Care Home: The Manor

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What the care home does well People who use the service are looked after in a well maintained comfortable home. A varied nutritious diet is offered throughout the day. There are comprehensive care plans in place to ensure assessed need is recorded, communicated to relevant people and met. The attached day centre offers a variety of activities in an environment outside the home which can be attended on a daily basis as the individual wishes. Outside trips and activities are also offered. Staff are friendly and caring and treat people as individuals. Equality a diversity issues are addressed. Quality assurance systems are in place to ensure ongoing awareness of how the service is meeting need and how it can improve. The home is managed well and in the best interests of the people who use the service. What has improved since the last inspection? All bedrooms are now single rooms and ten offer en suite facilities, five of these have showers. A new shower/wet room has been provided. There are apron dispensers, glove dispensers and hand gel cleansers throughout the building. The dining room has had new flooring as have some of the bedrooms Training opportunities for staff have improved What the care home could do better: This home offers an excellent standard of care and is functioning well on all levels. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Manor 75 Manor Road Selsey Chichester West Sussex PO20 0SF     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: Sheila Gawley     Date: 0 6 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: The Manor 75 Manor Road Selsey Chichester West Sussex PO20 0SF 01243602828 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) : mattmanning-smith@tiscali.co.uk Mrs Marcia Ann Manning-Smith care home 21 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 21 The maximum number of servicxe users ot be accommodated is 21 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission ot the home are within the following category: (LD) Date of last inspection Brief description of the care home The Manor is a care home providing personal care and accommodation for twenty-one older people (over 65 years) who have learning disabilities. The home is located in a quiet residential area a short distance from the centre of Selsey village where shops and other facilities are available. An activities centre is situated in the grounds of the home and residents access this facility on a daily basis. The activities facility is separately staffed. Mrs. M. Manning Smith owns the home. Care Homes for Older People Page 4 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: This site visit as part of the inspection process was carried out on 06/03/09. Prior to the visit all files held by the commission, complaints and safeguarding issues were reviewed. Prior to the visit all files held by the Commission were reviewed. We were not in receipt of any complaints. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. We were in receipt of six surveys from people who use the service and two from staff. All comments were very positive. Staff were spoken to on the day. Care Homes for Older People Page 5 of 25 Staff spoken to on the day stated that they were happy working in the home and confirmed that they receive induction, training and supervision. Two people who use the service were case tracked during the inspection and all records relating to them were inspected. The premises were toured. The registered manager facilitated the inspection and any documents required on the day were made available. The atmosphere within the home was peaceful and relaxed and the staff carried out their duties in a respectful manner taking into account the dignity and privacy of residents. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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 who use the service experience good quality in this outcome area because needs are assessed and information needed to make an informed choice is available. Evidence: There is a clear admission process which aims to bring all people into the Manor in a controlled and informed manner. People are treated as individuals and through visiting the Manor the prospective service user can be assessed in order for the home to see if it can meet his or her requirements. Families are involved in this process. Regular visits are encouraged as everyone in the admission process has a better understanding of each other and the the person whose admission is intended can get to know the staff. Documentation is in place to support this admission process and to record assessed need and information from involved health professionals. This documentation was available for inspection. Care Homes for Older People Page 9 of 25 Evidence: There is an up to date Statement of Purpose and Service user guide in place. These guides give detailed information on what type of service the Manor provides. Consideration has been given to the varying abilities of the individuals to understand the document and as such these documents are available in an accessible format. This was done with the support of the local speech and language therapists and advocacy services. 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. People who use the service experience good quality. All needs are assessed and met, They are set out in a plan and people who use the service are treated with respect. Medicines are administered safely in the home but there was one shortfall in medication storage which the registered manager will ensure is corrected. Evidence: Two people who use the service were case tracked. All documentations held for these people were inspected. All care plans have a profile of the person with name, diagnosis, medications, routines of living, feeding and sleeping clearly laid out. All needs are assessed including personal care, pressure area care, social needs and likes, mental and cognitive, sight, hearing, communication, continence, mobility, moving and handling and pain. the plans included information which was specific to assessed need such as catheter care, the specific sling to be used with that person, the need for foods to be liquefied and drinks to be thickened and the position the person should be in before feeding or offering drinks. Nutrition and weight are monitored. Care Homes for Older People Page 11 of 25 Evidence: The home is proactive in consulting health professionals such as speech a language therapist to improve outcomes for people with dysphagia. The input of health professionals were recorded. There were clear instructions in each room regarding turning , feeding, fluids and use of bed rails stating the individuals need and choice. There are daily records made and monthly review is in place. An optician visits the home, hearing tests are accessed