Care Home: The Manor Care Home

What the care home does well The manager visits people wherever possible to carry out an assessment of their care needs before they move in to the home to ensure that their needs can be met there. Individualised care and attention is provided and there is a welcoming cheerful environment so that people who are cared for feel comfortable and at home. People`s plans of care were well documented and reflected each person`s individual needs. We found people receive care and support that matches their expectations. Staff have a good understanding of the importance of treating people as individuals and promoting their privacy and dignity. Survey forms received by CQC stated, "Carers relate well to residents", "The Manor is a pleasant environment and they would appear to manage their clients extremely well". Meals were varied and offered choice and variety. The kitchen was cleaned to a high standard. People spoken with said " the meals are lovely". People who live at The Manor have choices about how and where they spend their time and the home provides a varied range of activities so that people have enough to do. A good standard of hygiene was seen throughout the home and the standard of decor was good. Staff were seen to treat people they cared for with respect and had an easy friendly manner. We were told, "all the staff are helpful and no request is too much trouble". The home is now managed by a well qualified and experienced management team. Staff, residents, and their visitors are given opportunities to express their views about the home. This helps to make sure the home is run in a way that suits residents` needs and preferences. Good recruitment procedures are followed to make sure new staff are suitable to work with vulnerable older people. All new staff complete a thorough induction programme to make sure they know how they should provide care for the people who live at the home. Most of the care staff have an national vocational qualification (NVQ) in care so they have the knowledge and skills to provide care for the people who live there. These are nationally recognised qualifications for people working in care and show they have been assessed as competent to provide good quality care. What has improved since the last inspection? The management of medication has improved and is audited regularly to highlight any errors so that they can be rectified quickly. What the care home could do better: The Manor provides a good service to the people who live there. This is confirmed by the people themselves and the staff. No requirements or recommendations have been made as a result of this inspection. We saw evidence that the manager is looking at ways to improve the service they provide. Key inspection report Care homes for older people Name: Address: The Manor Care Home Greendale Drive Manor Park Middlewich Cheshire CW10 0PH     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: Joan Adam     Date: 0 2 0 6 2 0 1 0 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 22 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: The Manor Care Home Greendale Drive Manor Park Middlewich Cheshire CW10 0PH 01606833236 01606833324 ahussa22@googlemail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Manor Care Home Ltd Name of registered manager (if applicable) Mrs Marina Brough Type of registration: Number of places registered: care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 44 The registered person may provide the following category of service only. Care home only - Code PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. Dementia - Code DE. Date of last inspection Brief description of the care home The Manor is a privately owned 44 bedded care home, providing personal care, to residents over the age of sixty five years set in four and a half acres of land close to the town of Middlewich. Care Homes for Older People Page 4 of 22 Over 65 0 44 44 0 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: We carried out an unannounced visit to the home on 2 June 2010 and the visit lasted seven and a half hours. The report will say we when referring to what was done and found at the visit, as it is written on behalf of the Care Quality Commission. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to the people who live in the home and the staff team to find out their views about The Manor. Other information about the home was also reviewed. During our visit we looked at various records and the premises. We looked at the care records of four people who live at the home, to see how their needs were being met. We also looked at four staff files to ensure that thorough recruitment processes had taken place and that people who live in the home were safeguarded from harm and supported safely. We spoke with some of the people who live at the Manor, the Care Homes for Older People Page 5 of 22 manager and other staff who were on duty at the time of this visit. They all gave their views about the home. Care Homes for Older People Page 6 of 22 What the care home does well: What has improved since the last inspection? What they could do better: The Manor provides a good service to the people who live there. This is confirmed by the people themselves and the staff. No requirements or recommendations have been made as a result of this inspection. We saw evidence that the manager is looking at ways to improve the service they provide. Care Homes for Older People Page 7 of 22 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 22 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 22 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. Peoples needs are assessed before they go to live at The Manor to make sure that the home will be able to provide the care they need. Evidence: Before someone new comes to live at the home, the manager goes to visit them and assesses their needs. We looked at the care notes of two people who came to live at The Manor not long before our visit and they both had full detailed assessments completed by the manager before they moved in. Full assessments had been provided by their social worker before they moved in. From the information gathered, a care plan was produced. This gave the staff guidance about what care and support the person would need when they first arrived. The care plan was then updated and added to as staff got to know the person. This gave the staff guidance about what care and support the person would need when they first arrived until a more in-depth care plan was completed. Care Homes for Older People Page 10 of 22 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 needs of the people living at the home are met and their medicines are managed safely, so they have the care they need to stay as well as possible. Evidence: Each resident had a care plan that included assessments of their needs and risk assessments for any identified risks. From the assessments, plans were written to give guidance and work instructions to staff about how the persons needs should be met. The manager and senior care staff had responsibility for writing care plans. We looked at a sample of four care plans. They had been well written in plain English and highlighted individual needs such as a request from someone who lives at the home who wants afternoon tea served on a tray with a cloth, tea-pot, milk jug and sugar bowl. Daily records had some very good entries giving a picture of what people were doing during the day. All of the care plans recorded regular reviews which were again detailed and it was possible to see how the persons health had been for that month. Residents had a choice of GPs and a dental service was being provided by the local Care Homes for Older People Page 11 of 22 Evidence: PCT. An optical company provided a visiting service for eye tests and supply of glasses. Residents also received a service from district nurses. A local chiropodist was visiting every six weeks. Comments made on survey forms sent to us included, all the clients are treated with respect and dignity. People spoken with said, it is a very pleasant place to live. We looked at the arrangements for the storage and recording of medicines. A designated senior carer has responsibility for the management of medicines, supported by the manager. We found that the management of medicines had greatly improved since the last big inspection. We