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Care Home: Swinton Hall Nursing Home Ltd

  • 188 Worsley Road Swinton Manchester M27 5SN
  • Tel: 01617942236
  • Fax: 01617270047

Swinton Hall provides accommodation for up to 62 older people. The home provides intermediate care for up to 18 residents on the lower ground floor, and provides continuing care which is staffed independently from the main body of the home and has dedicated input from the Primary Care Trust. Up to 10 residents of 35 years and over can be accommodated within the overall maximum occupancy of 62 service users. Accommodation is on three floors with access to all areas enabled with ramps, a lift and portable chair lift. There is a large car parking area to the front of the property with enclosed grounds to the rear. The building is set back from the main road and is within easy access to the cities of Salford and Manchester. The fees range from 355.52 to 537.31 pounds per week.

  • Latitude: 53.505001068115
    Longitude: -2.3420000076294
  • Manager: Shirley Lawton
  • UK
  • Total Capacity: 62
  • Type: Care home with nursing
  • Provider: Swinton Hall Nursing Home Ltd
  • Ownership: Private
  • Care Home ID: 15241
Residents Needs:
Old age, not falling within any other category, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 17th September 2009. CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Swinton Hall Nursing Home Ltd.

What the care home does well The home makes sure that prospective people are properly assessed before the offer of a place is confirmed at the home and people were given written information about the home. This means that people knew their needs could be met by the home. The atmosphere within the home was welcoming and friendly and staff were seen to be relaxed with the people accommodated. The privacy and dignity needs of people were respected, one person said, "the staff are respectful and always knock on my door before they come in." The home has an open visiting policy and visitors to the home said they were always welcomed in the home and felt comfortable. People said they enjoyed the meals at the home and mealtimes were seen to be a relaxed occasion. All eight people who returned surveys said, "the meals are always good." People spoke positively about the activities provided in the home. People who were asked and visitors to the home knew how to make a complaint and said they always knew who to speak to if they had any concerns. Health and Safety checks were regualrly maintained so that people`s safety and welfare was protected. People said the manager was "warm and approachable" and a staff member stated she, "Always brings out the best in people." What has improved since the last inspection? Since the last inspection the manager and staff have made improvements to the recording of medication received into the home to make sure they met the requirement made at the last inspection. The service have started using an advanced care plan which allows people and their relatives choices in relation to the final care an individual receives and the place where this care is carried out, for example, in the familiar surroundings of the Home or in hospital. The environment of the home has improved since the last inspection which has included a number of bedrooms being redecorated and refurbished. There has been an increase in the social activities provided and the training provided for the activites organiser. What the care home could do better: There were still some improvements that could be made in relation to medication record keeping and a recommendation was made for the manager to carry out more spot checks. Some improvements were needed to the way staff were recruited to the home and to the organisation of the staff files. A recommendation was made for the staff to carry out temperature checks of the hot water before people are bathed. Key inspection report Care homes for older people Name: Address: Swinton Hall Nursing Home Ltd 188 Worsley Road Swinton Manchester M27 5SN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Elizabeth Holt     Date: 1 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 26 Information about the care home Name of care home: Address: Swinton Hall Nursing Home Ltd 188 Worsley Road Swinton Manchester M27 5SN 01617942236 01617270047 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Swinton Hall Nursing Home Ltd care home 62 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N. To service users to the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places 62), Physical disability - Code PD (maximum number of places 10). The maximum number of service users who can be accommodated is: 62. Date of last inspection Brief description of the care home Swinton Hall provides accommodation for up to 62 older people. The home provides intermediate care for up to 18 residents on the lower ground floor, and provides continuing care which is staffed independently from the main body of the home and has dedicated input from the Primary Care Trust. Up to 10 residents of 35 years and over can be accommodated within the overall maximum occupancy of 62 service users. Accommodation is on three floors with access to all areas enabled with ramps, a lift and portable chair lift. There is a large car parking area to the front of the Care Homes for Older People Page 4 of 26 Over 65 62 0 0 10 Brief description of the care home property with enclosed grounds to the rear. The building is set back from the main road and is within easy access to the cities of Salford and Manchester. The fees range from 355.52 to 