Care Home: Manor Court

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What the care home does well Many improvements had been made at the home since our key inspection in April 2010. These included, Care plans checked were more detailed, person centred plans had been developed withpeople and relatives and people who used the service were being included in care plan review meetings. The plans checked had been regularly reviewed and people and their relatives told us they were satisfied with the care they received from staff. Some staff had completed care plan training and we saw evidence that other staff would be offered this training within the next few weeks. This will ensure that staff have a better understanding of the process to ensure people`s needs can be met safely. Medication was being managed safely, and we found evidence that staff were ordering, storing, administering and recording medication to ensure people`s health and safety was maintained. Staff had been trained in how to protect people from unnecessary harm or abuse and in how to alert their managers if anybody made allegations of harm or abuse. This will help to ensure people`s safety and welfare is protected. Training had been offered to carers to ensure they had the appropriate knowledge, skills and understanding of how to support people with dementia care needs. This will better protect people`s dignity. A new permanent manager had been appointed since our last key inspection, she confirmed to us that she was in the process of applying to become the registered manager with CQC. What the care home could do better: An action plan to detail how the provider will reduce the extra management cover from the home, whilst ensuring that standards are maintained, needs to be devised and presented to the overarching adult safeguarding case conference meeting on 20/08/2010. This will demonstrate how the provider is planning to ensure the improvements made at the home will be sustained to protect people`s safety and welfare. An extensive review of both the internal and exterior environment of the home needs to be made and remedial action taken to ensure people are living in an environment, which protects their dignity, safety and welfare. The interior of the home looks tired, furnishings, decor, furniture, carpets and other areas of the internal environment need to be checked and then remedial action taken to ensure that they are clean, safe, fit for purpose and free from malodours. The exterior areas of the grounds need to be checked and action taken to ensure the areas used by people who live in the home, their visitors and the staff are safe, and free from slips or trip hazards. Random inspection report Care homes for older people Name: Address: Manor Court 31 Churchfield Lane Darton Barnsley South Yorkshire S75 5DH zero star poor service 26/04/2010 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Shelagh Murphy Date: 1 7 0 8 2 0 1 0 Information about the care home Name of care home: Address: Manor Court 31 Churchfield Lane Darton Barnsley South Yorkshire S75 5DH 01226382321 01226381299 manorcourt@schealthcare.co.uk www.schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross Care Centres Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 32 Number of places (if applicable): Under 65 Over 65 0 22 dementia old age, not falling within any other category Conditions of registration: 10 0 The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category of service: Care Home only Code PC To service users of the following gender: - Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, maximum number of places: 22 Dementia - Code DE, maximum number of places: 10 Date of last inspection 2 6 0 4 2 0 1 0 Care Homes for Older People Page 2 of 11 Brief description of the care home Manor Court provides residential care for older people; the home has 32 beds. It is in the village of Darton with easy access to shops, post office, church, local village club and health centre and it is on the main bus route. The home accommodates people on two floors and there is a passenger lift. Manor Court has 28 single bedrooms, 7 of which are en suite and 2 double bedrooms. The upper floor accommodates 10 people. The home has 3 lounges and 2 dining rooms. There are extensive gardens, with lawns and an enclosed area, garden furniture and a water feature. There is parking at the front of the building. The scale of charges ranges from £356:77 to £535:87 per week. For further information about the service, its fees and admissions procedures please contact the manager of the home directly. Care Homes for Older People Page 3 of 11 What we found: The quality rating for this service is 0 star. This means that people who use the service experience poor quality outcomes. The last key inspection at this service was carried out on 26 April, 2010 and the service was rated as a 0 star, poor service. A random pharmacy inspection was carried out on 6 July 2010 and improvements were noted at this time as the service had complied with our previous requirements relating to the safe management and administration of medication. This was a random inspection carried out by Shelagh Murphy on 17 August 2010 from 9:45 am to 2:45 pm. The manager Deborah Hammerton was present throughout our site visit. We do not change a services quality rating at a random inspection as we do not look at all of the key standards. Therefore, this service is still rated as a poor service following this site visit. We carried out this random inspection because we wanted to ensure that the provider had complied fully with the legal requirements we made at the key inspection, to ensure that peoples safety and welfare was protected. There had been numerous safeguarding adult concerns at the service, and as a result of this, Barnsley Council Contracts Department had placed an embargo on admitting new people to the service, until it could be sure the provider was able to manage the service appropriately and ensure peoples safety and welfare. In the report we make reference to us and we. When we do this we are referring to the inspector and the Care Quality Commission (CQC). We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We used a variety of information as well as our findings from the visit to assess the quality of service offered to people who live at this home. We observed staff care practices to identify how people with Dementia care needs were supported. We spent time with two people who used the service, to find out their views. Two staff attended interviews with us and we also spoke to two visiting relatives, the new manager of the service and a Quality Inspector for the service. On the day of the site visit opportunity was taken to inspect a sample of care and medication records, we also checked some records relating to the running of the home, including staff training records. We checked all of the previous requirements, which related to the quality of the care plans, safe handling of medication, management of adult safeguarding within the service, staff training, support for people with dementia care needs and the management of the service. We found that the requirements had all been Care Homes for Older People Page 4 of 11 met. The specific progress made on each requirement has been recorded in this report. We checked three care plans and found they had been regularly reviewed, the quality of the care plans had improved since our last inspection. They were more detailed, they contained personal preference plans, which used a person centred approach to identifying and detailing the individuals, needs, wants and wishes. We spoke to two people who lived at the home and one person confirmed they had been given the opportunity to review their care plan, the other person said they had been asked were not interested in having this opportunity. One person said, The carers have asked me about how I want to do things, its good isnt it. A relative told us, The staff are good and I cant complain about anything, they tell me what I need to know and have invited me to reviews. This protected peoples rights and ensured people and their representatives were given the opportunity to be involved in planning