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Care Home: Manor House

  • 1 Amblecote Avenue Kingstanding Birmingham West Midlands B44 9AL
  • Tel: 01213600680
  • Fax: 01213251511

The Manor House was situated in a quiet residential area of Kingstanding in a modern purpose built building. It has access to buses within about 5-10 minutes walking distance and is accessible to the shopping area of Kingstanding. Servite Housing owns the home: one of two such homes in the city of Birmingham. There was accommodation for 35 older people set out in 35 single bed sitting rooms. These rooms had a kitchenette area and en-suite toilet and bathing facilities. The home had communal areas consisting of a lounge /dining room, a separate conservatory, and a hair dressing room. The home had assisted bathing facilities on both of its two floors. The upper floor can be accessed by a passenger lift if needed. There was level access entry to the front of the building and to the rear garden area and other equipment was available for residents with limited mobility. There were adequate parking spaces available to the front of the building. Information regarding the services and facilities was available in the reception area on entering the home. This is currently being updated so that prospective residents and their representatives have information to make an informed choice about moving into the home. The home currently charges between £375.42 and £430.83 per week and this is reviewed on an annual basis.

  • Latitude: 52.548999786377
    Longitude: -1.8969999551773
  • Manager: Tracey Tomlins
  • Price p/w: £403
  • UK
  • Total Capacity: 35
  • Type: Care home only
  • Provider: Viridian Housing
  • Ownership: Voluntary
  • Care Home ID: 10233
Residents Needs:
Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Manor House.

CARE HOMES FOR OLDER PEOPLE Manor House 1 Amblecote Avenue Kingstanding Birmingham West Midlands B44 9AL Lead Inspector Ann Farrell Unannounced Inspection 24th October 2007 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Manor House DS0000016775.V351212.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 House DS0000016775.V351212.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor House Address 1 Amblecote Avenue Kingstanding Birmingham West Midlands B44 9AL 0121 360 0680 0121 325 1511 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) Servite Houses Tracey Tomlins Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2007 Brief Description of the Service: The Manor House was situated in a quiet residential area of Kingstanding in a modern purpose built building. It has access to buses within about 5-10 minutes walking distance and is accessible to the shopping area of Kingstanding. Servite Housing owns the home: one of two such homes in the city of Birmingham. There was accommodation for 35 older people set out in 35 single bed sitting rooms. These rooms had a kitchenette area and en-suite toilet and bathing facilities. The home had communal areas consisting of a lounge /dining room, a separate conservatory, and a hair dressing room. The home had assisted bathing facilities on both of its two floors. The upper floor can be accessed by a passenger lift if needed. There was level access entry to the front of the building and to the rear garden area and other equipment was available for residents with limited mobility. There were adequate parking spaces available to the front of the building. Information regarding the services and facilities was available in the reception area on entering the home. This is currently being updated so that prospective residents and their representatives have information to make an informed choice about moving into the home. The home currently charges between £375.42 and £430.83 per week and this is reviewed on an annual basis. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social care inspection (CSCI) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that needs further development The inspection was conducted over one day commencing at 8am and the home/provider did not know we were coming. This was the first statutory key inspection for 2007/2008 and the manager was present for the duration of the inspection. Information for the report was gathered from a number of sources: a questionnaire was completed before the inspection; on the day of inspection a tour of the building was undertaken, records and documents were examined in relation to the management of the home plus conversation with managerial staff, visitors and residents. Also direct and indirect observation was used to inform the inspection process. Three residents who live in the home were’ case tracked this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. Verbal comments were also received from health professionals and the responses were positive. What the service does well: The home was clean, warm, odour free and well maintained. Residents’ flats were all single with en-suite and a kitchenette facility. They were comfortable, homely and personalised according to individual’s preferences, so providing a pleasant environment for residents to live. There were also a number of different types of assisted bathing and showering facilities. On discussion with some residents they stated they liked their flats. The senior staff’s office was situated in the reception area, so providing easy access to visitors who wish to discuss progress or any concerns. Relatives stated they could visit at a time that suited them, so residents were able to maintain contact with them. One stated, “I can’t fault it; staff have helped us, they could not be more helpful”. Another visitor stated they were very happy with the care and had recommended the home to others who they knew were looking for a home. