Care Home: Manor Road (30)

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What the care home does well The residents and staff responded well to this weekend visit and were very open and welcoming in their approach as they told us what it is like to live and work at Manor Road. Everyone we spoke to was very positive about the service provided. The people who live at Manor Road are supported to lead fulfilling lives and live in a comfortable family style house, supported by a consistent staff team who are well known to them and are able to identify and respond to their changing needs. People`s health needs are closely monitored and staff provide additional support to residents when they have to spend time in hospital, so that they are not anxious and receive the treatment they need. People are encouraged to maintain contact with their family and friends. People live in a safe well maintained home. What has improved since the last inspection? Each person now has a health action plan which sets out their needs and how they wish to be supported. It also provides clear and easily accessible information to ambulance staff, nurses, doctors and other specialists when people are attending planned appointments or in the event of an emergency. Dementia care training is being provided for staff to help them understand the changing needs of the people who live at Manor Road and provide appropriate support and assistance. New furnishings, fixtures and fittings continue to be provided to maintain the home to high standards and make it a pleasant place to live. What the care home could do better: The managers self assessment shows us that the quality of the service provided to the people living at Manor Road is kept under review therefore we can have confidence that the home will continue to be well run. CARE HOMES FOR OLDER PEOPLE Manor Road (30) 30 Manor Road Potters Bar Hertfordshire EN6 1DG Lead Inspector Sheila Knopp Unannounced Inspection Saturday 12th July 2008 10:20 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 Road (30) DS0000019455.V368413.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 Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor Road (30) Address 30 Manor Road Potters Bar Hertfordshire EN6 1DG 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) 01707 663 908 01707 663 908 H3Mo76Derrick@mencap.org.uk www.mencap.org.uk Royal Mencap Society Mr Francis G Derrick Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: 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: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 6 25th July 2006 Date of last inspection Brief Description of the Service: 30 Manor Road is a two-storey detached house, with six bedrooms. It is located in a quiet cul-de-sac in Potters Bar. The home is within walking distance of the town centre, train station and public transport routes. The home offers support to service users with learning difficulties and mild physical disabilities. Manor Road is a Mencap home. People have bedrooms on the ground and first floor. Adaptations and a walk in shower have been provided in the bathrooms to provide additional support as the current residents become older. There is no lift so people have to be able to climb the stairs. People are able to use the lounge and large kitchen/diner. The garden is accessible from the kitchen and has a sloping ramp with handrail leading to a lawn, patio, seating areas, summerhouse and greenhouse. The current fees, available from the manager, are based on individual payments from the funding authority and service user contribution subject to individual assessment. No additional charges are made. Information about the home is contained in the Service User Guide & Statement of Purpose, which is available from the manager or by contacting Mencap. Manor Road (30) DS0000019455.V368413.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. An inspector visited the service on a Saturday morning to spend time with the 6 people who live at Manor Road. We were able to meet all six residents a visitor and three staff. The residents went out for a ride in the mini-bus before lunch and were happy for the inspector to go with them. On return home everybody had lunch together. We also reviewed records in the home and information we have received about the service since out last inspection on 25/7/06. Manor Road is assessed as being a good service therefore we do not need to visit as often. Last year we carried out an annual service review, which did not involve a visit to the home. Each year managers of care services are required to send us their Annual Quality Assurance Assessment (AQAA), which tells us how well outcomes for people using the service are being met. We have assessed the service against the older people’s standards as the average age of the current residents is 75 years. What the service does well: The residents and staff responded well to this weekend visit and were very open and welcoming in their approach as they told us what it is like to live and work at Manor Road. Everyone we spoke to was very positive about the service provided. The people who live at Manor Road are supported to lead fulfilling lives and live in a comfortable family style house, supported by a consistent staff team who are well known to them and are able to identify and respond to their changing needs. People’s health needs are closely monitored and staff provide additional support to residents when they have to spend time in hospital, so that they are not anxious and receive the treatment they need. People are encouraged to maintain contact with their family and friends. People live in a safe well maintained home. Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 7 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 Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 8 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): Standard 3 (standard 6 does not apply to this service)- People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People choosing to live at Manor Road can be confident they will be involved in an assessment to see whether it is a suitable place for them to be and they will be able to visit the service to meet the other people who live there and try it out to see what it is like. EVIDENCE: To find out people’s experience of moving to Manor Road we spoke to a resident who had recently moved in. They showed us their room and answered our questions about what had happened to them. We also looked at their care records. The care records provided clear information about the detailed assessment process that took place to ensure their needs could be met. This included information from other people who know them and opportunities to visit and meet other the people living in the home. Staff had been very Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 9 sensitive to helping this person to settle in and are now encouraging them to be more independent. Manor Road (30) DS0000019455.V368413.