Care Home: The Manor House

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What the care home does well People are provided with good information that assists them with making their choice about moving into the home. People are provided with a good standard of care planning when a care need is identified. The care staff working with people who live in the home are very aware of people`s health care needs and ensure the appropriate health professionals are involved when needed. Staff are aware of the importance of promoting people`s privacy and dignity needs. The staff have a good awareness of the safeguarding process and this helps to protect people who live there. People are provided with a clean and suitable environment. What has improved since the last inspection? The Statement of Purpose and Service User Guide has been reviewed and improved. The Service User Guide is now available in all bedrooms for people to read. The manager now ensures that an assessment is carried out of all those people wishing to move into the home. This helps ensure the home is able to meet the needs of those individuals. Domestic staff are now provided in such numbers that allow the home to be cleaned to a good standard. Domestic staff have been appropriately trained to perform their roles. Medication training is now provided to staff involved with administering medication training. What the care home could do better: The recruitment process adopted by the home must be reviewed so that it is more robust and protects people who live in the home. The manager must ensure the environment which people have access to is regularly risk assessed by a person who is trained to do so. This will help protect the health and safety of people living and working in the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Manor House Hall Lane Old Farnley Leeds West Yorkshire LS12 5HA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sean Cassidy     Date: 1 4 0 5 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 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: The Manor House Hall Lane Old Farnley Leeds West Yorkshire LS12 5HA 01132310216 01132310216 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) : Mr Chamkaur Singh Dhaliwal,Mrs Manmohan Kaur Dhaliwal care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 The Manor House is a converted stone building that has been extended to provide residential care, without nursing, for thirty older people. The home is located west of Leeds, adjacent to the local park, with a housing estate and bus routes nearby. There are 22 single and 4-shared rooms over two floors. A shaft lift gives access to the second floor. There are four communal lounges, separate dining space, three bathrooms and one shower room. Toilets are near to the lounge areas and bedrooms. The gardens are well maintained with outdoor seating areas. Prospective residents are provided with ample literature prior to admission to inform them of the services and facilities provided at The Manor House. Fees charged are at the current basic Local Authority rates, for both privately funded and publicly funded people. The fees charged at the time of the inspection were #432 per week. Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home 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: The accumulated evidence used in this report has included: A review of the information held on the homes file since its last inspection. Information submitted by the registered provider in the AQAA (Annual Quality Assurance Assessment) Information received from people who use the service, relatives and staff. An unannounced visit to the home, which lasted eight hours. This included a partial tour of the premises. Care Homes for Older People Page 5 of 24 Evidence gained by direct observation, talking with people who use the service and management. Inspection of records including care plans risk assessments, medication administration records,and the homes policies and procedures. 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. Care Homes for Older People Page 7 of 24 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 24 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 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them 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 are appropriately assessed by the service before they move in. They are provided with up to date information to assist them with making the choice about using the service. Evidence: An up to date Statement of Purpose and Service User Guide are available in the home. Both documents contained all the required information needed to enable people to make an informed choice about moving in. Three people told me that they were provided with enough information about the service before they chose a place. They said they were offered opportunities to come and look around the home as well. One person did visit prior to moving in. The care documentation for three people who use the service was closely examined. These contained pre assessment documentation that showed they were all assessed by Care Homes for Older People Page 10 of 24 Evidence: the manager before moving into the home. This is good practice as it enables the assessor to identify whether individual needs can be met by the staff working at the home. Care Homes for Older People Page 11 of 24 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 people living in the home are clearly recorded in the care documentation. This helps ensure people receive the correct care. Evidence: I looked at the care documentation of three people living at the home. Each file contained care plans that highlighted the care each individual should receive. Two care files showed evidence that consent to care was obtained. They were reviewed monthly and there was also evidence in place to show the care plans were changed when the need arose. One example of this was, a person identified as experiencing mobility problems had her care plan altered to reflect this change. Staff spoken to said they regularly read the care plans and that they kept them up to date after each shift. The daily records were seen and these gave good information as to how each person spent their day. Care Homes for Older People Page 12 of 24 Evidence: Each file showed evidence that death and dying had been discussed with the relevant people and a plan was in place to deal with that persons needs in relation to this area. This is good practice. Clear records were in place to show that community professionals such as the GP, district nursing team and opticians are involved in the care packages when needed. The care file of one person identified that there had been significant weight lost since admission. Appropriate action was taken by the care staff to manage this situation. Staff were observed interacting well with the people that used the service. There was a lot of joking and laughing throughout the inspection. Staff spoke to people in a kind and helpful manner. People told us that they were happy with the way they were treated by staff who worked at the home. They said, Im really happy with the standard of personal care provided by the staff. The staff are helpful and always help me with my health needs. Mum recently has been helped to get new teeth and new spectacles. The medication administration process was observed and this practice appeared to be good. The Medication Administration Records were filled in correctly with no unexplained gaps seen. Staff are provided with training in medication administration from a local college and refresher training is provided. Care Homes for Older People Page 13 of 24 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 are provided with opportunities to engage with a range of social activities that suit their needs. Evidence: Each care document seen included a care plan that informed the reader what activities that person enjoyed doing. This was discussed at their assessment when they first arrived at the home. One lady