Care Home: Manor Court

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What the care home does well The home takes all of the necessary action to ensure residents are well cared for, have their health care needs met and are provided with the support they require. People living in the home are actively encouraged and supported to maintain family contact, friendships and relationships. People are treated with dignity and respect and have their right to privacy upheld. Discussion with staff and observation of practices revealed that staff had a positive attitude and respect for residents. Staff spoke to people in a sensitive and respectful way. One resident remarked, " Everyone is very kind." People benefit from a varied and nutritious diet and enjoy their meals as a social occasion. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. People are provided with clean, attractive, well-furnished and comfortable surroundings to live in and enjoy. There are sufficient staff on duty to meet the health and personal care needs of people living in the home. A resident told us "I have everything I need." The manager has organisational support to ensure the service is run in the best interests of people living in the home. The home manager was present throughout the inspection visit. Feedback was given at the end of the inspection. What has improved since the last inspection? The manager has ensured the care plans have been updated and contain all the information required. What the care home could do better: No requirements have been made following this inspection visit. CARE HOMES FOR OLDER PEOPLE Manor Court Manor Court Road Nuneaton Warwickshire CV11 5HU Lead Inspector Patricia Flanaghan Unannounced Inspection 11:40 21 & 26 February 2008 st th 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 Manor Court DS0000004253.V353722.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. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor Court Address Manor Court Road Nuneaton Warwickshire CV11 5HU 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) 02476 383787 02476 383787 Swinnerton Trust Mrs Yvonne Thompson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Manor Court may also provide care to the service user named in the variation application dated 28th November 2005. 31st October 2006 Date of last inspection Brief Description of the Service: The Swinnerton Trust (a voluntary organisation) owns and manages Manor Court. Manor Court is a Victorian house, which has been adapted to provide long-term care and accommodation for 24 older people. The home is located close to Nuneaton town centre, which provides local services e.g. shops, schools, public houses, restaurants and coffee bar, and is set in its own spacious grounds on the site of a medieval priory. Manor Court benefits from a well-established garden, which is attractive, well maintained and accessible. Included in the grounds are a stream and spinney. There is car parking space available for a number of vehicles. Accommodation is available on three floors. Three rooms are located on the ground floor, twelve rooms on the second floor and a further eight rooms on the top floor of the premises. Service users can furnish and redecorate their private room to their own taste if they wish. Service users can choose to use either a slow moving shaft lift or a stair lift for easy access to the fist and second floors. There are three bathrooms two of which offer assisted baths; the third bathroom also accommodates a shower facility. Communal accommodation comprises of a dining room, two lounges and a conservatory. Manor Court is registered to provide care and accommodation for older people assessed as not requiring either specialist dementia care or nursing care. At the time of this inspection visit the fees at the home ranged from £345.00 to £394.00 per week. There are additional charges for hairdressing, toiletries and newspapers. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by us is upon outcomes for people who live in the home and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. This unannounced inspection took place over two days, 21 and 26 February and lasted a total of nine and half hours. Before the inspection the manager of the home was asked to complete an Annual Quality Assurance Assessment (AQAA) detailing information about the services, care and management of the home. Upon the receipt of this a number of questionnaires were sent out to residents and their families to ask their views about the home. Only one survey from a resident was returned. Information contained within this survey, plus the AQAA are detailed within this report where appropriate. Two people who were staying at the home were ‘case tracked’. The case tracking process involves establishing an individual’s experience of staying at the home, meeting or observing them, discussing their care with staff and relatives (where possible), looking at their care files and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. Records examined during this inspection, in addition to care records, included staff training records, the Service User Guide, staff duty rotas, complaint records, health and safety records and medication records. Residents were observed during lunchtime to ascertain choices given and to view meals made available. A tour of the home was undertaken to view specific areas and establish the layout and décor of the home. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The manager has ensured the care plans have been updated and contain all the information required. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 7 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. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 8 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 Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The case files of a recent admission plus two people identified for case tracking were examined to assess the pre-admission assessment process. The manager said that it was usual for her to visit people who are considering moving into the home to undertake an assessment of their needs and abilities. Each of the files examined contained information gathered during a preadmission assessment that identified all of the person’s needs. The preadmission assessment is supplemented by a further assessment of long term needs on the day of admission. Manor Court DS0000004253.V353722.