via the health centre. A chiropodist visits the home six weekly and people who use the service are facilitated to attend dental surgeries as required. Risk assessment is in place covering pressure area risk, falls,choking, use of bed rails and behaviour. The interventions to be taken in respect of each risk assessed were clearly stated. Staff were observed offering care in a respectful and encouraging manner. Care is person centered and changing need is addressed. Equality and diversity issues are addressed. There are policies and procedures in place for the management of medicines. Only staff trained to do so administer medicines. Medicine administration charts inspected were up to date. There is risk assessment in place to assess if people who use the service can self medicate. There is not anyone self medicating at present. Medicines are stored correctly. The balance in the controlled drugs register was not an accurate reflection of the actual stock of one drug. This was discussed with the registered manager who will ensure that all controlled drugs received into the home will be added to the register at the earliest opportunity. 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 who use the service experiece excellent outcomes in this area because the lifestyle experienced in the home is individualised stimulating and meets the needs of those who live there. Evidence: The routines of daily living are discussed with residents on admission and individual preferences catered for where possible. The home encourages the individual to pursue activities of their choice. This may be activities which a person pursued before admission. The home has its own day centre which provides a change in surroundings for people each day as the wish. On the day of the visit people were enjoying preparing for Comic Relief and for Easter in the day centre in the afternoon. The day centre has a kitchen for making drinks and snacks. They were observed having fresh fruit, savoury biscuits and hot and cold drinks Activities range from music to lifestyle classes and swimming. The local church visits on Sundays and join in a Sunday service. People who use the service have the opportunity to take part if they wish. The home actively encourages family Care Homes for Older People Page 13 of 25 Evidence: involvement and works closely in promoting relationships. The Manor supports the individual in taking part in community life such as with the right to vote. A relationship has been forged with the local school and the pupils came and sang in the home at Christmas. There are seasonal events throughout the year. One person has a potting shed for working on his plants. The home is liaising with a cat and rabbit rescue centre to support an individual in getting an animal. All people who use the service are given the opportunity to access the community. There are frequent trips to places of interest or to go out for lunch. The trips are tailored to the individual. Four people were out on a day trip to Chichester today. The home contracts local car firms to supply vehicles for outings so the all needs are catered for and lack of mobility is nor a bar to going out. People who use the service have choice and control over their daily lives. Family involvment is encouraged and people have access to advocacy services. People can bring their own personal possessions into the home. People can manage their own money if assessed as being able to do this, the home holds allowances for people securely. There is a varied, nutritious menu in place which offers choice. It has recently changed following consultation with the people who use the service. A visual communication aid was used to establish which choices in meals people wanted. There were jugs of water and squash available in the sitting room throughout the day. The meal served on the day was appealing and the people who use the service enjoyed it. Assistance was offered to those who required it in an unobtrusive and encouraging manner. Pureed diets are prepared as required. Attention was given to the texture of food by the addition of chocolate buttons to the chocolate mousse for dessert. Some people have a fortified diet. The Manor continues to work closely with speech and language therapists in order that individuals enjoy their meals. The home was recently chosen by the speech and language therapists to support a trainee of theirs. The speech and language therapist was spoken to on the telephone and she confirmed that the home calls her in appropriately and that the staff have a lovely rapport with the people who use the service and that they are very good one to one focus on the individual Six surveys were received from people who use the service and all responses indicated satisfaction with the service, Care Homes for Older People Page 14 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. People who use the service experiece good outcomes in this area area because complaints are listened to and they are protected from abuse. Evidence: There is a clear complaints procedure which is on display and which is included in the Statement of Purpose and Service User Guide. The procedure clearly identifies whom a complaint should be addressed to and the timescales in which a complaint will be dealt. It displays the Commissions contact details. West Sussex Multi-Agency Policy & Procedures for Safeguarding Adults have been implemented in the home. There is a training programme in place which includes Safeguarding Adults training. Staff spoken to demonstrated an awareness of safeguarding procedures. Staff were observed interacting with people in a respectful manner. The Manor has a whistle blowing policy in operation so that staff have a system in which they could raise concerns. Care Homes for Older People Page 15 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 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 experiece good outcomes in this area area because they live in a safe and well maintained environment. Evidence: The home externally and internally is decorated to a good standard. It was neat,clean and free from offensive odours. There is a sitting/dining room and a further separate dining room. It has an activities centre in the grounds providing another communal space where people can relax. It is planned to redecorate this centre. It has comfortable, good quality and homely furnishings. Radiators are covered. There are well-maintained grounds. Bedrooms are comfortable with comfortable furnishings. The bedrooms are personalized according to the wishes of people who use the service. A locked drawer has been supplied in the new bedrooms. The specialist equipment required to meet the needs of people who use the service is in place. There are sufficient wheelchairs, hoists and assisted baths and there are grab rails. There are specialist beds to maintain the safety