found that medicines were all checked in and signed for when they were delivered to the home. Storage was good and secure. The medicine administration records were all fully signed and there were no tablets left in the blister packs that should have been given. When medicines with a variable dose were given the staff recorded whether one or two tablets had been given. Tablets that were not dispensed in blister packs were being counted daily and recorded to ensure that the quantities left were correct. The home had no controlled drugs at the time of our visit but a new controlled drug cupboard has been provided, as required by legislation. All senior care staff had training with regard to medication management and further training had been organised. The pharmacy that supplied medications to the home had completed a full audit and were to repeat this four times a year. The manager and senior staff completed detailed audits on medicines monthly to highlight any errors so that they can be rectified quickly. Care Homes for Older People Page 12 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at The Manor are able to choose where and how they spend their time so they have control over their daily routines. Visitors are made welcome and social activities are provided for people who wish to join in. Evidence: An activities organiser is employed at the home and notice boards showed a list of which activities were taking place. There was a structured activity programme that included one to one and group activities to meet the needs of the residents. Outside entertainers were a regular feature of home life and families were encouraged to participate. Activities that people had taken part in were recorded in their care plans. Choices were recorded in the care plans and visitors were welcome at the home at any time. Comments we received about the home included, I feel I can visit at any time including mealtimes which enables me to monitor food offered, the staff find different ways to stimulate my relative, relatives are kept informed of events via a newsletter which is very useful. Menus were being displayed in the reception area and in the dining room. Drinks and snacks were being provided throughout the day. There was a choice of dishes at every mealtime and we observed people being asked what they would like to eat. The tables Care Homes for Older People Page 13 of 22 Evidence: were nicely laid for lunch and there was a menu on each table which was written in large print so that people who live at the home can see this more clearly. People we spoke with during our visit told us, the food is lovely. Care Homes for Older People Page 14 of 22 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. There are policies and staff received training to make sure that people who live at the home are protected from abuse and complaints are taken seriously. Evidence: The Manor has a complaints policy, a copy of which is given to new residents and their relatives and a copy is displayed in the entrance area of the home. In the information we were sent from the home we were told that two complaints had been received in the last year. There were good records of all complaints to show how they had been investigated and what the outcome was. All of the staff have completed training on safeguarding adults so that they would know what to do a resident or their relative expresses a concern or if a suspicion of abuse is alleged. Care Homes for Older People Page 15 of 22 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. The Manor is well maintained so that it provides a homely, clean and safe environment for people to live in. Evidence: A full time maintenance person was employed to deal with day to day repairs and there was a maintenance book for reporting any faults in the home. A redecoration programme was on-going and residents were able to be involved in choosing colour schemes and soft furnishings. The old part of the building was due to have more improvements during the twelve months following our visit to create a shower room. Residents and their families were encouraged to personalise rooms to add to the homely feel. Mobility aids, hoists and grab rails were being provided and the manager told us that she was able to buy any other equipment needed for the care of residents. Bedrooms, toilet and bathroom doors had good clear signs so that people could find which room they need. The home had hand washing facilities in every bedroom and was cleaned to a good standard at the time of the visit. Surveys received from relatives said, the home provides a homely environment with good standards of cleanliness. Care Homes for Older People Page 16 of 22 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. Robust recruitment procedures are followed to ensure that new staff are suitable to work with vulnerable residents. Staff receive regular training so they know how to work safely. Evidence: We looked at the duty rotas and found that there were adequate numbers of staff on duty to meet the needs of people living at the home. There were six care staff on duty during the day and four staff on duty throughout the night. Staff spoken with said that there were enough staff on duty. Staff surveys we received, training is good and we have a lot of training so we can improve care. A training matrix showed that staff had received training in fire safety, moving and handling, health and safety, safeguarding adults, infection control. The majority of staff working at The Manor had achieved a national vocational qualification (NVQ) in care and all other staff have been enrolled on the course. NVQs are nationally recognised qualifications for carers and show they have been assessed as competent to provide care. The staff records we looked at showed that all appropriate checks had been done before the staff were employed so that the management can be sure they are safe to work with elderly people. Care Homes for Older People Page 17 of 22 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. The home is well-managed to ensure that peoples views are listened to and people who live and work at the home are kept safe. Evidence: The home manager had been at the home since September 2009 and was an experienced manager who had attained the relevant management qualifications. Staff spoken with said that they felt supported by the manager of the home and that the home had improved since she had been in post. She has recently been registered with CQC as manager of this service. Improvements had been made by the management and staff at the home since our last big visit there. The Manor had a comprehensive home audit that covers all aspects of the service. This was completed monthly by the manager and covered areas such as medicines, accident reports. Health and safety of the home was being checked monthly, and a Care Homes for Older People Page 18 of 22 Evidence: random sample of care plans was also being checked regularly. Residents/relative meetings were held monthly and minutes were circulated and people given opportunities to express their views. Staff were being supervised on a daily basis and formal recorded supervision was also taking place. This ensures staff had a chance to discuss their work with their manager, so they could provide good quality care of the people who live at The Manor. An administrator was being employed part-time to deal with day to day office work. Residents could put small amounts of personal spending money in safekeeping to pay for items such as hairdressing. Individual records were being kept and a statement was available by request from the administrator. The maintenance person was keeping a file to record the regular safety checks he carried out. This included a weekly checks of hot water temperatures, wheelchairs, bedrails and fire doors. Emergency lighting was being tested monthly and fire drills held approximately monthly. The names of staff attending fire drills were being recorded. The information we were sent from the home provided information to show that equipment was being tested and serviced as required. Care Homes for Older People Page 19 of 22 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 20 of 22 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 21 of 22 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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