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): Standards 7, 8, 9 & 10 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Each person has a person centred care plan that sets out how they wish to be supported to meet their personal, health and social care needs. People experience a positive and supportive approach from staff, which respects their need for privacy and maintains their dignity. People, who need to take medicines to keep them healthy, can be confident that it will be given safely and regularly reviewed to make sure it is still suitable for them. EVIDENCE: We observed that residents had received the individual assistance they needed to maintain high standards of personal care and hygiene. People were able to tell us where they shop for clothes and have their hair cut to maintain their own individual styles and preferences. Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 11 Previous reports have confirmed people have good access to local community services to maintain their health. We were able to confirm that people had recently had contact with dentists, chiropodists and opticians. One resident was very pleased with the style of new glasses, which were very flattering. Each person has a person centred care plan that tells staff how they wish to be supported. Increasing use of photographs and pictures is making these more real for the people they are about. Residents and their representatives are invited to sign them when they are first put in place and when reviews take place. The three care plans we looked at had been kept up to date and reflected what we knew about the people concerned. The care plans provide clear instructions to staff on how to meet specific needs and we observed that information about meal times was put into practice over lunch. Each person has a healthy eating and exercise plan to enable them to maintain their health and mobility. People were aware of being involved in decisions about meals and choosing healthy options. The care records confirmed people are weighed regularly to identify any changes. We looked at how residents are given the medicines they need and found staff were following the procedures in place and have clear information about the effect of the medicines they are giving. Checks on the storage temperature of medicines are carried to make sure they are kept correctly and remain effective. Manor Road (30) DS0000019455.V368413.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): Standards 12, 13, 14 & 15 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who live at Manor Road lead busy fulfilled lives aimed at maintaining their independence, strengths, skills and self-esteem through planned activities, contact with family and friends, access into the community and involvement in day-to-day daily living activities. People are provided with a healthy diet that they are involved in preparing and which reflects their individual preferences and choices. EVIDENCE: The manager’s assessment is that ‘residents lead a busy and active life, within the limits of their age and physical ability’. Our visit found this to be the case with residents recently having enjoyed holidays chosen to meet their individual needs and preferences. The new resident has spoken about parts of the country they remember and staff are planning to visit this area. The photographs displayed around the home show the range of activities people are involved in and their enjoyment. One person had brought gifts home from their holiday to give members of their family when they saw them. Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 13 People attend a range of day time activities based on day centres and a college. Having a mini bus means spontaneous trips and visits to local places of interest can be arranged at short notice, to suit the individuals concerned. Each person has an activity folder setting out how they would like to spend their time and how staff can make this happen. A pictorial activity calendar for each person shows them what is planned for the week. Risk assessments are in place to encourage people’s independence within the home and when they are out and about. People told us about what they did. We heard about people using local buses to get about and visits to local cafes and restaurants. There are links with other Mencap services so people can visit friends and arrange parties and outings together. One resident likes walking and arrangements have been made for them to walk a dog. Residents prepare and eat their meals in the large welcoming kitchen / diner. Drinks, snacks and fruit are readily available, for people to help themselves. People confirmed they enjoyed their meals. Manor Road (30) DS0000019455.V368413.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): Standards 16 & 18 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can feel confident that their concerns or changes in how they feel will be listened to and acted upon because there is an open and mutually respectful culture, which enables service users and staff to raise issues and concerns. Service users are protected by the vigilance and knowledge of staff who understand their vulnerability in specific situations. EVIDENCE: We have not received any complaints about this service between our inspections. The manager has also reported they have not received any complaints in the last 12 months. Service users are provided with support and advice regarding protecting their own safety when out and about in the community. The feelings of service users about situations in their lives are recorded and action taken to monitor and address issues that arise. Staff confirmed they have received training in protecting residents from abuse and would be able to raise any concerns with the manager, should the situation arise. Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 15 One of the residents who has lived in the home for many years said they had ‘never had any trouble’. Manor Road (30) DS0000019455.V368413.