and comfort of those cared for in bed and there is pressure relieving equipment available. There is a passenger lift. Care Homes for Older People Page 16 of 25 Evidence: There are sufficient assisted baths to meet the needs of people who use the service, one of which is new. There is a new shower/wet room. There are suitable laundry facilities sited away from areas of food storage and preparation. Washing machines have the required programmes. There are apron dispensers; glove dispensers and hand gel cleansers throughout the building for carers to use when supporting the individual, which provides a proficient environment. There is an ongoing programme of maintenance and decoration. Some painting was being done today. There is a plan to add a conservatory but planning permission is not yet in place. There are also plans to enlarge some of the smaller bedrooms and to include en suites in these. Care Homes for Older People Page 17 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 excellent 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 experience excellent quality in this outcome area because they are cared for by suitably recruited and trained staff. Evidence: Staff rota showed staffing levels were sufficient to meet the needs of people who use the service. There is housekeeping and kitchen support. Pictures of staff are now displayed so that people who use the service know who is going to be offering their care. There are robust recruitment procedures in place and staff files inspected contained all the documentation required to ensure the protection of people who use the service. There was evidence of application forms with employment history, Criminal Records Bureau Clearance and POVA check, two references, identity documentation, and photograph were all in place. Contracts, job descriptions and terms and conditions are in place for staff. Two new staff members were working under supervision on the day, one a carer and one a member of the housekeeping staff. The Manor ensure staff have clarity in what their responsibilities are for the particular person they are supporting. There is a system for highlighting people who may have Care Homes for Older People Page 18 of 25 Evidence: had a general practitioner visit or some amendment to their care plans to the staff. Daily rota and plans are clear on who staff should be supporting each shift. The comments received on staff surveys received were positive indicating that staff find the home to be a supportive place to work and that communication is good. Surveys from people who use the service indicated that they find the staff helpful. People spoken to on the day indicated that they were happy with the care. Staff were observed interacting with people who use the service in a respectful and encouraging manner. The opinions and wishes of people who use the service were sought and acted upon. Personal care need were met promptly and in private. There is a staff-training programme in place which staff spoken to confirmed they attend. Training records were seen in staff files. The training provided includes food hygiene, moving and handling, safeguarding adults, fire, infection control, first aid and health and safety. There is also training on challenging behaviour, dementia. New members of staff complete the Learning Disabilities Award Framework induction process. Twelve of the twenty eight care staff have attained the National Vocational Qualification Level 2 in Care. A further five are completing it. Another staff member confirmed that she was about to undertake the Learning Disability Qualification. Care Homes for Older People Page 19 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. People who use the service experience excellent quality in this outcome area because the home is run in the best interests and all needs are met in a person centered way. Evidence: There is a registered manager in place. He has degree in Management and has completed the NVQ Level 4 in care and the Registered Managers Award. There is an open positive style of management in the home which was confirmed by staff. One survey received from a staff member commented I cannot fault the manager. I have been so happy in my work. Another commented manager is always to hand and there are always senior staff available. A very nice place to work and all staff do actually care for the service users. The registered manager demonstrated a clear commitment to the home and spoke clearly about the direction he wanted to take the home. Care is offered in the home in a person centered way. Care Homes for Older People Page 20 of 25 Evidence: Quality assurance systems are in place. There is evidence that the home constantly strives to improve, there is an awareness of the rights and wishes of the people who live there. Stake holder surveys are completed annually, health profession responses seen were all very positive. People who use the service have recently been consulted on changes to the menu. A speech therapist was spoken to on the telephone and she had very positive comments on the home. There is a development plan in place for the home. There have been environmental improvements to the home and there are plans for further improvements. The home ensures equality and diversity issues are addressed. The introduction of visual aids to help individuals voice their choice more clearly is one example. Using local care companies that can meet the transportation of people with diverse physical needs is another. The registered manager ensures staff are aware of policies and procedures by implementing a Policy of the Month whereby each month a different policy is read. This ensures staff remain up to date and provide good outcomes for the people who use the service. The registered manager seeks the views of relevant professionals to improve outcomes for people who live in the home, such as the speech and language therapist in the development of communication tools. Staff turnover is low with several of the staff having been employed at the home for many years. Bank accounts are managed for people by West Sussex County Council. The home holds allowances for people securely. Expenditure is recorded and receipted. Staff are supported by regular supervision which they confirmed they receive. Supervision records were available for inspection. The registered manager ensures the health, safety and welfare of people who use the service and staff by the provision of mandatory training. The home meets the requirements of the local Fire authority and Environmental Health Department. Substances hazardous to health are stored securely. Contracts for utility and equipment maintenance are in place. Care Homes for Older People Page 21 of 25 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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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