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 6 There were no rigid routines in the home. Staff respected Resident’s privacy and dignity and residents were able to exercise choice in their daily life. Residents and relatives reported favourably on the standard of care and the friendly staff. One stated, “The staff have been brilliant, they even went up to visit her when she was in hospital”. Residents stated they enjoyed the meals, the food was of a good standard and they received choices. The meals were culturally appropriate for the resident group and special diets were catered for. On discussion with a resident who had recently moved into the home they stated the moving in process was well organised and they had looked around the home before moving in. Suitable systems were in place to meet resident’s personal care and health needs, so ensuring their needs were met appropriately. One relative stated,” the staff keep us informed of any concerns”. The medication system was of a good standard with checks in place to ensure residents receive the medication prescribed to them. Staff recruitment procedures were robust with appropriate checks undertaken to ensure residents are protected by the employment of new staff. The home has quality assurance systems and this enables residents to have a voice about the home and helps planning for future improvements. Money held on behalf of residents was accounted for and robust systems were in place for safeguarding resident’s personal money. The home had good maintenance and inspection records of services to maintain fire safety and the building services What has improved since the last inspection? Training is ongoing and a range of training has been completed in the last year, so ensuring staff has the appropriate skills and knowledge to meet resident’s needs. The manager has introduced medication audits to ensure robust procedures, so residents receive the medication prescribed by health professionals. The staff have consulted residents about their interests and preferences in respect of activities, so that individuals needs can be addressed more effectively. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 7 The manager has completed NVQ level 4 and is working towards the Registered Managers Award. Policies and procedures are in the process of being reviewed and updated and training is to be provided, so ensuring good practice. 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 House DS0000016775.V351212.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 House DS0000016775.V351212.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): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information was available for prospective residents and their representative enabling them to make an informed decision about moving into the home. The information is to be updated in the near future. The information obtained prior to a resident’s admission enables staff to determine if resident’s needs could be met in the home, so providing confidence to prospective residents. EVIDENCE: The home usually admits people who require long-term care. Documents were available on entering the home that gave information about the services and facilities. In the past the manager has also considered producing the information in an alternative format to meet the needs of an individual resident. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 10 The manager stated that they were going to update the information and had arranged for a photographer to visit, so that photographs could be included. It was suggested that residents should be consulted about the content and format to ensure it is appropriate to meet needs. On inspection of records it was noted that residents had the opportunity to visit the home before moving in, so that they can meet staff, residents and view the premises and this was occurring on the day of inspection. A pre admission assessment was completed and staff had received information from the social worker, which enabled staff to determine if they could meet residents needs before they move in. The manager also confirms the details of the assessment in writing, so providing confidence to prospective residents and their representatives that their needs can be met on entering the home. On discussion with a residents who had recently moved into the home they confirmed that they had visited and the moving in process and been managed to a good standard. Feedback from relatives was very positive and they stated they would recommend the home and have done so in the past. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable arrangements were in place to meet resident’s health care needs and ensure their well being. The care planning and recording systems need further development to ensure that residents’ needs are being met in a consistent manner. Medication systems were adequately robust to ensure residents received the medication prescribed to them. Residents were treated with respect and their privacy was respected. EVIDENCE: Following admission to the home staff draw up a care plan for each resident indicating the residents needs and how they should be met. It was found that the staff were in the process of changing the documentation and were having training in respect of care planning and risk assessments. The care plans were found to be of varying standards with some having very good details in areas, but others were lacking information about the action required by staff to meet residents needs. Some areas of need had not been included in care plans e.g. a resident who had mental health problems Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 12 identified on assessment had not been included in the care plan and records did not indicate any monitoring in this area. Where a resident had a catheter there was no care plan in place regarding the care of the catheter. The care plans were based on physical needs and this needs to be extended to provide a holistic plan to cover areas such as physiological, emotional, spiritual needs etc. Risk assessments were varied and in some cases a tissue viability risk assessments had been completed, but where risks had been identified there was no evidence that any action had been taken. In other cases where residents were at high risk in respect of tissue viability there was no risk assessment and no evidence that advise had been