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 and 10 Quality in this outcome area is good. Each person living in the home has a plan of care and access to health care services so that their health and personal care needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents observed during this inspection visit looked well cared for; it was evident that the service is meeting their personal care needs. People were well presented and groomed and they wore well laundered clothes that were suited to the time of year. Two people were identified for ‘case tracking’. Each care file contained a profile about the person’s life history and enduring interests and relationships. This good practice should help staff to understand the cultural and social background of individuals and assist them to give ‘person centred’ care. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 11 Each person had a plan of care with information about the actions staff need to take to meet most of their identified needs. Care plans are based on the initial assessment of peoples’ needs and there is evidence that they are reviewed and updated. The service uses risk assessment tools for identifying the risk of falls and developing pressure sores. A dietary assessment is completed for each person to identify potential risk of poor nutrition. This good practice should identify risks to the health and well being of people living in the home so that care plans can be developed to minimise identified risks. Records examined showed that people are supported access to GP services, hospital out patient appointments, community nurses and optician. The systems for the safe management of residents’ medication were examined. A monitored dosage (‘blister packed’) system is used. Medicine administration records (MAR) were completed correctly. Audits of the medication of the people involved in case tracking were undertaken and were found to be accurate indicating that people living in the home have their medicines administered accurately. Staff make appropriate records on the MAR sheets when residents refuse medication. Good practice was observed when staff administered medicines. Staff checked the MAR sheet before administering medicines to an individual and made sure they had taken their medication before starting to administer the next person’s medicines. People living in the home were observed to be treated with respect and their dignity maintained; for example, personal care was provided in private and residents were spoken to respectfully. During observation of working practice it was evident that staff are knowledgeable about the likes and dislikes of people living in the home and were kind, caring and attentive towards them. Manor Court DS0000004253.V353722.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 and 15 Quality in this outcome area is good. People living in the home are supported to maintain their independence and enduring interests which enhances their quality of life. People benefit from a varied and nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The full programme for activities is displayed on the notice board with daily activities written on a chalkboard. Regular outings are undertaken and there were photographs on display of recent outings. People said they enjoyed an outing on a canal barge last September. Entertainers regularly visit the home during afternoons to provide such things as ‘sing a longs’. People are encouraged to go out for walks, shopping or to visit the local church. One person said, “There’s usually something going on. Sometimes I join in and other times I just like to sit quietly reading by myself.” Another person commented, “I just like to watch.” Residents meetings are held monthly with minutes of the meetings displayed on the notice board. The minutes of recent meetings demonstrated that Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 13 residents have a say in the running of the home with several suggestions on activities they would like to see provided. Visitors are made welcome at all times and they are involved in the residents’ care and planning. The home is friendly and welcoming and visitors and residents are able to communicate well with staff. People use their bedrooms as well as communal areas to receive their visitors. This good practice supports people to maintain their enduring relationships. People are encouraged to take some control of their daily lives. There was evidence that people are consulted about their care. People signed their care plans to indicate their agreement. The manager said that a local church visits the home on a monthly basis to provide a service. The meals looked appetising and service users were seen to enjoy their meals. One person said the food was “very good” and they had a choice each day. Another said the food was “very nice” and there was enough to choose from. Manor Court DS0000004253.V353722.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 and 18 Quality in this outcome area is good. Complaints are taken seriously by the home and there are appropriate policies and procedures to safeguard residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All comments from residents or relatives are recorded in a comments book. There had been no complaints recorded by the home since the last inspection visit. Discussions with people in the home confirmed that they feel at ease with staff and feel they can openly make comments about daily matters in the home without any fear of reprisals. Residents felt that they could report any matters or concerns to the manager and these would be dealt with. Comments received included: • • “I’ve no need to complain” “What would I have to complaint about? Everyone is so good here.” These comments suggest that people know how to make a complaint and feel confident that their views would be listened to. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 15 A policy on adult protection is available in the home. Staff have attended training on how to recognise abuse and when questioned were able to state what they would do including reporting this to the manager. Manor Court DS0000004253.V353722.