Care Home: Steepleton Manor

Similar services:

• Fairfields Country Rest Home
• Queensmount
• Poldhu
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well People only move into the home once an assessment has been completed and they have been assured that the home can meet their needs. People have individual plans of their care so that staff know exactly how they need to be supported. Medication policy and practice in the home ensures that people are protected. People who live in the home tell us that the lifestyle experienced matches their expectations. They tell us that they maintain contact with those who are important to them and they have control over their own lives. People are offered a varied and balanced diet in relaxing surroundings. People live in an elegant well maintained home. Good infection control policy and practice means that the home is hygienic. Staff are supported to complete training which ensures that people living in the home are in safe hands. The home`s recruitment policy and practice ensure that people are protected. Staff receive the training they need to do their jobs well. People using the service benefit from the leadership and management approach of the home. The quality assurance process in the home ensures that people are listened to. The homes policy and practice ensures that individual financial interests are safeguarded. What has improved since the last inspection? At the last key inspection in February 2007. There were two requirements and six recommendations. All staff receive safeguarding training this ensures they understand how to protect people from harm and report concerns. The registered provider visits the home monthly and keeps a record and report of these visits. When someone needs moving and handling equipment they are provided with the correct equipment to meet their needs. People living in the home are respected and their dignity maintained throughout their stay. the service user guide clearly explains the additional fees. There is a policy on complaints and how to respond to them. Staff receive the training they need to meet the needs of the people using the service. All staff receive fire training. What the care home could do better: At the end of this inspection there are no requirements and no recommendations. The home is working to wards maintaining excellent outcomes for people using its service. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Steepleton Manor Winterbourne Steepleton Dorchester Dorset DT2 9LG     The quality rating for this care home is:   three star excellent 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: Tracey Cockburn     Date: 1 9 0 3 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 Older People 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 Older People Page 2 of 25 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 Older People Page 3 of 25 Information about the care home Name of care home: Address: Steepleton Manor Winterbourne Steepleton Dorchester Dorset DT2 9LG 01305889316 01305880165 heather@steepletonmanor.co.uk www.altogethercare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Altogether Care LLP care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 30 The registered person may provide the following category of service only: Care Home only - Code PC to service users of either gender whose primary needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Steepleton Manor is a large Grade II listed late Victorian Manor House set in 6.5 acres of landscaped grounds, which include a Victorian walled garden. It is situated in the quiet rural location of Winterbourne Steepleton. The village church is nearby and Dorchester is approximately 4 miles away: a river runs alongside the property. Steepleton Manor is registered to accommodate a maximum of 36 older people, in 24 single and 6 double bedrooms. With the exception of one single bedroom (which has a Care Homes for Older People Page 4 of 25 Over 65 30 0 Brief description of the care home separate dedicated private bathroom) all offer en-suite toilet facilities. A passenger lift enables access to the first and second floors of the home: at this level four bedrooms are accessed by a short additional flight of stairs. At first floor level a separate stair lift is fitted to a small staircase and provides assistance to negotiate the stairs. Other facilities include an outdoor heated swimming pool, which can be used during the summer months. Fees range from 740 pounds to 760.00 per week. Weekly fees for respite are 700 pounds. Care Homes for Older People Page 5 of 25 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home without warning. We also arranged for an expert by experience to visit the home and find out what peoples experience of living in the home is like. An expert by experience has knowledge, understanding and expertise in services for older people. We will use extracts of the experts report throughout our evidence. We received survey forms back from people who use the service as well as people who work in the service. Six survey forms were returned from staff and eight from people who live in the service. We looked at care records, staff records, health and safety information on how the home is maintained as well as medication records. We talked to people who live and work in the home and we observed daily life. We also used information from the annual quality assurance assessment to plan our visit. Care Homes for Older People Page 6 of 25 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 Older People Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 only move into the home following an assessment and agreement that the home can meet their needs. Evidence: We looked at the files for three people who moved into the home. One person was staying in the home for respite and we found there was a pre admission assessment in place. we also found pre admission assessments in place for the other two people. We talked to people who told us that they had visited the home before making a decision about moving in. Another person told us that their family had visited and made the choice for them. The manager told us that all the pre admission assessments are completed by her. The annual quality assurance assessment says: All new residents are fully assessed pre-admission and that information forms the basis for the decision as to whether the Home can meet that persons needs if we can then a letter of confirmation is sent. The pre-admission assessment also begins the Care Homes for Older People Page 9 of 25 Evidence: process of the formation of a person centred care plan with a focus on identifying and achieving positive outcomes. At the last inspection a recommendation was made that any additional fees are clearly recorded in the service user guide. This has been done. Care Homes for Older People Page 10 of 25 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. The health and personal care that people receive is based on their individual needs. the principles of respect, dignity and privacy are put into practice. Evidence: The manager is in the process of changing the current care plans and has introduced a more person centred approach to care planning. We looked at the care plans of three people. The manager told us that there were two plans she was happy with and one which was yet to be written the way she wanted. We could see the different approach in each plan. The