Care Home: Hurst Manor Nursing and Residential Home

Similar services:

• Fairfields Country Rest Home
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well Overall this is a well run, comfortable and friendly home where people receive good care. People spoken to confirmed that they were well looked after and were able to access health care when they needed it. There is real attempt to enable people to enjoy living in the home. People are encouraged to make choices about how they spend their days and can access a range of activities and social events. People said that they enjoyed their meals and food is of a high standard. The home offers choices whenever possible. The home recruits staff safely and offers some interesting training opportunities. There is a training policy and plan that aims to meet the needs of the home and staff. Twenty five of the thirty one care staff are qualified to National Vocational Level 2 and above. Over the last twelve months all 60 employees undertook the Alzheimer`s Yesterday,Today and Tomorrow training. Staff said that this training had changed the way they worked in the home. The environment of the home is pleasant and well maintained. The design of the home means that many people can access outside space through patio windows or have pleasant views. The respect that staff have for people who live in the home is shown in many ways. People look smart and well cared for because the laundry service is efficient and attention is paid to the presentation of clothes. A hair dresser visits regularly and people are supported to access her services. Staff take the time to offer people real choice whether this is about how they would like to spend their day or what sort of biscuit they would like with their coffee. The home responds promptly to any concerns expressed and takes effective action. There is a commitment to continued improvement both through the formal quality assurance systems and through interaction with people who live in the home on a daily basis. The management of the home includes the use of a comprehensive audit system that records the standards of all key areas of home practise. What has improved since the last inspection? The home has addressed requirements made at the last inspection and has improved the recording in care plans. It is now clear that action is taken to ensure that the nutritional status of people is monitored and appropriate action taken when required. Staff have received training relating to the requirements made at the last inspection. What the care home could do better: The home is currently undertaking a review of the extensive communal space to consider the what arrangements would be most beneficial to people who live in the home. There are some comments from people who live in the home that indicate a review of the deployment of staff and in particular trained nurses may be useful to ensure that people feel they have sufficient contact with the nurses. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hurst Manor Nursing and Residential Home Hurst Manor Nursing and Residential Home Hurst Martock Somerset TA12 6JU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Shelagh Laver     Date: 2 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 26 Information about the care home Name of care home: Address: Hurst Manor Nursing and Residential Home Hurst Manor Nursing and Residential Home Hurst Martock Somerset TA12 6JU 01935823467 01935825728 sue@hurstmanor.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Hurst Manor Ltd care home 36 Number of places (if applicable): Under 65 Over 65 0 36 dementia old age, not falling within any other category Additional conditions: 11 0 The maximum number of service users who can be accommodated is 36. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) - maximum of 36 places Dementia (Code DE) maximum of 11 places Date of last inspection Brief description of the care home Hurst Manor is a three storey Grade II listed georgian house situated in the centre of the village of Hurst. The home is set in its own landscaped ground with lawn and flowerbeds. Hurst Manor is a care home providing nursing for up to 36 elderly persons of either sex, not less than 60 years, who require general nursing care. Day care is provided for service users requiring nursing care within the registered numbers. The home can provide care for 11 people whose primary needs relate to dementia. The accommodation is mainly in the main house and the garden wing. Bedrooms in the Care Homes for Older People Page 4 of 26 Brief description of the care home new wings have en-suite bedrooms with patio doors onto the gardens. There is a large car park to the side of the care home. There is a choice of communal rooms and attractive outdoor spaces.There are trained nurses on duty at all times and staff receive excellent training. Care Homes for Older People Page 5 of 26 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 home completed an Annual Quality Assurance Assessment which gave us information about the achievements of the home over the last year and the plans for the future. We (Care Quality Commission) visited the home for one day and met with people who live there. We were also able to talk to the home managers and staff. We sent comment cards to people who live in the home and staff who work there. These were returned with very positive comments. People said that they received the care and support they needed and that staff listened to them and were on the whole available when needed. They liked the meals and knew how to make a complaint although many had not felt the need to do so. One comment wasI cannot ask for anymore care than I am having now. Everyone who Care Homes for Older People Page 6 of 26 works in the home is super. Staff were also positive in the responses to comment cards and during the inspection. One person wrote that training was very good. Another staff member praised the care given to people who live in the home. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 26 The home is currently undertaking a review of the extensive communal space to consider the what arrangements would be most beneficial to people who live in the home. There are some comments from people who live in the home that indicate a review of the deployment of staff and in particular trained nurses may be useful to ensure that people feel they have sufficient contact with the nurses. 