Care Home: Manor House Nursing & Residential Home

What the care home does well Manor House is a spacious and well-appointed building that is set in very attractive grounds. The communal areas are very nicely decorated and furnished. There is a large lounge on the ground floor that divides into different areas, and there are other sitting areas around the building for people to use. Bedrooms are all en suite with bath or shower, and there are also assisted baths and wet rooms. All parts of the building were exceptionally clean and there were no unpleasant smells. Visitors are made welcome. The home has an activities organiser who is verycommitted and enthusiastic. There are good facilities for social activities and a regular weekly programme including guest speakers and an art group. People can choose whether they wish to join in group activities and the activities organiser also spends one to one time with people in their rooms. There are links with local community groups including schools and a hospice. There are two spacious and very pleasant restaurants on the ground floor which look out over the gardens. Three courses are served at lunch and evening meal, and there is also morning coffee, afternoon tea with cakes, sandwiches and smoothies, and the same again in the evening. A `nite bite` initiative ensures that there is food available through the 24 hour period so that people who are unable to eat a big meal can have small amounts regularly. Menus displayed on the dining tables showed that a good choice is available and people we spoke with said that the food is very good. Records showed that any complaints received are fully investigated and responded to appropriately so that people can be sure that their complaints are taken seriously. Each person living at the home has a detailed care plan that identifies their needs and how their needs should be met. New staff do not start working at the home until all of the required safety checks have been carried out to ensure that they are safe and suitable to work with vulnerable people. What the care home could do better: Keep a record of all medicines that are being kept in the home. This to include accurate checking in of new medicines delivered by the pharmacy, and any items that are carried over from previous prescriptions. This ensures that there is an audit trail for all medicines that have been received at the home and helps prevent any misuse of medicines. Ensure that all staff have regular training relating to topics that protect the health and safety of everyone in the home, including moving and handling and fire safety. Keep an accurate training matrix to show when people have attended training so that the manager can see when updates are due and if anyone has missed important training. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Manor House Nursing & Residential Home Moreton Road Upton Wirral CH49 4NZ three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Wendy Smith Date: 0 6 0 3 2 0 0 9 Information about the care home Name of care home: Address: Manor House Nursing & Residential Home Moreton Road Upton Wirral CH49 4NZ 01516770099 01516040328 Telephone number: Fax number: Email address: Provider web address: www.bupa.com Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (BNH) Ltd care home 59 Number of places (if applicable): Under 65 Over 65 59 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category of service only: Care home with nursing - Code N To people 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 The maximum number of people who can be accommodated is 59. Date of last inspection Brief description of the care home Manor House is a large care home providing nursing and personal care for up to 59 people. It is part of the BUPA group of healthcare services. It is situated in extensive and well-maintained grounds that are fully accessible. Accommodation is provided on three floors with stair and passenger lift access to the first and second floors. All bedrooms have en-suite facilities. There are several spacious sitting areas and two large dining rooms. Information about fees is available from the manager. Care Homes for Older People Page 2 of 10 What we found: This random inspection was carried out to satisfy ourselves that nothing has changed and that our judgment that the home provides excellent quality outcomes for the people who live there remains valid. We visited Manor House on 6th March 2009 and spoke with the manager and some of the staff and residents. We looked at the communal areas of the home and some bedrooms. We looked at records including medication records, care plans, staff training records and management records to see how various aspects of the home were being run. Choice of Home Plenty of information about the home is available for people who are interested in going to live there, or having a short stay there. We saw evidence that new residents have a full assessment of their needs before going to The Manor, which ensures that it will be the right home for them. Health and Personal Care Each person has a very detailed care plan that is kept in their room. We looked at a sample of care plans. They are very lengthy and time-consuming to complete, however they had been completed to a good standard and good daily entries were made. We saw evidence in the care plans that peoples health is monitored regularly, for example monthly weights and pressure sore risk assessment. We spoke with a visiting GP who said that he had no complaints about the home. We saw that equipment is provided to meet peoples needs, including pressure relieving mattresses and syringe driver. Medicines are stored in a medicine room that is within the nurses office on the first floor. There is a drugs trolley for each floor. Storage and recording of controlled drugs was satisfactory. There were no missed signatures on the medicine administration record sheets which suggests that people always receive their medicines as prescribed. The medicines received for monthly repeat prescriptions had not been checked in onto the medication administration record sheets and there were no dates or signatures. Any medicines carried over from the previous month had not been recorded and this meant that it was not possible to check whether the quantities were correct, and there appeared to be a number of discrepancies. The manager said that there is a checkingin procedure for medicines but this had not been followed. We observed that the staff had a positive and respectful attitude towards residents and were mindful of peoples privacy and dignity. Bedroom doors are lockable. Daily Life and Social Activities There were visitors in the home throughout the day and they were made welcome. The Care Homes for Older People Page 3 of 10 home has an activities organiser who is very committed and enthusiastic. There are good facilities for social activities and a regular weekly programme is publicised throughout the home. This includes guest speakers and an art group. People can choose whether they wish to join in group activities and the activities organiser also spends one to one time with people in their rooms. There are links with local community groups including schools and a hospice. There are two spacious and very pleasant restaurants on the ground floor and most people were having their lunch in the restaurants, which look out over the gardens. Three courses are served at lunch and evening meal, and there is also morning coffee, afternoon tea with cakes, sandwiches and smoothies, and the same again in the evening. People have breakfast in their own rooms. A nite bite initiative ensures that there is food available through the 24 hour period