537.31 pounds per week. Care Homes for Older People Page 5 of 26 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 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: This key unannounced inspection included a site visit. The manager and staff at the home did not know that the visit was going to take place. On the first day of the visit we arrived at 12.noon and left at 16.30 and on the second visit we arrived at 12.30 and left at 17.00. During the visit we looked at documents including a selection of care plans, staff files and policies and procedures. We spoke to people who live at Swinton Hall, visiting relatives, the manager and four staff members. A partial tour of the premises was undertaken. Before our visit the manager had completed an Annual Quality Assurance Assessment (AQAA). This document gave us the information we needed and told us what the service does well, how they have improved over the last twelve months and their plans for improvement over the next twelve months. Eight people completed and returned surveys to tell us what they thought life was like Care Homes for Older People Page 6 of 26 at Swinton Hall, where possible comments and results from these surveys have been included in this report. Care Homes for Older People Page 7 of 26 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 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 8 of 26 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 9 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good system in place to introduce peole to the home, with information provided and needs assessments done, so they know that their needs can be met at the home. Evidence: The homes Statement of Purpose was available and a Service Users Guide. For information about the intermediate care unit and continuing care unit, the manager was waiting for a new brochure to be provided from the primary care trust to add to their information pack. People who use the service stated they received information before their admission to allow them choice. The manager stated they were devloping an information pack to give to people before they chose to live at Swinton Hall. Pre admission assessments are carried out to ensure the care needs of the prospective person can be met in full. A review of three of these assessments showed detailed assessments of these peoples needs. Other professionals assessment information was held on file for the staff to start the care plan. For one person who was admitted Care Homes for Older People Page 10 of 26 Evidence: to the home on the day of this visit there was a detailed assessment of the persons needs in place. The manager sated, We speak to the patient and their families and we look at a person holistically, so we understand why people act and behave as they do. One person was a mill worker and always wanted to be up at 05.00hrs. Knowing their life history helped us to understand their needs and possibly why they behaved in the way they did and for us to respect this. A sample of pre admission assessments were looked at and were found to be detailed on the Intermediate care unit. This unit is where people are supported who need additional nursing and therapy input before returning home from hospital or for people who require a short period of nursing but do not need hospital care. In the AQAA the manager stated that prospective people are encouraged to visit the home and have a look around and spend time sitting and chatting to staff and people who live in the home. Two peolpe said they had found the manager and the staff very welcoming when they visited and the home had been recommended to them from other people who had stayed here. Seven out of eight people who filled in surveys stated that they had received enough information to help them decide if the home was the right place for them before they moved in. One person stated, they did not know because a family member had been more involved in the decsion. Care Homes for Older People Page 11 of 26 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. Peoples health and personal care needs were met in the way they preferred and with respect for their privacy and dignity. Evidence: A sample of care plans were reviewed on each unit. The care plans contained detailed person centered information about a wide range of personal and health care needs, including details of a persons physical and mental health, mobility, weight and nutritional needs, range of risks including pressure risk management and risks of falls. Care plans included detail for the staff on how to meet each persons needs in the way the person liked. In the care plans looked at there was some evidence to show that the person themselves or their representative had been involved in the care planning process. Care plans were evaluated and monitored on a monthly basis. The care plans showed that advice is sought from appropriate health professionals and those allied to medicine in line with the persons care needs. People who could express a view were happy with the care provided and there was evidence the health care needs of people living at the home are monitored closely. One shortfall was noted which had the potential to put the persons health at risk. We noticed following a review of a sample Care Homes for Older People Page 12 of 26 Evidence: of medication charts that one person who was new to the home had not been given any of their prescribed medication. The daily record keeping had not been filled in because the registered nurse was due back to complete their shift late afternoon. The manager handled this situation in