their own care. The care plans checked were adequately detailed, to ensure staff knew how to meet peoples needs and wants. We also asked staff and saw training records, which confirmed that some staff, 7 out of 18 staff, had completed care plan training provided by the Community Matron. We saw evidence that more training had been planned for end of August and beginning of September 2010. This will ensure the staff, develop a greater understanding of the importance of the care planning process in order to meet peoples individual needs. We spoke to two relatives who both confirmed they had been asked to participate in care plan reviews with their parents. They both gave examples of how this enabled them to develop greater understanding of how their relative was being cared for and that it had enabled, better communication with the staff and both were happy that they had been asked to be involved. We checked three peoples medication administration record sheets and found they were all completed appropriately and the medication in stock tallied with the medication recorded as administrated. We also checked to ensure that only appropriately trained staff were administering medication and found evidence that this was the case over the night and day shifts. The home was had employed trained nurses, as well as trained senior carers and managers to carry out this task. We checked with the manager about how the most recent adult safeguarding investigations had been managed and at what stage they were at in the process. We were advised that these were all now closed and that appropriate action to address the findings of the investigations had been taken. We have checked this out with the safeguarding adults team in Barnsley and were advised that all of the cases were now closed. The manager told us they had been attending adult safeguarding core review meetings on a monthly basis and had presented improvement action plans and other monitoring information to them to ensure that peoples safety and welfare was protected. Care Homes for Older People Page 5 of 11 We also checked the staff training records to ensure that staff had up to date training in adult safeguarding, We found that 92 per cent of staff had completed training in safeguarding adults. This information will be fed in to the overarching adult safeguarding case conference to be held on 20 August 2010, which the provider and a CQC representative will also attend. We then checked the staff training records and found that 92 per cent of the staff had completed training in how to meet the needs of people with Dementia. We also observed staff practices to ensure that staff interactions with people were appropriate and found this to be the case. The staff interviewed said they had developed greater awareness of peoples needs from the training and senior carers told us they believed this had led to staff supporting peoples needs better. We wanted to check to ensure that the home was being managed appropriately. At the time of our visit to the home extra management arrangements were in place, to ensure that standards within the home improved. This included qualified nurses working on every night shift to ensure there was always a trained person to administer medication and extra management cover to monitor the service at weekends and in the evenings. We discussed the current arrangements with the manager of the service and a Service Quality Advisor for the home. We asked them what arrangements they had been made to reduce the extra line management cover, using a planned and agreed approach to ensure that the improvements made could be sustained. They advised they would use a management `step down plan and agreed to produce an action plan of this, for the forthcoming adult safeguarding overarching review meeting to be held on 20/8/2010. This will ensure that the management of the home continues to be closely monitored, by the provider, to ensure the standards within the service are maintained. The manager who had been appointed since out last key inspection, was Deborah Hammerton, who advised us she had completed a CRB check with CQC and was waiting for this to return before sending in the completed registered managers application, we then spoke to our CQC registration team, who confirmed this was correct. During our site visit we also took the opportunity to look at some areas of the environment as the manager told us some areas had been refurbished and redecorated. We saw evidence that some corridors and a lounge had been redecorated, new furniture had also been provided in one of the lounges and some bedrooms were in the process of being decorated. However, we also found areas of the environment where action needed to be taken to ensure people were living in a clean, safe and odour free environment. Requirements to devise an action plan and make the necessary maintenance and refurbishments in a timely way have been made in this report. To ensure people are living in a safe and comfortable environment. What the care home does well: Many improvements had been made at the home since our key inspection in April 2010. These included, Care plans checked were more detailed, person centred plans had been developed with Care Homes for Older People Page 6 of 11 people and relatives and people who used the service were being included in care plan review meetings. The plans checked had been regularly reviewed and people and their relatives told us they were satisfied with the care they received from staff. Some staff had completed care plan training and we saw evidence that other staff would be offered this training within the next few weeks. This will ensure that staff have a better understanding of the process to ensure peoples needs can be met safely. Medication was being managed safely, and we found evidence that staff were ordering, storing, administering and recording medication to ensure peoples health and safety was maintained. Staff had been trained in how to protect people from unnecessary harm or abuse and in how to alert their managers if anybody made allegations of harm or abuse. This will help to ensure peoples safety and welfare is protected. Training had been offered to carers to ensure they had the appropriate knowledge, skills and understanding of how to support people with dementia care needs. This will better protect peoples dignity. A new permanent manager had been appointed since our last key inspection, she confirmed to us that she was in the process of applying to become the registered manager with CQC. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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, 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 1 19 23 The care home must be kept 30/11/2010 in a good state of repair both internally and externally and all areas of the home must be kept clean and reasonably decorated. When the action plan has been devised, action must be taken to address all of the areas of concern by 30/11/2010. To ensure the safety and welfare of people who live in the home. 2 19 23 The care home must be kept 20/09/2010 in a good state of repair both internally and externally and all areas of the home must be kept clean and reasonably decorated. Therefore an action plan must devised, along with timescales for completion, which identifies all areas of the environment which require attention including Care Homes for Older People Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 redecoration, refurbishment and repair or replacement. A copy of the action plan must then be sent in to CQC. To ensure that the provider is taking adequate steps to ensure people are living in a safe and comfortable environment. 3 33 13 A planned approach must be 30/08/2010 used to reduce the extra management cover at the home. Therefore an action plan of how the provider will safely manage this must be devised and presented to CQC and the overarching adult safeguarding case conference. To ensure that the improvements made at the service are maintained and peoples welfare is protected. 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 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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