information in the care plans focused on the abilities that people had and how to support them to maintain those. There was also good information on how they prefer to be supported and and the action to take if people were unwell. Care plans are reviewed with the involvement of the individual and anyone else they wish to have with them. Each care plan has written confirmation from the individual that they were involved and agree with the contents. Where people need support with their mobility there is a moving and handling care plan which details the support and equipment they need. In the files we looked at there was evidence of nutritional screening taking place and Care Homes for Older People Page 11 of 25 Evidence: action put into place if someone lost weight. We also saw risk assessments which were regularly reviewed. We looked at one care plan where someones mobility had decreased and we found that there was an assessment of their skin vulnerability. Monthly review were detailed about changes and action being taken. We saw from the records that people have access to a variety of health care professionals and have annual health checks. Care plans are audited monthly. The home has a medication policy which was recently reviewed in a pharmacy audit by Boots. The pharmacy report states comprehensive medication policy and was dated 10/02/09. We looked at the Controlled Drugs (CD) cabinet and found the recording and storage to be accurate. All staff who are responsible for dispensing medication to the people living in the home are put on a 16 week medication course. The Registered Manager and head of Care complete separate monthly audits of the medication. There is a separate fridge for any medication which needs to be kept at a specific temperature. During the site visit we observed medication being given out. This was one persons task and when supervision and checking was required for Controlled Drugss this was done. Medication Administration Records were up to date. A recommendation was made at the last inspection that staff ensure people living in the home are treated with respect and their dignity maintained at all times. At this inspection we found that people living in the home spoke highly of staff and that staff receive training as part of induction on how to respect the people they are supporting. Care Homes for Older People Page 12 of 25 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People tell us they are able to live the life they want to. The service continues to develop a person centred approach to care. Evidence: The expert by experiences report says: A new mini-bus was being launched on the day of the inspection which becomes the second vehicle available to transport residents. There is an extensive programme of activities available to residents who can participate as they choose. These included trips, exercise activities art, bingo etc. and a very active beetle drive which I saw in progress. There were individual aromatherapy activities as well as those for groups. When the designated activity coordinator is on leave activities are continued by other staff. Most residents told me they enjoyed the activities whilst some preferred to read from the well-stocked library and mobile library. One resident had planted some pots outside her room and adopted the house-cat which she fed in her room. A hairdresser visits three times a week and normal wash and set etc is included in the fees. Residents are invited to join the monthly service in the church immediately opposite the Home, as well as the offer of communion within the Home. One resident on a respite stay takes a taxi to a Methodist place of worship. Key workers are now developing life histories with residents to ensure that activities are designed to meet individual needs. The manager Care Homes for Older People Page 13 of 25 Evidence: told me was that she was trying to arrange for those residents who were interested, could join a computer classes in Dorchester, for which transport would be provided. Some residents had their own computers in their rooms and paid for broadband connection The expert by experiences report said: A menu is displayed in each of the two dining rooms showing the lunch and tea choices for the week. Residents have two choices for each meal and an alternative will be made if they dont like either of the choices. Breakfast is served in bedrooms or dining room according to the residents choice. The chef showed me the list of choices for breakfast made that day by residents which included full English, to porridge, cereal, toast etc. I observed the lunch served that day which was well presented in substantial portions with fresh vegetables served separately. One person with a sight impairment was given a plate with a guard and staff offered to cut up the food. Residents are offered the choice of which dining room they use and a few residents who require more help with eating have opted to use a smaller dining room with fewer people. There was quite a lot of interaction between residents at lunch creating a homely buzz The last residents meeting was on 2/2/09, one of the topics of discussion was the last fire drill on 30/01/09, there were concerns it did not go as well as it should and this was an agenda item at the meeting. There are photo albums in the entrance hall with information about the activities which take place in the home as well as parties and special occasions such as one persons 100th birthday. One of the comments received from staff who returned survey forms was: Does special days and events well There is access to the internet in the communal rooms and some people have broadband access to the internet in their own rooms. Activities are arranged on a daily basis at Steepleton Manor and there is a dedicated activities organiser. The Bridge club is a popular option, which friends and family also attend as well as those in the local community. There are art classes, exercise groups, excursions, the hairdresser attends three times a week and for all residents there is a complimentary daily newspaper. There is a well stocked library, satellite television and church services available. During the summer there are cream teas in the garden, themed events such as fetes, mystery bus tours in the homes own transport as well as trips to the theatre and the occasional entertainer. There is a range of games available such as dominoes and a key worker system encourages individual interaction between staff and resident. Visitors are actively welcomed at the home family and friends may stay for meals. Many of those living at the home are independent and pursue their own activities externally. People we spoke to were all happy with daily life at the home and felt their expectations were well met. Care Homes for Older People Page 14 of 25 Evidence: Steepleton Manor employs a chef who provides a varied menu with wide ranging choices throughout the week. Many residents choose to dine together there is always a cooked breakfast available and lunch with a choice of meals and supper which may include, pastries, sandwiches cakes and other dessert. A recent inspection by the food standards agency gave the home five stars. Care Homes for Older People Page 15 of 25 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Improvements in training mean that people are protected. A complaints policy made available to everyone ensures that people know how to complain