sought regarding specialised equipment etc. There was no evidence of a nutritional risk assessment to determine if residents were at risk nutritionally. Risk assessments had been undertaken in some areas and the action required to reduce the risk had not been included in the care plan. In addition, some risk assessments had been undertaken in respect of general aspects of care and may not be appropriate. Staff training was just being provided in these areas and this should provide the knowledge required by staff to ensure these shortfalls are addressed. As without comprehensive risk assessments and care plans it cannot be guaranteed that residents needs will be met in a consistent manner. Daily records were written by staff and it was found that they were based on tasks and did not provide any information about the residents mood, the type of day they had, activities etc. This area should be reviewed to provide a more meaningful record of the type of day experienced by residents. All bedrooms are single en-suite rooms and residents have keys to their own doors, so enhancing resident’s privacy. Staff knock doors and gain residents agreement before entering. Staff were noted to treat residents with respect and greet them in the morning. There is a mixed group of residents in respect of gender and ability; all were well presented with assistance from staff where required and the hairdresser visits twice a week. A telephone is also available in a separate room enabling residents to make calls in privacy. All residents are registered with a local GP and they are given a choice of GP on moving into the home. Records indicated that when staff identified health concerns or where residents requested health professionals would be contacted. There was evidence of visits from the chiropodist and optician, but there was no evidence seen of visits by the dentist. It was stated that the dentist would be contacted when required. It was recommended that a regular oral health check should be undertaken. There was no evidence of health checks where residents had chronic diseases such as diabetes, high blood pressure, asthma etc. It was recommended that this be followed up with the practice nurse of the GP surgery so that regular monitoring can be undertaken to prevent complications from occurring. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 13 On the day of inspection the GP was visiting and he stated that staff carried out instructions as requested. The home notifies the Commission of any accidents and incidents in the home as they happen. During inspection it was noted that some walking frames had rubbers on the feet that were worn and this may pose a risk to residents. It is recommended that an audit of all frames be undertaken and action taken where necessary. Some of the medication was stored in a medication trolley and storage cabinets in the ground floor office, which were observed to be clean and organized so that medication could easily be located. Also a number of residents store medication in their bedrooms in lockable cabinets. The manager stated that she hoped to change the system so that all medication would be stored in resident’s own bedrooms in the future. When this occurs they will need to consider where keys are stored and risk assessments should be undertaken for each individual resident. The homes medication system consisted of a blister and box system with printed Medication Administration Record (MAR) sheets being supplied by the dispensing pharmacist on a monthly basis. The home had copies of the original prescription (FP10’s) for repeat medication, so they were able to check the prescribed medication against the MAR chart when it entered the home. On inspection of the medication for the current month it was found to be of a good standard with the majority of audits correct. There were some minor discrepancies, which may be due to the recording of medication carried forward from the previous month. It was noted that some handwritten medication details had not been consistently signed by two members of staff to ensure a safe checking procedure. During inspection it was noted that some creams and eye drops that were in use had not been dated when opened. These should be dated and discarded within specified timescales to reduce the risk of bacterial contamination. The record of controlled drugs was satisfactory, but staff will need to ensure they obtain the signature of the person receiving them when they are returned to the pharmacist. A record of all medication returned to the pharmacist was retained to enable auditing to be undertaken. It was noted that there was a large number of returns and the manager stated that she was due to have a meeting with the pharmacist in the near future and hopefully this issue can be resolved to reduce the amount of wastage. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 14 Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a homely atmosphere with no rigid rules. Visitors could visit at a time that suited them and were made welcome, so residents are able to maintain contact with family and friends. Whilst the home arranges some activities further development is required to meet individual needs and ensure residents are adequately stimulated. Residents were encouraged to maintain their independence and can make choices about daily aspects of living. The arrangements for meals and catering were of a good standard. EVIDENCE: Arrangements for visiting were flexible enabling relatives to visit at a time that suited them and residents to maintain contact with them and this was confirmed on discussion with residents and visitors. There were no rigid rules in the home. Residents were able to make choices and spend time as they wished e.g. they could get up; go to bed when they wished, they had freedom of movement around the home and able to return to Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 16 their flats as they wished. Staff encourage residents to maintain their independence as much as possible. Records in respect of activities indicated there was a