the persons best interest and took appropriate steps to monitor their health care needs. This person was visited in their bedroom, they looked comfortable and the positional change chart in place showed they had received personal care on a two hourly basis. The registered nurse had obviously not monitored this person above the care the care workers had delivered. The persons bed could only be accessed from one side, a request was made for the manager to make sure the persons bed could be accessed from each side for the staff to deliver care. The manager stated she had followed an appropriate course of action with the registered nurse, however this situation highlighted some staff management practices that need to be reviewed to avoid this happening again. The manager was clearly distressed by this event and told us that due to unfortunate circumstances the registered nurse had missed the morning handover report. The information provided in the AQAA showed that the manager had developed a handover sheet for the passing of information to trained nurses at each shift. Staff need to show better diligence in respect of monitoring the health needs of people. Following this visit the manager has stated she has taken steps to address the issues identified. Six of the eight people who returned surveys stated that they always recieved the care and support they needed, one person said usually and one person sometimes. We discussed wound care and their management in the home. The nurse gave a detailed verbal report of the condition of the three current wounds in the home and how these were being managed. She confirmed that where needed appropriate professional input had been sought from the tissue viability nurse or the podiatrist to support their practice. Throughout the two visits observations were made of the manager and staff members sitting and supporting people by listening and talking to them. People spoken to during the visits and visitors to the home stated they always showed respect and consideration for the persons needs. One person said, The staff always knock on my door before they come in and leave me when it is appropriate.Another person said, There cant be people better looked after anywhere than here. People looked appropriately dressed and their fingernails looked clean and at a comfortable length. A care worker was seen supporting a person to have their nails trimmed, this persons usual practice was to have a glass of sherry to keep them calm during this which was provided. Staff were seen to be respectful to the people at the home in the way they spoke to them and the staff clearly knew the needs of the people well. The home had policies and procedures in place for the management of medication and Care Homes for Older People Page 13 of 26 Evidence: staff spoken to said they had read this. Medication was appropriately stored in a clinical room. An audit of a sample of medication administration records (MARs) and blistered medication showed these were administered as prescribed. The following shortfalls were noted, for one medicine an incorrect dosage had been written onto the MAR chart, there were a number of gaps where staff had not signed the charts following the administration of the medicines, the specific instructions for the staff in relation to the application of creams were not always clear. The charts on the Intermediate care unit were handwritten, although these were well written a recommendation was made for the nurse to sign these and have them countersigned as a good paractice recommendation. Staff must remain diligent in their checking of medication administration charts and the manager should consider more formal audits of the current medication systems to highlight the shortfalls. Care Homes for Older People Page 14 of 26 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. The social, cultural and recreational activities generally meet the expectations of people living at the home and people are given support to exercise choice and control over their lives. Evidence: The full time activities organiser is now well established at the home and provides a wide range of activities to suit the individual needs and expectations of the people living at Swinton Hall. The activities organiser works with relatives to develop an awareness of the persons life before they came to live at Swinton Hall. People are encouraged to follow their interests. One person had recently enjoyed using a computer to find information about his area of interest and other people had been supported to email their family members. On the day of the visit a group of people attended an exercise class whilst othere were seen having a chat with the activities organiser. One person said, I find the hand massages a lovely treat.Comments from people at the home, relatives and staff showed that the increase in activities and stimulation has made improvements to the daily lives of the people at the home. The AQAA showed that the activities organiser had undergone training, including an instructors course in providing Healthy Hearts and Hips to support her to provide a varied programme to meet peoples needs. It was evident that the service aims to Care Homes for Older People Page 15 of 26 Evidence: support people to follow the religion of their choice. A number of people received communion on a regualr basis and one person said, I like just having a blessing, it means alot to me. The eight surveys returned showed that six people always felt the home arranged activities and two people stated they could usuallytake part in activities if they wanted. The