if they have concerns and should feel they are listened to. Evidence: Safeguarding training has been put into place for all staff. The requirement made at the last inspection has been addressed. The recommendation made at the last inspection regarding the recording of verbal as well as written complaints has been addressed. However we noted there have been no complaints since the last key inspection. We also noted in both discussion with people living in the home and in looking at the minutes of meetings that small issues are encouraged, discussed and addressed. Care Homes for Older People Page 16 of 25 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in surroundings which are comfortable,spacious and elegant. Evidence: The expert by experience said in their report: Steepleton Manor is a large old manor House in a lovely setting with extensive grounds and a heated swimming pool which some residents told me they enjoy using during the summer. Many residents referred to enjoying the proximity of birds and deer which they can see from the windows of their rooms. Several people commented about the lift one person said it is completely inadequate. The passenger lift is for two people and is regularly serviced. The manager told us that the lift is old but is in good working order. We looked at the service record for the lift and found this to be in order. One person told us that they did not like travelling in the lift on their own as they feel claustrophobic and a member of staff always accompanies them. On the day of the site visit a new oak staircase was being put into place leading to the second floor. A new bespoke reception area has been made and the panelling matches the oak panelling in the reception area. The communal areas are decorated and furnished to a very high standard which is keeping with the period of the home. There are a variety of places for people to sit and engage in activities and meet with family and friends. Bedrooms are individually decorated and people are able to furnish the rooms with their own possessions. The manager Care Homes for Older People Page 17 of 25 Evidence: told us that when a room is vacated it is re decorated and new carpet and bathroom flooring laid if necessary. Care Homes for Older People Page 18 of 25 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Improvements to training mean that staff are developing the skills they need to provide excellent care. Evidence: We looked at the training matrix for the service. The manager is able to keep a track of all staff training and when refresher courses are due. We were told it is easy to book training and the spreadsheet demonstrated that not only is mandatory training up to date but additional more specialist training is also taking place covering such topics as dementia care, palliative care and physical conditions such as strokes. The expert by experiences report said: It would appear that there has been an improvement in staff interaction with residents. All residents confirmed that staff were polite, responded quickly to buzzers, and ensured dignity was maintained during the carrying out of personal care. A recommendation at the last inspection regarding training for staff in more specialist areas has been addressed. There are a variety of training opportunities for staff including palliative care. The head of care, team leader and lead carers are completing palliative care training at the moment. The head of care and team leader completed training on how to use the Malnutrition Universal Screening Tool. Care Homes for Older People Page 19 of 25 Evidence: All staff are undertaking a course on dementia care entitled Yesterday, Today, Tomorrow. We looked at the recruitment records for three people and found that all the information was in place, face to face interviews had taken place. There was a record of the interview, proof of identity, two written references and the Protection of vulnerable adults check had been completed before the individual started work as well as the return of a Criminal Records Bureau check. We found a record of the induction training for all three people. we received a variety of comments from staff who work in the home. One person said that the induction training was excellent. Care Homes for Older People Page 20 of 25 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and the interests of the people living in the home are at the centre of the care provided. Evidence: The manager is registered with the commission and has completed the Registered Managers Award. We found that the manager is very experienced and understands the needs of older people well. We found that the manager works with her staff to achieve excellent outcomes for people living in the home. People living in the home attend meetings regularly they provide a forum for an exchange of views and for people to comment on standards within the home. The home has a comprehensive quality assurance system, people are able to express their views and a report is shared with everyone on the outcome of the process and the action the home is taking to improve. The previous report identified a requirement for the Registered Individual to provide to the Commission for Social Care Inspection reports on his Regulation 26 visits to the home. We looked at the regulation 26 visits completed by a senior manager in altogether care and found that the reports were up to date and kept in the home. The Care Homes for Older People Page 21 of 25 Evidence: requirement from the previous inspection has been met. Portable Appliance Testing is up to date. There was a service report on equipment last done 10/11/08. Stairlift was serviced 10/11/08. Passenger lift was serviced in January 2009. New boiler fitted for the heated swimming pool in July 2008. All fire checks were up to date. They are completed by the maintenance person and there is a contingency plan if he is away and the RM does it if there is no one else. The home has a quality assurance process survey are sent to people who live in the home as well as other stakeholders. the provider also commissions an independent consultancy to complete survey and procedure a report. It was unclear if this information is passed back to people who live in the home so they know the outcome of the survey and what the home are proposing to do. The Annual Quality Assurance Assessment was returned, there was a request of a two week extension which was agreed. Fire Action plan in place. fire alarms last tested 20/03/09. Fire doors, fire equipment last done 26/02/09. System serviced 11/12/08. A recommendation at the last inspection regarding fire training for staff has been addressed. The service won an excellence in customer care award from Dorset Businesses, the first care company to win this award. The home had a recent inspection of its kitchens and was awarded five stars. The service has a maintenance person who completes all the fire safety checks, there is a back up person if they are away and the manager would also complete these checks if both people were absent from the home. Care Homes for Older People Page 22 of 25 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 Older People Page 23 of 25 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 Care Homes for Older People Page 24 of 25 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. Care Homes for Older People Page 25 of 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!