knitting club, bingo (which residents enjoyed) and progressive mobility, (passive exercises to music). On the morning of inspection a notice was outside the dining room indicating there was a knitting club, but only one resident was knitting. A small group of residents were playing dominoes and a member of staff was present. There is a pool table in the conservatory plus a range of games. In addition, there is a piano, television and video recorder in the small lounge area of the dining room. On discussion with residents some stated they were satisfied, but others stated they were bored on occasions. There have been occasional outings, but residents stated they would like to go out more often. On discussion with the manager she had already identified that activities were lacking and a questionnaire had been sent to residents to determine their individual interests. She is hoping to develop this area further in the near future and possibly introduce an activity organiser. There were records of regular monthly meetings with residents. Minutes of the meetings and proposed dated of meetings were available in the dining room. In addition, there was a monthly newsletter and this was available on the notice board on entering the home, so keeping residents informed of any changes and enabling them to have a say in aspects of the home. The hairdresser visits twice a week and it was stated there was always a queue for her, so ensuring residents appearance and self-image is maintained to a good standard. One resident stated she visits her local church about four times a week and a lay minister visits regularly to provide communion, so meeting residents spiritual needs. The library visits on a regular basis with books. Also talking books were delivered to the home on a regular basis for residents with sight difficulties. The home employs separate catering staff who provide breakfast, lunch and evening meal. There was a four-week rotating menu and it was stated that it was drawn up by senior staff to ensure it is nutritionally balanced, but the chefs takes residents preferences into consideration. Special diets such as diabetic and puree meals were catered for. The menus showed that residents had a range of breakfast available daily consisting of cereals, toast, prunes boiled eggs, and twice a week a full cooked breakfast was available. Residents had a choice of at least two cooked meals at lunchtime and a choice of pudding. At teatime soup, a cooked snack or sandwiches were available with cake etc. Drinks were available between meals with a choice of biscuits and fruit. In addition, residents have a small kitchen in their flats where they are able to make drinks and light snacks if they wish. The inspector observed breakfast and lunch and residents were offered choices. Tables were laid Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 17 appropriately with tablecloth, menu and condiments etc. The meals were not rushed and residents were treated with respect. On discussion with residents they all stated the meals were of a good standard and they enjoyed them. The home maintains a record of food taken by residents demonstrating that choices are regularly provided. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was an open approach to complaints and staff strive to address any concerns and continually improve the service provided for residents. Residents were protected from abuse and follow the Birmingham Multi-agency guidelines. EVIDENCE: The home demonstrated openness in how it managed complaints and staff consult with residents regularly through meetings and general discussion to try to improve the service. Information was available in the reception area about complaints with forms for completion if required. The Commission received a concern about the type of dressing used to a minor injury on a resident following a fall. At the time of inspection the manager had already obtained advice about the most appropriate dressing to use in the event of a further incident and had obtained a supply, which were available in the first aid box. The homes record indicated that they had not received any complaints since the last inspection. They have a system of achieving documents after a period of time in another building and records of previous complaints had been sent for storage. This issue was discussed with the manager and it was suggested that details of any further complaints should be kept on the premises until the next key inspection, so that the process can be inspected. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 19 The feedback obtained from residents and relatives was very positive and they stated they had no concerns or complaints. However, on discussion with some residents they stated they were not aware of the procedure if there were any concerns. Although written information was available it was suggested that other formats be used to inform residents e.g. residents meetings, newsletter etc. At the last inspection it was identified that the complaints policy required updating and the safeguarding procedures did not reflect the multi-agency guidelines that the home uses. The organisation are in the process of reviewing these and when complete a programme of training will be rolled out to staff to ensure they are aware of up to date guidance. The majority of the home’s staff had completed an NVQ 2 in care that contains a module on safeguarding residents. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 20 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): 19,20,21,24,25,26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is maintained to a high standard and provides a clean, fresh, and comfortable place for residents to live. Aids and equipment were available to meet the needs of residents with physical disabilities. EVIDENCE: The home was a modern two-storey building, which was cleaned to a high standard, odour free and well maintained, so providing residents with a pleasant environment to live. There was adequate parking space to the front of the home with a very pleasant garden to the rear of the building, which had a range of seating for use when the weather permits. On the day of inspection work was being undertaken in respect of the paving slabs as it had been identified that some were uneven and could present a trip hazard to residents. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 21 On entering the home there was a spacious reception area with a range of notices and information for residents or anyone visiting the home. There were also some chares that were being used by residents who could watch the comings and goings in the home. There was level access to and from the building, which was suitable for residents who use wheelchairs or have mobility problems. There was a range of aids to assist with mobility e.g. handrails, grab rails, raised toilet seats and a passenger lift that gives access to all areas in the home The home offers a good environment with individual flats that allow residents a degree of independence. All flats have an en-suite facility that includes toilet, wash hand basin and shower or bath and kitchen facilities that included cupboards, sink, fridge and kettle enabling residents to make snacks and drinks for themselves if they wish. The baths in the flats are domestic in type and would not be suitable for many of the residents. In addition, there were communal bathrooms on each floor that provided assisted bathing facilities. Toilets are strategically placed through the home. Some of the extractor fans required cleaning and it was stated that this was being addressed and some were being replaced. On discussion with some residents they stated they liked there flat and it was always clean. All flats were provided with locks and letterboxes to doors; they are carpeted and beds are provided routinely. Generally residents provide all other furnishings, which provides a home from home environment. Residents have keys to their door and lockable facilities are available in each room, so enhancing resident’s privacy. Samples of rooms were inspected and were decorated to a good standard, comfortable and personalised. It was noted that some of the mattresses were rather “lumpy” and a full audit of all mattresses should be undertaken and any worn/damaged mattresses replaced. Flats were individually and naturally ventilated and windows were provided with restrainers for safety and security reasons. Radiators and hot water temperatures were regulated to reduce the risks of accidents from scalds. There was a large dining room/lounge area on the ground that leads into a separate conservatory, which overlooks the garden. Laundry facilities were appropriately sited and were orderly with appropriate equipment and separate staff to ensure suitable laundering of residents clothing etc. On discussion with residents they stated the laundry was of a good standard. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 22 The kitchen is adjacent to the dining room and was clean, well organised and it was stated that the kitchen is to be refurbished in the near future. Whilst touring the kitchen it was noted that some potatoes were stored on the floor, decanted foods did not indicate a use by date and some of the chopping boards were worn and in need of replacement. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 23 Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing levels were maintained at an adequate level to meet resident’s needs with the use of agency and bank staff. Action should be taken to ensure retention of staff to enhance consistency of care in the home. There were robust recruitment procedures in pace so protecting residents with the employment of new staff. Staff training is ongoing, so ensuring staff have the skills and knowledge to meet residents needs. EVIDENCE: Adequate staffing levels were maintained to meet residents needs with the use of agency and relief staff. The manager stated there were a number of vacancies as seven staff with NVQ training had left the home over recent months and she was recruiting. Although adequate staffing levels were maintained the loss a number of staff who have completed training and the use of agency or relief staff could impact on continuity of residents care. It is recommended that this area be explored through exit interviews to look at possible strategies for staff retention in the future. Inspection of duty rotas indicated there was always a senior member of staff or manager on duty during the day and one of them is on call overnight in Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 25 case of emergency. The care staff were supported by catering, housekeeping, laundry and maintenance staff to ensure residents needs were met. A sample of staff files were inspected to assess the recruitment process and this was found to be robust with all checks completed, so ensuring residents are protected with the employment of new staff. There was evidence of induction training for new staff, which meets the standards for the Social Skills Council. On inspection of a sample of records it was noted that in one case it had not been completed and in another the whole training had been completed in one day. The manager will need to review this process to ensure the training is undertaken and completed in a manner that ensure all newly recruited staff have the appropriate knowledge to meet residents needs effectively. A sample of records were inspected in respect of other training that staff had completed and it appeared that updated training had been given in respect of health and safety, fire prevention, manual handling, first aid and food hygiene in 2006 or 2007. It was stated the infection control procedures were being updated and when completed training will be provided to staff. It is recommended that the manager look at other training for staff in respect of specific areas related to residents e.g. tissue viability, diabetes, etc. The information provided indicated that over 50 of care staff had completed NVQ level 2 in care. Such training provides staff with the knowledge and skills they require to meet resident’s needs. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 26 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed and run for the benefit of residents. Good management systems were in place to ensure residents were safeguarded and the effective running of the home. Systems were in place to monitor quality and obtain feedback from residents and relatives. EVIDENCE: The manager of the home has worked in residential care for older people for a number of years. She has completed NVQ level 4 in care and is now working towards the Registered Managers Award. The manager showed leadership and ensured that appropriate procedures were carried through if there were any shortfalls in the homes or staffs performance. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 27 The home had several methods of checking the quality of the service the home offered. There were regular residents meetings, some staff meetings and service managers from the organisation visited. The home had an independent quality assurance assessment plus a health and safety audit and they had scored well in the quality assurance assessment. The organisation undertakes audits of the home’s performance in several areas. The home holds small amounts of resident’s money in a secure facility. On inspection of a sample of records it was found that residents’ money was appropriately accounted for with robust systems of monitoring. All the records matched the amount held. There were clear receipts for any money spent and the home had good systems of checking that the money and the accounting were correct. Residents that wanted to manage their own money were able to do so. At the last inspection it was identified that some of the policies and procedures required review and further development to ensure they matched practice and were in line with up to date guidance. The manager stated that this was currently taking place and when completed staff would be provided with training in the relevant areas. The home had the appropriate maintenance and inspection documents and certificates to ensure that the home was safe. A sample of records were inspected to include; the electrical wiring, fire alarm system, fire extinguishers, passenger lift, assisted bathing facilities and gas safety certificate. They were all satisfactory with the exception of the gas certificate for kitchen equipment and the manager was in the process of addressing it. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 28 Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 29 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X X 4 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 30 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 15 Requirement Care plans must outline in detail residents needs and the action required by staff to meet them. They must be dated, signed, reviewed on a monthly basis and updated where required. Where it is necessary to update them new entries must be dated and signed. This ensures staff have the appropriate information required to meet residents needs and changes in condition are noted. (Work has commenced in this area.) Comprehensive risk assessments should be undertaken where there are risks to residents and the actions required to reduce the risks should be incorporated into the care plans. This is required so that staff are fully aware of the action to take to prevent risks to residents. Daily records should clearly indicate the care given, the type of day experienced by residents, dietary intake etc. so that staff DS0000016775.V351212.R01.S.doc Timescale for action 30/01/08 2 OP7 13(4) 15 30/12/07 3 OP7 17(2) 30/11/07 Manor House Version 5.2 Page 31 4 OP8 13(4) 5 OP19 16(2)(j) are able to monitor residents conditions and care given. An audit of all walking frames should be undertaken on a regular basis and worn rubbers be replaced to reduce the risk of accidents. The following areas should be addressed in the kitchen; • Food items must not be stored on the floor • All decanted foods should be dated with a use by date. • Worn chopping boards should be replaced. 20/11/07 20/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP8 OP8 Good Practice Recommendations It is recommended that residents be given the opportunity to see a dentist on a regular basis to assess oral care. It is recommended that residents with chronic diseases such as diabetes, high blood pressure and asthma have regular health checks to monitor their condition and identify any complications at an early stage so that treatment may be given and optimum health is maintained. The following should be introduced to ensure robust medication systems; • All creams and eye drops should be dated when opened and discarded within specific timescales. • Two staff should countersign handwritten medication details. • The signature of the person collecting controlled drugs must be obtained. • Ensure accurate recording of medication that is carried forward from previous months. A review and development of the arrangements for DS0000016775.V351212.R01.S.doc Version 5.2 Page 32 3 OP9 4. OP12 Manor House 5 OP16 6 7 8 OP24 OP29 OP30 9 OP33 activities should be undertaken to ensure residents receive appropriate stimulation. It is recommended that alternative methods of informing residents about the complaints procedure be explored to ensure they have the information and support should they wish to raise any concerns. It is recommended that an audit of all mattresses be undertaken to ensure they are fit for purpose. It is recommended that systems be implemented to enhance retention of staff. It is recommended that a review of the induction training be undertaken to ensure staff are trained effectively when they commence employment and are able to meet resident’s needs. It is suggested that feedback be obtained from other stakeholders as part of the quality assurance system. Manor House DS0000016775.V351212.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 House DS0000016775.V351212.R01.S.doc Version 5.2 Page 34 - 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. 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