service users who are currently accommodated are under the age of 65 and also have dementia (DE). If these service users leave the category will revert to OP. When either of the service users reach the age of 65 the category will be OP (DE). 26th February 2006 Date of last inspection Brief Description of the Service: Walkden Manor is a residential care home situated in the centre of Walkden, Salford. The home provides personal care only to people over the age of 65 years. Bedrooms are situated on the ground and first floor of the accommodation with the laundry, office and main kitchen located in the basement. There is a large flagged patio area to the rear of the home and a small car park situated at the side of the building. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was undertaken as part of a key inspection, which includes an analysis of any information received by the Commission for Social Care Inspection (CSCI), in relation to this home prior to the site visit. The site visit was unannounced and took place over the course of 6.5 hours on Tuesday 23rd October 2006. During the course of the site visit time was spent talking to the area manager, 4 of the residents and 4 members of care staff to find out their views of the home. Time was spent examining records, documents, residents and staff files. A tour of the building was also conducted. During this inspection one of the requirements from the previous inspection had been addressed and there was evidence that this home was working towards developing the service and meeting the National Minimum Standards. During this inspection the key National Minimum Standards were assessed. What the service does well: What has improved since the last inspection? What they could do better: All staff should receive training in Adult Protection procedures. Care plans must be more appropriately stored. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Walkden Manor DS0000062619.V306190.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 Walkden Manor DS0000062619.V306190.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 at least once during a 12 month period. 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. Residents’ care needs are assessed before they are admitted to the home. Information is available to help service users make an informed choice to move into the home. EVIDENCE: A copy of the home’s Statement of Purpose and Service User Guide was available in the home. These gave relevant information about the home to any person considering living there. Each resident was provided with a statement of terms and conditions outlining the costs for living in the home. A copy of this document was seen in the foyer of the home and was accessible to both residents and visitors. Four residents’ care plans were examined they were found to contain a preadmission assessment and included information that would support care staff to develop an appropriate care plan. Walkden Manor does not offer intermediate care facilities. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 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): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the health and personal care needs of the residents were being met at the home. EVIDENCE: Each care plan examined was found to contain an up to date photograph of the resident for easy identification. The plans of care should be more detailed and clearly set out the action that needs to be taken by staff to ensure that all aspects of health, personal and social care needs of the residents were met. The residents’ care plans included risk assessments. The commission had received some concerns from the district nurses about the moving and handling techniques used for one resident and this was discussed with the area manager. The care plan identified that the resident cannot mobilise and then stated that they use a walking frame. It also stated that a hoist must be used at all times with two staff. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 10 Care plans and risk assessments should include information relating to all aspects of services users’ lives and identify the most appropriate way support is to be given and identify the preferred choices of the individuals. Copies of Moving and Handling certificates were seen on some staff files. However, these were over twelve months old. To make sure staff are up to date with current moving and handling techniques and to reduce the risks to residents. A requirement is made relating to staff training under standard 30 in this report. One care plan also identified that the resident was at high risk of developing pressure areas but there was nothing recorded in the daily records to evidence that skin viability is checked on a regular basis. One care plan stated that a resident was unable to communicate and that staff must watch for body language. However there was no detail given about what staff should be looking for and what this means for the resident. It is acknowledged that the home was in the process of introducing a new care plan format and this is gradually being introduced. The care plans will be examined again at the next site visit. The care plans were stored in an unsecured moulded plastic trolley that fell apart when moved. The trolley was stored under a desk in the ‘work station’ on the ground floor corridor and accessible to everyone. The care plans must be more appropriately stored to ensure information held about residents is secure. Each resident had a ‘daily record sheet’ in their care plan that is completed by staff. Entries in the daily reports should be more detailed to fully reflect the care given to residents over the 24-hour period. This is to make sure there is continuity of care for residents. Medication at the home was administered from a Blister pack monitored dosage system. Guidance on when (PRN) medication should be given needs to be included in the care plan. This should provide staff with details of why medication is prescribed and in what circumstances and for what conditions PRN medication is given. Staff should also be aware of the signs to look for in those residents who are unable to ask for PRN medication. The home was using a loose-leaf logbook to record Controlled Medication. This could result in pages being ‘lost’ or altered and could potentially place residents at risk. A more appropriate and secure method of recording the administration of controlled medication must be implemented. The thermometer used to record the temperature of the medication fridge was faulty and therefore the temperature could not be accurately recorded. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 11 The home was recording the outcome of the medication audit in a ‘reporters’ style notepad this could be tampered with and pages lost. The medication return book was not signed and dated on every entry. A more appropriate method of recording the medication audit should be implemented. The medication policy had been reviewed since the last inspection. Each senior carer responsible for the administration of medication was booked on a training course at Pendleton College. All residents were registered with a local General Practitioner (GP) and could be seen in the privacy of their own room. Nutritional screening, continence assessments and oral hygiene needs of residents were undertaken on admission and a plan of care had been implemented where appropriate. Six residents were spoken to during the site visit and all said that the staff in the home were respectful. Walkden Manor DS0000062619.V306190.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided some activities and a nutritious, well balanced and varied diet for residents. EVIDENCE: Residents spoken to during the site visit were very complimentary about the standard of food. One resident said, “ The meals are lovely and the cook is very nice”. One relative spoken to said, “ I sometimes have a meal here and the food is nice”. The meal on the day of the site visit was Gammon with carrots and creamed potatoes or meat and potato pie with carrots and creamed potatoes with apple crumble or stewed apple and custard for desert the inspector viewed the lunchtime meal, which looked appetising. The cook said that she had worked at the home for 8 years and knew the residents and their likes and dislikes. There were ample supplies of fresh, frozen and tinned foods available. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 13 Residents are able to attend religious services either in the community or a minister of their chosen denomination can visit them in the home if preferred. A private room can be made available for these meetings. Family and friends are encouraged to visit regularly, where this is not possible staff at the home will assist residents to maintain contact via telephone or letter. Residents are able to go out with relatives whenever they wish. A visitor spoken to confirmed this to be the case and said, “I can visit at any time and I usually take my husband for a walk”. Walkden Manor DS0000062619.V306190.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a complaints procedure and a copy had been given to each resident. There was a policy in place for the protection of vulnerable adults. EVIDENCE: The home had a complaint policy and procedure and this information was displayed in the hallway. There was information relating to the Age Concern Advocacy Service displayed in the hallway. The home had a copy of the Salford Social Services Adult Protection Policy and Procedure. The home had developed an Adult Protection Policy to inform staff of how to deal with allegations of abuse. This information was held in the basement office this information should be easily accessible to staff to make sure the correct procedures are followed. Not all staff had received Adult Protection training. All staff must receive awareness training in relation to local Adult Protection procedures. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 15 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): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The premises are safe however, the standard of cleanliness was generally poor and the home both internally and externally was in need of some redecoration. EVIDENCE: Some areas of the home were dirty, in particular window ledges and skirting boards were very dusty and banister rails were sticky and grimy. This was unpleasant for residents and gave a poor first impression to visitors to the home. This raises concerns that there is not sufficient domestic cover to meet the needs of the home. The home must assess the situation and act accordingly to ensure that the home provides a clean and hygienic environment for residents. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 16 There was some evidence that a number of bedrooms had been redecorated since the last inspection. The communal areas were in need of some redecoration to provide a pleasant and homely environment for residents. The home must produce an audit of decoration in the home, which identifies when work is completed. The refurbishment of the kitchen on the ground floor, which had begun prior to the last inspection, had not been completed. This lack of attention to detail is poor practice. Work must be completed in this area to ensure the health and safety of residents, staff and visitors. The requirement made at the last inspection to make safe the patio door style window in the attic had been addressed. As the door opens inwards this has been achieved by fitting a frame to the inside of the door to prevent it from being opened. The home had sufficient toilet and bathing facilities, which were close to bedrooms and lounges. The car park at the rear of the building was being tidied ready to be resurfaced. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of care staff were sufficient to meet the needs of the residents accommodated. However, staff hours allocated for domestic duties need to be reviewed. The homes recruitment policies and procedures promoted the safety and wellbeing of the residents. EVIDENCE: The skill mix, experience and numbers of staff appeared to be appropriate to meet the general care needs of the residents accommodated, however as previously stated there have been concerns raised relating to the Moving and Handling techniques used in the home. All staff must receive updated moving and handling training. This should include practical demonstrations rather than staff watching a training film and the home must be able to demonstrate that staff are competent. It was also recommended that the home arrange meetings with visiting professionals to discuss residents’ care plans and to make sure all staff involved in the residents’ care are working to the same moving and handling techniques. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 18 Staff files were securely locked away in the attic office. None of the staff files examined had a training record as required at the last inspection. Staff spoken to during the site visit said that the manager was supportive. All the staff spoken to confirmed that they had regular training sessions on care related/health and safety topics. However not all staff had undertaken Adult Protection training and a requirement is made under standard 18 of this report. As previously stated the allocation of domestic cleaning hours is required to be reviewed. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 19 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems and procedures in place, which safeguards and protects residents’ financial interests EVIDENCE: The registered manager was not present during the site visit and the visit was facilitated by the area manager. A number of documents could not be found and staff had to call the manager to locate them. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 20 There was a quality monitoring system but no formal system for monitoring the results. The information gained from asking for views and comments from service users and their families should be analysed and provide a framework for the homes development. The accident report book contained completed reports. These must be filed away in the individual residents or staff files in line with the requirements of the DATA protection Act 1998. There was documentary evidence that fixed gas and electrical appliances were being maintained. To ensure the health and safety of residents, staff and visitors a Portable Appliance test had been carried out and any new electrical items were tested before use. The passenger lift and emergency lighting systems had been regularly maintained. There was evidence that a fire drill had been carried out within the last month. All financial transactions made on behalf of residents were recorded and receipts were kept. Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 2 Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes. 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 OP7 Regulation 17 Requirement Care plans must give full and accurate details of residents care needs and the care provided. Care plans must be securely stored. 2. OP9 13 The registered person is must make arrangements for the recording, receipt, storage, handling, administration and disposal of medicines. All staff must receive awareness training on adult protection. It is required that the refurbishment work on the ground floor kitchen is completed. And where required redecoration of communal areas and bedrooms. The responsible person must reconsider allocated number of domestic hours within the home. All staff must receive updated moving and handling training. DS0000062619.V306190.R01.S.doc Timescale for action 20/12/06 12/12/06 3. 4. OP18 OP19 13 23 30/12/06 30/11/06 5. 6. OP26 OP30 23 18 30/12/06 30/01/07 Walkden Manor Version 5.2 Page 23 7. OP38 13 All completed accident reports must be stored in line with the DATA Protection Act 1998. 30/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Walkden Manor DS0000062619.V306190.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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