manager and staff said that she gets information about peoples choices by speaking to people every day and through residents and relatives meetings. Relatives of people who use the service on the days of the visits said they were Always made to feel welcome, this is good because it encourages people to maintain their family relationships. Menus are operated over a four week period and people spoken to said the staff did ask them what they wanted the day before. The main meal of the day during these visits looked appetising and people said they were offered a choice of meal, one person said, The food is lovely, I do enjoy the meals here. Another person said, The meals are always well presented and its good food. The dining tables were pleasantly laid and people were seen to enjoy socialising at this time, others who chose to eat in the privacy of their bedroom had their wishes respected. Care Homes for Older People Page 16 of 26 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. People were confident the manager and staff would listen to their concerns and staff training in the protection of vulnerable adults safeguarded people from abuse. Evidence: The home had the policies and procedures in place, which gave people the information required to make a complaint. The manager had a record of complaints made and following a review of this, none had been recorded since the last visit. From the eight surveys returned to the Care Quality Commission, people who filled in the forms stated that they were comfortable in raising any concerns or complaints with staff members at the home and they knew how to make a formal complaint. Examples of comments included, The staff always listen and act on what we say, they are very helpful, and the staff here are great, although busy.One visitor stated that the managerCommunicates well with relatives. In the AQAA the manager recorded that,We have an open door policy whereby residents and visitors are able to speak freely and with confidence, knowing their concerns or complaints will be dealt with appropriately in accordance with our policy. The manager had cascaded some safeguarding vulnerable adults training to a number of staff at the home following training herself and some staff had received training from the Salford Vulnerable adult protection team. There were some more recently recruited staff who had not yet received this training but the manager plannd to address this. Staff spoken to were aware of the procedure to follow in the event of an allegation of abuse and could give examples of how they would deal with certain Care Homes for Older People Page 17 of 26 Evidence: situations. There is currently one concern being investigated under Salford Councils adult safeguarding procedures with involvement of other agencies. Care Homes for Older People Page 18 of 26 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 benefited from a warm, clean, safe and well maintained environment. Evidence: A partial tour of the three units at Swinton Hall was made, including visits to some peoples bedrooms, bathrooms and communal areas. The home felt comfortable and homely and all areas of the home were clean and free from odour during these visits. All eight people who returned surveys stated that the home was Always fresh and clean. Peoples bedrooms were pleasantly decorated, homely and personalised. Since the last inspection more bedrooms have been redecorated including new furniture, soft furnishings and carpets. One person said, Isnt my room just lovely and I helped choose some of the colours in here. The home has large well maintained gardens with seating areas for people and their visitors. The home employ a full time housekeeper and domestic staff who maintain a clean and comfortable home with a system to monitor infection control safeguards. The maintenance person employed keeps the Health and Safety records up to date and makes sure any equipment is appropriately maintained. Care Homes for Older People Page 19 of 26 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. People who use the service are supported by experienced and committed staff who they trust. Recruitment procedures generally protected people living at the home. Evidence: On the nursing unit there was one Registered Nurse and 3 care workers to meet the needs of the older people accommodated. On the day of the visits the manager was on duty and was supernumerary to the staff on duty. Separate staffing levels are provided for the Intermediate and Continuing care units. From observations made and comments from the staff they felt the staffing levels were generally sufficient to meet the needs of the people accommodated. One staff member stated, If another part of the home is struggling we are there to help each other out. People who returned the surveys made positive comments about the staff , for example They look after my mother well, she is always happy and looks cared for. Another person said, They even look after me when I come and visit, the staff are great here. The way in which staff are recruited was assessed by looking at the files of four staff who had joined the service most recently. Some of the information was well recorded and included photographs of staff, copies of documents including driving licences and passports, POVA first checks (the initial check that is done while waiting for the CRB) and Criminal Records Bureau checks(CRBs). The staff files would benefit from being more organised with the use of clear indexes so the information could be readily Care Homes for Older People Page 20 of 26 Evidence: accessed. A