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, 24 and 26 Quality in this outcome area is good. The environment is generally well maintained providing an attractive, clean and homely place for the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was fresh, clean, warm and homely on the day of the visit. There is good lighting and plenty of communal space for all residents to be able to pursue their own activities. The home has a large communal lounge, television lounge, a conservatory used as a quiet area and a separate dining room. People living in the home moved around it freely making good use of both the communal and individual space. Residents were seen to come and go to their rooms as they choose. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 17 Communal areas were clean and hygienic, furniture was in a good state of repair and various types of chairs are provided for the comfort and safety of residents. The gardens are well maintained and garden furniture is available for the residents to sit out if they wish. Two residents were seen to dress up warmly for a walk around the large garden. A number of bedrooms were viewed. It was evident that residents are encouraged to personalise their rooms with their own items such as photographs or soft furnishings. A handyman is employed who completes routine repair and maintenance tasks. The laundry in the home is adequate to meet the needs of the residents and the size of the home. It was clean and well organised with a number of health and safety procedures displayed. Protective clothing such as plastic gloves and aprons were available and arrangements are in place for the disposal of waste. The kitchen was clean and tidy on the day of the inspection. The Environmental Health Officer had undertaken an inspection on 06/02/08 and no requirements or recommendations had been issued. Manor Court DS0000004253.V353722.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 and 30 Quality in this outcome area is good. There are sufficient numbers of staff on duty to meet the needs of people living in the home and robust pre employment checks safeguards people from risk of harm from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection there were 17 people in the home. Duty rotas seen evidenced that staffing levels are being maintained within agreed levels. On both days of the inspection there were four carers plus a senior carer on duty in the morning and three carers plus a senior carer in the afternoon/evening. Two waking staff are on duty each night. Two housekeepers, a laundry assistant two catering staff and a maintenance man provided ancillary cover. The manager is supernumerary. The personnel files of two recently recruited staff members were examined and they contained evidence that satisfactory checks such as Criminal Record Bureau (CRB), Protection of Vulnerable Adult (PoVA) and references are obtained before staff commence employment in the home. Robust recruitment procedures and pre-employment checks should protect the vulnerable people living in the home. Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 19 Staff training records demonstrate that staff complete an induction programme and receive mandatory training in Health and Safety, Infection Control, Fire Training, Moving and Handling, Abuse Awareness and Food Safety. The manager maintains a monitoring system, which identifies these staff who require updates in their training, so that training can be arranged. A number of staff have undertaken equality and diversity since the last inspection visit. The manager advised that all new staff complete induction training to the required standards and once this is completed they are enrolled onto an appropriate training course to complete the National Vocational Qualification (NVQ) Level 2 in Care. This training is to support staff in providing more effective care to the residents. Training records provided by the manager demonstrate that 16 carers have completed NVQ level 2 training. Manor Court DS0000004253.V353722.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 and 38 Quality in this outcome area is good. The manager is competent and fit to be in charge of the home. Robust policies and procedures offer a sound framework and safeguard service users’ interests and safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home has been in post for a number of years and has the necessary experience and training required to undertake the role. She has an in-depth knowledge of the care needs of those that live at the home. The home has good quality assurance systems, which include ways of gaining the opinions of the people at the home about the service they receive. This includes regular residents meetings as well as seeking people’s views about a Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 21 various aspects as part of the care review process. Feedback from relatives and others was obtained in a less formal manner during ‘one to one’ meetings and from thank you letters and cards. Regular monthly visits are carried out by the responsible individual to ensure the home is running properly. The manager and the maintenance man to ensure the home is safe and well maintained for people to live in also carry out thorough monitoring checks of various aspects of the home. People’s personal monies are stored away safely and a clear record of expenditure is kept so that it is possible to check how people’s money has been spent. Information provided by the home in the AQAA shows that the home has undertaken the required safety checks related to electrical and gas installations, portable appliances, hoists and other equipment. Fire safety management includes regular testing of fire alarms, emergency lighting, and all records relating to fire safety management were up-to-date and in good order. A record is maintained in the home of any accident or incident that happens to person using the service. A sample of records were examined to assess the home’s systems for maintaining equipment and services. These were all in order. Manor Court DS0000004253.V353722.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 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 3 X 3 X X 3 Manor Court DS0000004253.V353722.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. Refer to Standard Good Practice Recommendations Manor Court DS0000004253.V353722.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Manor Court DS0000004253.V353722.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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