has her paper delivered to the home every day. Another lady said she gets a magazine a couple of times a week. People spent most of the day sat in the lounges at the back of the house. No planned activity was provided during the inspection. People said that they did go out at times and sit in the garden at the back of the house. The care documentation contains good information as to how each person spends their day. There is a newsletter developed for the home that informs people of planned events. Care Homes for Older People Page 14 of 24 Evidence: Three people said they often got involved with different activities during the day. Peoples religious needs were provided for by visits from local clergymen from the Catholic and Protestant churches. We were told by relatives that the home promote contact with their relatives in care and that there was always a welcome when they arrived. There was a notice board in the hallway that informed people what activities are planned for the week. People were observed having lunch and I was able to join them. Those that needed assistance received it. The food was of a good quality and was very tasty. People said the food was generally good in the home. Staff were observed explaining to a person with poor eyesight where his food was on the plate. This was good practice. The cook explained how she develops the menus and how she incorporates peoples choices within it. There was a wide variety of food choices on offer at the home. This was confirmed by speaking to relatives and people who us the service. Care Homes for Older People Page 15 of 24 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 living in the home are properly protected by the complaints and safeguarding policies and procedures implemented by the home. Evidence: People spoken to said they knew how to complain if they needed to. The information provided by the service at admission informs people how to make a complaint and who they should contact. The complaints procedure was also displayed in the home. Staff were asked about their awareness of safeguarding vulnerable people. Good responses were given and they showed a good awareness of how to manage a safeguarding issue. Those spoken to had recently received safeguarding training. No safeguarding incidents had been reported by the service recently. There is a policy and procedure in place to assist staff with managing safeguarding incidents should they occur. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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 live in an environment that suits their needs. Evidence: People spoken to were happy with the environment of the home. Positive comments were received. These included, Im very happy here. My room is just the way I want it. The manager and staff helped my family bring in the things from my home that I wanted with me. Its nicely decorated and suits me. Its always clean and tidy. A random inspection of peoples bedrooms showed evidence that people are helped to personalise their rooms with their own belongings. One person had been supported to have their own drink making facilities in their room. The home has allocated domestic staff that perform all the cleaning duties. People spoken to were satisfied with the cleanliness of the service. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent 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 are confident that the staff group are properly trained to meet their needs. They said they were confident that there were suitable numbers of staff to provide their care package. Evidence: The staff were observed performing their duties over the course of the inspection. They appeared unhurried and had time to provide assistance to people when it was required. Staff were observed sitting and chatting to people and positive interactions were seen. People spoke highly of the staff group and said they were always helpful and were there when they needed them. They said, There always seems to be enough staff on duty. They are always there when i need them. They are quick to respond to the buzzer when i use it. Staff seem well able to provide care to the people living in the home. There is a rota system that highlights which staff are on duty. The manager has implemented a new recruitment system that assists her with ensuring all the required information needed before a person can work in a care home is obtained. Two recruitment files were inspected and the evidence found that this system is not yet robust and does not fully protect people living in the home. Two Care Homes for Older People Page 18 of 24 Evidence: references had not been obtained and evidence to show POVA (Protection of Vulnerable Adults) checks had been obtained before a person could start work could not be found. This does not properly protect people in the home. Evidence was seen in files to show new carers are properly inducted when they start working in the home. Evidence was also seen in files to show training is provided in areas such as safeguarding vulnerable people, food hygiene, medication, manual handling and infection control. The manager has no tool in place that highlights what actual training staff have had. It was recommended that a training matrix be developed to assist the manager with identifying which member of staff attended which training and also which staff member needed specific training. Care Homes for Older People Page 19 of 24 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 living in the home know that the management of their care suits their needs and provides them with a personal touch. Evidence: The manager has worked in this home for a long period and is well known by the people who live there. She is a hands on manager and likes to ensure she has regular input with the care of the people who live there. People were confident that she was able to do the job and that she was very approachable. They said, Its like living in your own home. The manager is very helpful and personal. The manager sometimes sits and chats like one of the family. There are some quality tools used to monitor and improve the care provision within the home. Care plans and risk assessments are randomly checked monthly and changes are made where appropriate. The manager showed evidence that she reviews the environment. This was reviewed and it was acknowledged that some good work Care Homes for Older People Page 20 of 24 Evidence: had been done. However, it was recommended that all areas of the home where people had access needed to be assessed to ensure people are safe. These included areas such as stairways, hallways lounges and dining rooms. The manager acknowledged that this health and safety audit needed to be performed by someone trained in this area. The provider visits the home on a monthly visit and reviews the quality of care in the service. A report of this visit is written and available. Staff acknowledged that they did receive regular supervision and attended staff meetings. The supervision records were not available to view as they were not on the premises. The manager was informed that this information should be available at all times in the home and should not be removed from the premises. The home has a policy that it does not look after the personal monies of any person living there. If anyone needed a service such as hairdressing or chiropody then they would be individually billed for the service. The lifts and hoists used in the service are assessed and checked by an outside agency. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 13 The environment of the home must be appropriately risk assessed by someone trained to do so. This will help ensure people are properly protected when living in the home. 31/07/2009 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 All documentation relevant to the care home should be properly stored and available at all times in the home. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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!