shortfall noted on one of the files looked at was that the application form did not include a full detailed employment history and there was no record to show the questions asked at interview in relation to any gaps in the persons employment history. There was an interview check list in place and we discussed the good practice of writing interview notes. For one person one of the written references had not yet been received however this had been chased up and there was a note of a telephone call to the referee. The home shows a commitment to staff training and the development of staff. Staff spoken to were positive about the service and feel they have the skills and training provided to support them to meet the needs of the people accommodated. The home employs 38 permanent care workers of which 32 have successfully achieved a National Vocational Qulaification level 2 or above in Care. The home offers Intermediate and Continuing Care as well as nursing care for older people, staff spoken to said they felt well trained to meet the specific needs of caring for these people. Other training staff have done in the last twelve months has included dementia care, End Of Life Care and diabetes management. In the AQAA the manager stated, We provide a good standard of care in a clean and well maintained, comfortable environment by staff who are well trained and have a willingness to learn and further develop their knoweldge. The staff training matrix was not available at this visit due to this being updated, there was copies of certificates for some staff seen in their training files and evidence of some planned training. In the past few months four staff had become Moving and Handling trainers and were following a programme to train other staff. Care Homes for Older People Page 21 of 26 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 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 and their relatives were confident that the manager was running the home in the best interests of people who live there and that their health and safety was promoted. Evidence: The manager is an experienced Registered Nurse who has been with Swinton Hall for ten years. In the AQAA the manager described herself, With an open style of management, fully committed to her responsibilities and supported by a dedicated team of staff. People spoke positively about the manager, one staff member stated that, she has to be the best manager, she is so supportive. She is approachable and brings out confidence in people. All interactions between the manager and staff and between the manager and people who use the service were seen to be professional. The manager was seen communicating with a recently bereaved person who used the service in a supportive, reassuring and empathic way. Due to the shortfalls observed during this inspection in relation to the diligence of the Registered Nurse and in relation to some of the recordings of medications, the Care Homes for Older People Page 22 of 26 Evidence: manager should monitor the care practices of the staff and audit the medication more regualrly. The home has the policies and procedures in place for ensuring the financial interests of people living at the home are safeguarded. The home have a dedicated administrative department which deals with the financial and accounting procedures. There are both informal and formal quality monitoring processes in place. Formally the manager sends out a questionnaire to service users, relatives and visiting professionals which was last sent out in November 2008 and informally through talking and listening to people on a daily basis. The manager stated the survey would be sent out in the next few weeks and they would look at the outcomes to see if there was action they could take to make things better for people who use the service. Some of the maintenance records for the service were looked at, these included the fire safety checks which were up to date and a fire risk assessment was in place. Records for the checking of water temperatures were looked at and a recommendation was made for the staff to check the temperature of the bath water before a full body emersion is carried out even though the taps are monitored by a thermostatic valve to minimise the risk of the water temperature being too high. Any reported accidents/incidents were recorded in an appropriate record book. The manager audited the accident / incident records on a monthly basis to look for any ways to minimise risks to people. The care plans showed where risk assessments had been adjusted. The Commission are notified under Regualtion 37 of the Care Homes regulations of any accidents/incidents or deaths that occur in the Care Home. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 29 19 The manager must make sure that detailed employment history and appropriate references are taken. This is to make sure that people who use the service are supported by staff who are appropriately vetted to ensure they are protected. 09/11/2009 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 33 It is recommended the manager should ensure the that systems are in place to check care practices and medication practices and put plans in place to improve identified shortfalls. It is recommended the staff should check the temperature of the bath water before a full body emersion is carried out even though the taps are monitored by a thermostatic valve to minimise the risk of scalding due to the water temperature being too high. 2 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!

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