Care Home: Manor View Nursing & Residential Home

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What the care home does well Care plans are `person centred` and reviewed on a regular basis to address the changing needs of individuals who have complex care needs. The care planning approach involves the resident and significant others, in order to ensure the needs, wishes and aspiration of the individual are at the centre of service delivery. The home was well run. The registered manager has implemented a good ethos, provides clear leadership and has a good management approach in the provision of this service. Staff members have the necessary skills and they receive appropriate training to meet the varying needs of the residents. Staff were very knowledgeable about the needs of individuals whom they were supporting and caring for. The home provides a bright modern environment for its residents who have single rooms, which reflect their individual needs and personalities. The home is well maintained and all areas of the home were fresh and clean. Feedback from the completed staff questionnaires was positive. One stated that `the home promotes residents` preferences, choices and wishes and respect their rights to privacy and dignity`. What has improved since the last inspection? Information taken from the AQAA stated that all support plans and risk assessment have been updated and word processed on approved company documents. There has been an increase in the range of activities accessed by the residents, some have tried different holidays and new experiences including going abroad. All staff have received training in epilepsy and the administration of a specific anticonvulsant medication so as to support a resident when having a seizure. What the care home could do better: The home should ensure that all staff including night staff are included in fire drills so that they are kept up to date with fire safety procedures. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Manor View Nursing & Residential Home 45 Manor View Stevenage Hertfordshire SG2 8PS     The quality rating for this care home is:   two star good service 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. Lead inspector: Bijayraj Ramkhelawon     Date: 0 5 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Manor View Nursing & Residential Home 45 Manor View Stevenage Hertfordshire SG2 8PS 01438311615 01438311615 lynne.richardson@hpcha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Hightown Praetorian & Churches Housing Association care home 8 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Additional conditions: 8 8 One named service user aged 65 years and over may be accommodated. This home may accommodate up to 4 people with learning disability and associated physical disability who require nursing care. This home may accommodate up to 8 people with a learning disability and associated physical disability who require personal care. Date of last inspection Brief description of the care home 45 Manor View provides care for up to 8 people with learning disabilities and associated physical disabilities. Within the overall numbers, 4 service users with learning disabilities and associated physical disabilities requiring nursing care may be admitted. The purpose built bungalow is set back from the road in its own grounds with a parking area to the front of the building. The home blends into the local environment and has good access to local facilities. There are 8 single rooms and a large kitchen/ diner and Care Homes for Adults (18-65 years) Page 4 of 24 Brief description of the care home lounge. The home has level access and bathing and shower facilities to suit the needs of disabled service users. The current fees charged are £ 1102.88- £1131.88 per week. A copy of the Statement of Purpose, Service Users Guide and the most recent inspection report is available from the care home. Care Homes for Adults (18-65 years) Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out on the 5th of June 2009 and took one day. It included talking to people using the service, staff, examining care plans, medicine records, staff files, staff training records, fire safety procedures, health and safety procedures, maintenance records, all other records and documents and a tour of the premises. The home sent us their Annual Quality Assurance Assessment (AQAA), a document, which gives the manager the opportunity to tell us how the home is meeting the standards and regulations. 5 completed survey questionnaires were received from staff. Care Homes for Adults (18-65 years) Page 6 of 24 Care Homes for Adults (18-65 years) Page 7 of 24 What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who would like to use the service are able to make an informed choice and be sure that their needs would be assessed and met. Evidence: Information about the home was available to current and prospective individuals including the Statement of Purpose and Service Users Guide. Records examined and information gained from members of staff indicated that individuals were admitted to the home after assessment of needs has been carried out. Care plans seen and staff spoken to confirmed that normally individuals admitted to the home are under a Care Management arrangement and have a full assessment of needs carried out by their respective Social Worker, prior to admission to the home. Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their identified needs would be met appropriately and that they would be enabled to live the lifestyle they chose. Evidence: Care plans examined show that these were drawn up from a range of sources including individuals assessment of needs, reports from Social Workers, input from family representatives, staffs ongoing assessment during the trial period and contributions from other professional as appropriate. Care plans were detailed and comprehensive which reflected the identified needs of people using the service and how these needs were being met. Regular review of individuals care needs was also carried out and details of their changing needs were reflected in their care plans. Staff spoken to confirmed that they treated information given by people using the service and significant others in confidence. Records regarding the residents are compiled and stored in accordance with the organisations written procedures and the Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: Data Protection Act 1998, and in their best interests. As stated in the AQAA, the manager will within the next twelve months develop a communication tool/passport for each resident which they can carry with them so as to enable them to communicate more effectively to make their choices and wishes known to staff and significant others. Care Homes for Adults (18-65 years) Page 12 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that they would have opportunities for personal development and enhanced their daily living skills so that they would be enabled to lead as near normal a life as possible. Evidence: Individuals personal development was promoted by engaging in planned day care, social and leisure activities. A weekly programme of individuals activities