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 set out 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 9 of 26 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 10 of 26 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. People are considering coming to live in the home can access information that will assist them to make an informed choice. People who come to live in the home benefit from a needs assessment to ensure their needs can be met. Evidence: It is stated in the Annual Quality Assurance Assessment submitted by the home that all admissions, other than emergency admissions are preceded by an assessment by a trained person. The homes capability to meet a persons needs is carefully considered before an admission is made. Emergency admissions are followed by an assessment as soon as possible after admission. People met during the inspection were able to talk about their admission process and one person said she had been visited in hospital. People and their families are welcome to visit the home and the first month in the home is a trial period. Care Homes for Older People Page 11 of 26 Evidence: The care documents seen contained comprehensive assessments and information from other health professionals. Information is available for people before they come to the home and is presented in an attractive and easily understood format. The home also has a web-site that can be accessed. Fees are set out in the Statement of Purpose and all people in the home have a contract stating clearly the circumstances of their admission to home. Additional information booklets are provided to people on arrival at the home. Care Homes for Older People Page 12 of 26 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. People living in the home benefit from a good standard of health and personal care. People in the home feel that they are treated with respect and kindness by staff. There are systems in place to store and administer medication safely. Evidence: There was evidence of comprehensive health and personal care in the home. All people seen looked well cared for. People are treated with dignity and respect. We heard staff speaking to people kindly and were aware that they knocked on doors and respected peoples privacy throughout the inspection. Four care plans were examined in detail. The plans were overall of a good standard including person centred assessment and clear guidance to staff. They had been reviewed and up-dated regularly. Plans showed that the home manages the prevention of pressure damage effectively. Currently no one has any damage and there was evidence that people who are vulnerable to damage are assessed and receive appropriate care. We saw records of turns and plenty of pressure relieving equipment in the home. There was evidence that Care Homes for Older People Page 13 of 26 Evidence: people who came into the home with pressure damage improved. In care plans records of actions to be taken and equipment to be used were recorded. Care plans showed that the home monitors peoples nutritional status and takes prompt actions when there are any concerns. It would be helpful if all records related to nutrition are located together in the care plan so that staff can see at a glance what is happening to individuals. Nutritional supplements are recorded. We spoke with the nurse responsible for medication on the day of the inspection and looked at the Medication Administration Charts. There was evidence that when appropriate people can be responsible for their own medication. One person is supported in managing her diabetes. There is a robust system in place for the storage and administration of medication including the management of controlled drugs. Records checked were accurate and up-to date. There was evidence that there is attention to the management of peoples pain in the home and examples of good practise were seen. The home benefits from the regular support of General Practitioners who visit routinely and in emergencies. People are able to visit clinics and keep health related appointments when appropriate. Care Homes for Older People Page 14 of 26 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. People living in the home make choices about how they spend their time. There is a programme of activities and social events if people wish to access them. People living in the home are offered a choice of well prepared wholesome meals three times a day. Evidence: People are able to make choices about how they spend their time at Hurst Manor. It is an aim of the home to enable people to access flexible and varied routines of daily living and activities. The activities organiser gets to know newly arrived people in the home and will discuss their interests. Sometimes one to one activities are preferred including trips out. There is now a monthly magazine called Aurora. Copies seen were very well presented and included the events programme,wordsearchs and news of the home. In May the programme was varied and included a regular musical entertainment as well as games,quizzes and discussion groups. People said that they were quite happy to access as much or as little of the programme as they wished. One person said I go down for scrabble or a chat and a quiz. I play indoor bowls and I enjoy knitting. Care Homes for Older People Page 15 of 26 Evidence: There are no set visiting hours and visitors are welcomed in the home. There are well established opportunities for people to invite guests to lunch (known as Lunch with a Friend) in the main dining room or in a separate dining room. There is a four week menu that varies according to the seasons. The current menu was interesting and varied with plenty of choice. Each morning at coffee time the order for lunch is taken. We heard the menu being described and discussed with people. There is a three course lunch available but people were heard to express many choices. People spoken to said that the food was very good One person said the food is excellent. You do not see many plates with much left on them. Another person said I am not interested in food. I prefer cheese on toast and I can have that. Another person spoke of the attention to her special diet and the effort made to ensure it was still nice. Care Homes for Older People Page 16 of 26 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. There systems and procedures in the home to protect peole from abuse. People living in the home can be confident that their concerns and complaints will be listened to. Evidence: During induction staff receive information about safeguarding adults and must sign to say that they understand this and the Whistleblowing policy. The home has copies of the local authority guidance Safeguarding Adults in Somerset and key staff are familiar with actions to be taken. Senior staff have attended additional locally organised safeguarding training. There is a register kept of any complaints and there was evidence that any issues raised by people who live in the home (or their relatives) are dealt with promptly by the management team. Often issues are resolved by email or telephone call before a formal complaint is required. This was confirmed by people living in the home. An Age Concern Advocate visits the home periodically and will attend when required. Care Homes for Older People Page 17 of 26 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. People live in