Neville Manor Recovering After Health Violations

After a nine-month fight to put the ailing city-operated Neville Manor Nursing Home back on its feet, things finally seem to be looking up.

City officials and staff at the Cambridge nursing home have been battling overtime to improve patient care and facilities, following warnings last month from state health inspectors about violations in nursing care, safety and sanitation conditions there.

A team of health care experts from the Cambridge Department of Health and Hospitals have descended on the nursing home in recent weeks in an effort to "turn the place around" before a critical reinspection in April, City Manager Robert W. Healy said last week. If health inspectors find then that deficiencies cited in June and again in November have been redressed. Healy added, the state will end its move to decertify all "Level II" beds in the home.

Decertification would end Medicare reimbursements for treatment of patients who are very ill, but not classified as terminal.

But officials at the nursing home say they are confident that Neville Manor will now pass the lest.

"We've had five weeks of a lot of power and movement in here, and the change has been phenomenal," said Penelope Woody, acting assistant director of nursing. Woody is one of several administrators regularly employed by Cambridge Hospital who have been working at Neville Manor since early February in an attempt to improve patient care there.

"We're doing this gratis, for no overtime pay," she explained. "I'm here because it became evident that there was a problem that affected patients, and that's been my business for 20 years."

In addition to nursing staff, Cambridge Hospital has also sent pharmacy, maintenance, and financial personnel to work at Neville Manor until new staff there have been hired and trained.

Most of the problems afflicting the nursing home earlier this year stemmed from a lack of enough qualified employees, Healy said. "It's difficult to get nurses to work in the geriatric field for a long time," he explained, adding that "it's a depressing occupation."

Since January, 22 new nurses' aides and four supervisors have been hired, Woody said, and communication between departments has been increased. "For the first time we're collaborating on how we deliver care," she said.

In addition, she said, a new decision to allow nurses' aides to transport patients has left the medical staff with more time for substantive patient care.

Woody added that city and state health inspectors who dropped in unannounced last Monday had admitted that things were "moving in the right direction" in the home. They indicated, she said, that "the level of patient care had improved dramatically--we can now effectively guarantee better nutrition, ambulating, and restorative therapy."

Most long-time staff agree that recent improvements in Novelle Manor have been phenomenal. "There's been a great change both psychologically and physically in the home," said Sheila Rafferty, a social worker who has worked at Neville Manor for two years.

"Before we were understaffed and overworked." Rafferty added, "and under those conditions you were lucky if you could just get the necessary things done. "Now, she said, she has more time to "really talk" with the home's 155 patients, and "orient them" to their new surroundings.

Recreation activities have also been stepped up, and plans for new programs, including a therapy session for eight blind residents, are already underway.

"This really can be a model nursing home if everyone works together," Rafferty added with excitement. "We've always had good ideas, and now we have enough time and people."

The enthusiasm of the staff for what they call the "new Neville Manor" is evident in the appearance of the building itself. The walls are painted cheerful greens and yellows, and plants and St. Patrick's Day decorations hang from ceilings, posters and even lampshades. "If families don't bring in stimulating decorations for the patients' rooms." said Rafferty, smiling, "we just make them ourselves."

On the third floor, recreation activites are constantly underway. Only 20 hours of available recreation are required by state regulations, but the staff at Neville Manor keep activities going for 41 hours each week. Patients can spend their time doing arts and crafts or discussing current events, watching films or playing bingo. Friday morning at 10 a.m. is bowling hour, and the assistant recreation director pushes patients in wheelchairs up to the miniature alley to loss the ball.

Activities like bowling "are a lot of fun." said a patient who introduces herself only as 'Helen.' "They give you something to do, and a way to get along," she adds.

In good weather a bus takes 20 residents a day on outings to nature areas, shopping malls, or "dinners out," and in the springtime ambulatory patients will be able to wander on the grounds.

"It's still and like home," says Margaret O'Brien, a telephone operator in Harvard Square for 39 years who moved into Neville Manor in September, "but they've all been very good to me."