was included in their care plans. People were encouraged to maintain contact with their relatives and those who are important to them. There are yearly holidays and trips according to peoples preferences. Summer holidays were planned in August this year at Warners in Cheshire and Bognor Regis. Community activities records included trips to the local places of interests, shopping, Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: Visists to parks and outings. People also attended the Leyden House Centre for day care activities. A rotational menu was in place. The dining area was comfortable and reasonably spacious. As stated in the AQAA, the manager will within the next twelve months ensure that residents will be supported to develop their interests and meet new people and develop friendship. Care Homes for Adults (18-65 years) Page 14 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their personal and healthcare needs would be met appropriately. Evidence: Peoples personal and health care was being provided as set out in their care plans. The progress notes indicated that identified needs were being met and kept under review. Changes in any needs were also reflected in individuals care plan. None of the people living in the home are able to self-medicate due to their complex needs and profound learning disabilities. The administration and management of medicines were kept in good order. As stated in the AQAA, the manager is liaising with families and people using the service to identify wishes concerning terminal illness and death. Care Homes for Adults (18-65 years) Page 15 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their concerns and complaints would be listened to and acted upon and that they would be safeguarded from abuse, neglect and harm. Evidence: A daily communication book is used between staff in the home and day centre for each resident so issues which may have an effect on the emotional needs of a service user can be identified. Information on complaints is also included in the Service Users Guide and Statement of Purpose. The home maintains a record of complaints. No complaints have been received since the last inspection. The home has a copy of the Hertfordshire procedures on Safeguarding Adults. Staff spoken to confirmed that they are familiar with the procedures and staff records showed that they have received training on the Safeguarding Adults. Care Homes for Adults (18-65 years) Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are cared for in an environment that is homely, comfortable and safe. Evidence: All rooms are for single accommodation. Peoples bedrooms were personalised with individuals belongings. Staff encouraged people to bring and/or choose their own furniture and can decorate and personalise their rooms, subject to any fire and safety regulations. The premises were safe, accessible, comfortable, reasonably clean and fresh. Each room has sufficient light and ventilation. The bathroom and toilet provision is sufficient for the number of residents in the home. The home has a rolling programme of maintenance. The home uses its own transport for people to access local amenities and relevant support services Care Homes for Adults (18-65 years) Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service do benefit from the care and support they receive from a competent and qualified staff team and that they feel protected by the homes recruitment policy and practices. Evidence: Information gained from duty roster and staff spoken to confirmed that the day and night staffing levels remain adequate to meet the needs of the residents. Staff members have the necessary skills and they receive appropriate training to meet the varying needs of the people using the service. Staff were knowledgeable about the needs of individuals whom they were supporting and caring for. Currently, 6 care staff have completed their NVQ Level 2. One is undertaking this course and another at Level 3. and 4 Level 3. This represents 75 of the care staff have successfully completed the required NVQ Level and above. The recruitment files for 6 members who have been recently employed including registered nurses were examined. These files had all the documents required by this standard. Staff spoken to said they all had their CRB checks carried out prior to an offer of employment was made. Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: Staff also confirmed that they received one to one formal supervision on a regular basis. Supervision records were maintained. Staff also confirmed that they received support from the management team and that senior members of staff were approachable and available for advice as and when needed. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their health, safety and welfare are protected by the systems and practices in place and the support they receive from an open and transparent management team. Evidence: The management communicate a clear sense of leadership within the home and has an open-door policy where staff could see them at any time with any issues or concerns they may have. The effective implementation of a number of systems including assessment and admission process, care planning and review, consultation and communication, recruitment, induction, training, supervision and appraisal of staff ensures that the home operates in an efficient manner; this clearly benefits people using the service and the staff teams. The risk assessment systems are thorough and tailored to the needs of the individuals. The home has a quality assurance system in place and seek the views of people using the service, relatives, staff and other interested parties. Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: All statutory records were available for inspection and maintained in accordance with legislation. Records inspected were up-to-date and accurate and were held securely. Staff spoken to were aware that people using the service can access their records and information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of people using the service and staff are promoted and protected. These records were accessible to all staff. All accidents and injuries are recorded in the accident book and RIDDOR forms have been completed where applicable. The Commission has been kept informed of all accidents and admissions to hospital. Regular checks on hot water temperatures and moving and handling equipment were recorded. However, it was noted that the night staff have not have a fire drill in the last two years. A valid insurance certificate was displayed in the reception area and this offered cover of no less than £5 million. Care Homes for Adults (18-65 years) Page 21 of 24 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 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, Care Homes 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 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 1 42 Night staff should be included in fire drills so that they are kept up to date with safe fire practices. Care Homes for Adults (18-65 years) Page 23 of 24 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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