so that people who are unable to eat a big meal can have small amounts regularly. Menus displayed on the dining tables showed that a good choice is available and people we spoke with said that the food is very good. Complaints and Protection The homes complaints procedure is displayed in the entrance area and on notice boards on each floor. The manager keeps a record of any complaints received. We looked at the records and found that complaints had been investigated and responded to appropriately so people can be sure that their complaints are taken seriously. Policies and procedures are in place, and all staff have received training so that they know how to recognise abuse and what action they should take. The whistle-blowing policy is currently being revisited with all staff in meetings and supervisions. Environment Manor House is a spacious and well-appointed building that is set in very attractive grounds. The communal areas are very nicely decorated and furnished. There is a large lounge on the ground floor that divides into different areas, and there are other sitting areas around the building for people to use. Bedrooms are on three floors, mainly in a purpose-built extension. On the top floor there are some bedrooms in the original part of the building which are accessed by stair lift from the main lift. These have recently been refurbished to a high standard. All bedrooms are en suite with bath or shower, and there are also assisted baths and wet rooms and a new shower chair that can be used by people who need more support. All parts of the building were exceptionally clean and there were no unpleasant smells. There is a well-equipped laundry, and a sluice room on each floor. Staffing There are three nurses on duty in a morning and two during the rest of the 24 hour period. One of the nurses told us that she had been working at The Manor for three months and was enjoying it very much, she said that all of the staff had been very helpful to her settling in. There are six care staff on duty in a morning, five in an Care Homes for Older People Page 4 of 10 afternoon and three or four at night. Staff hours have been reduced recently because of current low occupancy. In addition, waitresses are employed to help at mealtimes. The manager told us that 50 of the care staff have a national vocational qualification (NVQ) in care. Six care staff are waiting to start NVQ and some of the housekeeping staff are going to do NVQ relevant to their work. We looked at the recruitment records for two recent members of staff. The records showed that good recruitment processes had been followed and the required checks had been carried out to ensure that they were safe and suitable to work in a care home. There is a full induction process for new staff, with different workbooks for each staff group. Staff training records were difficult to follow and did not provide clear information so that we could tell whether everyone is up to date with the mandatory training that protects the health and safety of residents. The manager was aware that a better training matrix is needed and had started to develop a form on the computer. Management and Administration The manager has been in post for twelve years and is well qualified. She recently won the regional Customer Champion award. She holds monthly heads of department meetings, quarterly health and safety meetings and staff meetings for the various groups of staff. The last resident and relatives meeting was in October 2008. An annual satisfaction survey is carried out by BUPA, and a senior manager visits the home at least once a month to carry out a monitoring visit. The last visit was on 3rd March 2009 and the report was available for us to see. In general, the standard of record keeping is good and documents were readily available for inspection. The Commission is kept informed of important events that happen at the home and accident forms are well completed and always countersigned by the manager or deputy. The home employs a full-time maintenance person and all parts of the building appeared to be in a very good state of repair. The annual quality assurance assessment gave details of the servicing of all plant and equipment. We noticed that the last electrical circuits examination was in August 2003. This should be done every five years and the manager contacted the estates department immediately to remind them that this needs to be renewed. What the care home does well: Manor House is a spacious and well-appointed building that is set in very attractive grounds. The communal areas are very nicely decorated and furnished. There is a large lounge on the ground floor that divides into different areas, and there are other sitting areas around the building for people to use. Bedrooms are all en suite with bath or shower, and there are also assisted baths and wet rooms. All parts of the building were exceptionally clean and there were no unpleasant smells. Visitors are made welcome. The home has an activities organiser who is very Care Homes for Older People Page 5 of 10 committed and enthusiastic. There are good facilities for social activities and a regular weekly programme including guest speakers and an art group. People can choose whether they wish to join in group activities and the activities organiser also spends one to one time with people in their rooms. There are links with local community groups including schools and a hospice. There are two spacious and very pleasant restaurants on the ground floor which look out over the gardens. Three courses are served at lunch and evening meal, and there is also morning coffee, afternoon tea with cakes, sandwiches and smoothies, and the same again in the evening. A nite bite initiative ensures that there is food available through the 24 hour period so that people who are unable to eat a big meal can have small amounts regularly. Menus displayed on the dining tables showed that a good choice is available and people we spoke with said that the food is very good. Records showed that any complaints received are fully investigated and responded to appropriately so that people can be sure that their complaints are taken seriously. Each person living at the home has a detailed care plan that identifies their needs and how their needs should be met. New staff do not start working at the home until all of the required safety checks have been carried out to ensure that they are safe and suitable to work with vulnerable people. 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 6 of 10 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 7 of 10 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 8 13 Keep a record of all 27/03/2009 medicines that are being kept in the home. This to include accurate checking in of new medicines delivered by the pharmacy and any items that are carried over from previous prescriptions. This ensures that there is an audit trail for all medicines that have been received at the home and helps prevent any misuse of medicines. Ensure that all staff have 30/04/2009 regular training relating to topics that protect the health and safety of everyone in the home, including moving and handling and fire safety. Keep an accurate training matrix to show when people have attended training so that the manager can see when updates are due and if anyone has missed important training. To ensure that the health and safety of staff and 2 30 18 Care Homes for Older People Page 8 of 10 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 residents are 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 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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