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): Standards 19 & 26 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a comfortable, clean, hygienic, safe and well-maintained home that meets their needs. EVIDENCE: Manor Road is very much a home with residents involved in the day-to-day chores and domestic arrangements associated with home life. We could see that involvement in setting tables and watering the garden plants was carried out willingly and people were pleased to be identified with these jobs. One resident who showed the inspector their room is very proud of the fact they keep it clean and tidy. Each person’s room reflects their individual interests and enables them to have time away from other people if they wish. Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 17 The minutes of the resident meetings indicate they have been involved in choosing new furnishings. The newest resident is still in the process of sorting out their belongings and deciding where they want to put things. They confirmed they were happy with their room and the bed was comfortable. Aids and adaptations are being fitted as necessary to support people who need more assistance and include a wet room style shower. A new large screen TV has been provided and new carpets fitted in the communal areas with pleasing effect. Residents are currently choosing carpets for their bedrooms. We observed a high standard of housekeeping and staff have access to the equipment they need to prevent infection. This includes the provision of a new washing machine with sluice cycle. Manor Road (30) DS0000019455.V368413.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): Standards 27, 28, 29 & 30 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home can be confident they will be supported by staff who understand how they wish to be looked after and will keep them safe. EVIDENCE: All three staff we met on the day of inspection were experienced and known to the people living in the home. One person told us how recent training in dementia care had increased their understanding of how to deal with specific needs. We observed positive interaction between the staff and residents. The staff showed they respected the resident’s home and involved them in the day to day management and choices that needed to be made. The staff response to questions demonstrated a positive and understanding approach that places residents at the heart of the home. Although residents commented on being sad when staff leave there is a core group of permanent and relief staff they are familiar with. Residents are involved in meeting people invited to visit the home as part of the staff selection process. Our previous inspections have confirmed that the required checks are carried out on staff before they are employed to make sure they are suitable to work with vulnerable people. Staff confirmed they have received training in recognising and preventing abuse. The relevant local Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 19 authority safeguarding procedure was available to let staff know what they should do should a disclosure arise. The manager’s self assessment shows us staff are well trained with 6 (75 ) out of 8 permanent staff having achieved National Vocational Qualifications (NVQ). Staff are also supported by Mencap to gain additional skills and expertise Manor Road (30) DS0000019455.V368413.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): Standards 31, 33, 35, 36 & 38 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can have confidence in the service provided at Manor Road because it is well managed and takes account of their individual views and needs. People can be sure that their finances will be looked after and their money will be available to them when they want it. People who live and work in the home are protected by the policies and procedures in place that ensure regular safety checks are carried out and staff receive the training they need. Manor Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has been in post since 2002 and achieved the Registered Manager Award in February 2006. He is also involved in developing projects within Mencap demonstrating an on-going commitment to ensuring the service provided is in line with current professional practice. Resident meetings are held in addition to one to one sessions for each person to express their view on the running of the home and to make decisions affecting the group. The quality of the service is kept under review. Mencap senior managers make regular unannounced visits to the service and provide the manager with detailed reports covering all aspects of the service. The manager told us ‘our Continuous Improvement Plan is live and active. It ties in very closely with the monthly quality review visits by our Area Services Manager and is updated frequently’. The manager works well with us and keeps us informed of important events happening in the home and the effect they have on the people who live there. We looked at the systems in place to support people to manage their finances and give them access to money. This is checked daily by staff as part of the shift handover, to make sure things are in order and residents can have access to their money when they want it. There are clear instructions for staff on their contribution to meals and social occasions when they go out with service users. The manager has told us the fire safety risk assessment has been updated following a visit by The Hertfordshire Fire safety Service. On the day of our visit the fire alarm panel was fully functioning and records of the regular checks on fire safety equipment were available. To protect people from accidents individual risk assessments are in place for potential hazards within the home and when residents are out and about. The temperature of the bathwater is recorded each time a bath is run. The hot water temperatures are regulated and the test we carried out showed the water was within the safe range. The self assessment information provided by the manager confirms that the checks required to maintain the safety of systems and equipment have been carried out. Staff confirm that Mencap provides them with health & safety training and updates as required. Manor Road (30) DS0000019455.V368413.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 x 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 Road (30) DS0000019455.V368413.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 Road (30) DS0000019455.V368413.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Road (30) DS0000019455.V368413.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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