a safe, well maintained environment. People benefit from the availability of equipment and and that make their lives easier. The home is clean pleasant and hygienic. Evidence: Overall the home is comfortable clean and well maintained. There are new rooms and bathrooms built to an excellent modern standard and other parts of the home that have maintained the charm of an old house. The atrium entrance to the home provides an attractive area for people to sit and have coffee. Individual rooms often contained furniture and possessions from peoples homes. One person talked about the large television that had been fitted on her wall as a present from her family.There were comfortable chairs in bedrooms and throughout the home so that people can chose where they spend part of the day. There are attractive gardens and outside spaces around the home. Small enclosed courtyards are decorated with potted plants and water features and can be accessed easily from patio doors from the bedrooms. At the back of the home there is a larger area of garden which one person said was really lovely. I have the best room in the house. Bathrooms and shower rooms are very well equipped and were immaculately clean on the day of the inspection. Staff receive infection control training and hand washing Care Homes for Older People Page 18 of 26 Evidence: facilities are available throughout the home. There is ample communal space in the home comprising the atrium, two sitting rooms and a dining room as well as small informal spaces to sit and rest for a few minutes. During the inspection the use of the space was discussed. Some areas appeared crowded with furniture whilst others were underused. It was agreed that there would be some benefit in considering the use of all areas with a view to the up-dating of some areas. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are protected by recruitment and induction procedures that are efficient and well organised. People living in the home benefit from a stable care team who have access to varied training opportunities. Staff training is innovative and encompasses manadatory training, qualifications and opportunities for development. Evidence: Records show that there are sufficient staff on duty including a registered nurse. There may be up to three trained nurses on duty and it may be worth reviewing the way in which the team works as there were a small number of comments from people who live in the home that indicated that the one nurse on the floor was overwhelmed at times. An analysis of how trained staff are deployed would be useful to ensure that people living in the home have maximum benefit from the availability of trained staff. The home employs a team of dedicated ancillary staff. The responsible individual told us that by employing sufficient numbers of kitchen cleaning and laundry staff care staff are freed up to concentrate on people who live in the home. People enjoyed talking to all staff. Interactions with cleaning staff and the person who took the food orders were mentioned during the inspection. Care Homes for Older People Page 20 of 26 Evidence: There is evidence of a robust and well organised recruitment system. Four staff files checked showed that there is a good system for recording information and that all appropriate steps are taken to ensure staff are given induction and trained whilst working at the home. A check list is used to ensure all information such as references and Criminal Record Bureau checks are received before people start work . The home benefits from a designated administration and training manager. Training records are clear and show that in addition to the mandatory training such as Manual Handling staff have access to a range of training opportunities within the home and can attend external events. The home has offered some innovative training opportunities. There has been an in-house caring for the carer programme which had received good feedback. Over the last twelve months all 60 employees have undertaken the Yesterday, Today and Tomorrow training accredited by the Alzheimers Society. Staff sat an exam offered at different times to ensure all were able to complete it. Staff spoken to said this had been interesting and had changed the way they work. Staff are asked to complete a training evaluation form indicates how they think they have benefited from the training. There was also evidence that the home had responded promptly to a training need identified within the home. Staff are offered training for their particular roles, for example nurses can access clinical updates and team leaders have received stress management training. Thirty one care staff are employed. Twenty five of these have National Vocational Qualifications at level 2 or above. There is evidence in the files that staff are given supervision and annual appraisals and this system is developing further. There is evidence that staff are offered oppportunities to improve their skills and knowledge in the home. Care Homes for Older People Page 21 of 26 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. The home is run in the best interests of people who live in the home. The manager leads a team of experienced and well qualified people who take responsibility for key areas in the home. There are systems in place to ensure the health,safety and welfare of people who live in the home and the staff. Evidence: There is a clear management structure in place and people work together as team. The manager is very experienced and well qualified. She is committed to continued clinical and management training up-dates and recently did Neuro Linguistic Planning training. The atmosphere in the home is open and inclusive. Staff who returned comment cards said that help was available when needed. The home has an established system of quality assurance. An annual questionnaire sent to people who live in the home and their relatives is analysed and action taken on any matters raised. Care Homes for Older People Page 22 of 26 Evidence: Since the last inspection the home has implemented a comprehensive audit system that evaluates key areas of operation in the home. This has proved effective and is seen as good practise. There is a sound system in place for the organisation and administration of peoples personal finances. Two records were checked and found to be accurate. Staff receive regular supervision and annual appraisals. There is a record of equipment maintenance that is audited monthly. The audit gives an indication of the frequency of checks to be made and the dates of the last certificate ensuring that all servicing and maintenance is current. Care Homes for Older People Page 23 of 26 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 24 of 26 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 20 The home has commenced a review of the use of sitting areas. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!