Inspection on 30/01/09 for Afton Lodge Care Home

This is the latest available inspection report for this service, carried out on 30th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Afton Lodge Care Home 15/05/07

Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Afton Lodge Care Home 9-15 St Catherines Road Bootle Merseyside L20 7AL one star adequate service The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Stephanie West Date: 3 0 0 1 2 0 0 9 Information about the care home Name of care home: Address: Afton Lodge Care Home 9-15 St Catherines Road Bootle Merseyside L20 7AL 01519226183 Telephone number: Fax number: Email address: Provider web address: Noemail Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Asif Iqbal Alvi,Muhammad Fayyaz Chauhdry care home 27 Number of places (if applicable): Under 65 Over 65 0 27 learning disability old age, not falling within any other category Conditions of registration: 1 0 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 Learning disability - Code LD (maximum number of places: 1) The maximum number of service users who can be accommodated is: 27 Date of last inspection Brief description of the care home Afton Lodge is registered to provide accommodation and care without nursing for up to 27 older people. The home is a large double fronted house in a residential area of Bootle. The local shopping centre is near by as is the local train station . There is also good access to public transport close by. Internally the home offers two lounges, one Care Homes for Older People Page 2 of 10 Brief description of the care home of which is cuurently used by people who smoke, however due to change in legislation all lounges will be made non smoking in the near future. People who use the service have use of a communal dining room which is large enough to seat everyone in one sitting. People who use the service are able to have a private single bedroom or share facilities with another person if they wish. However most double rooms are currently used for sigle occupancy. To the rear of the home is a large garden area which is well maintained and safe for use, to the front there is limited parking within the walled forecourt. On-street parking is only allowed with a residents permit from the local council. The home does not provide nursing care but has care staff 24 hours a day it also provides the services of a cook, handyman and domestic staff. The current charge for accommodation is £360.50 which includes care support, meals laundry and activities. Charges are made for personal purchases such as hardressing. Contubutions may be asked for towards external trips. Regency healthcare (UK)LLP became registered owners in March 2007. Care Homes for Older People Page 3 of 10 What we found: We visited the home to see how concerns about the safe handling of medicines, seen at previous visits, were being addressed. The visit lasted approximately four and a half hours and involved discussing the handling of medication with the manager and care staff, examination of medicine records and storage arrangements. At the end of the inspection feedback was given to the manager. Overall, we found improvement in the arrangements for handling medication at the home but some weaknesses remain to be addressed to ensure people are best protected. Trained carers administered most medicines, but people who chose to and where able to, were supported to manage their own medicines. Written self-administration assessments were completed. But, there could be more written information about how safe self-administration is supported, to help ensure people always receive any help they may need. One person was prescribed a when required medicine but consideration had not been given as to whether it should be taken with them for selfadministration, if needed, when away from the home. Consideration needs to be given to peoples medication needs when away from the home. The home has arrangements in place so that non-prescribed medicines for the treatment of minor ailments can be given. This benefits people as they can receive treatment for conditions such as minor pain without delay. However, some of these individual arrangements had been agreed with doctors several years ago and should be reviewed. We found that medicines record keeping had improved to better support the safe administration of medication at the home. Recent medication administration records were generally clearly completed. But, we saw some good practice was not consistently applied. For example, where medicines were prescribed for example One or Two the actual dose was not always shown. Occasionally, it was not possible to track the handling of medicines in the home because any quantities carried forward from a previous month were not recorded. We saw some records that showed medicines were regularly refused, or rarely taken. It is recommend that doctors advice is sought where medicines are not needed or not taken as prescribed. This helps to ensure people get the best treatment for them. Where medicines were prescribed when required we found that there was not always sufficient written guidance for staff about when they may be needed, or how this is need is made known. This is recommended to help ensure consistency in the use of these medicines. Similarly, there was sometimes a lack of information about the use of prescribed creams explaining where they were for, and when they may be needed. Medicines including controlled drugs were safely locked away, helping to reduce the risk of miss handling. But the law about storing controlled drugs has changed and the home will need to buy a new cupboard to meet with current law. On the whole adequate supplies of medicine were kept at the home without overstocking. But, it was of concern that the quantity of a liquid medicine for one person was not enough to last the whole month, increasing the risk that they may miss doses because there is none left to give. There was only a small quantity left on the visit day. Medicines refresher training was being organised and medicines were to be discussed at the next staff meeting. The medicines policy was available for reference but needed reviewing and up dating to provide clearer written guidance for staff about the safe Care Homes for Older People Page 4 of 10 handling of medicines at the home. Competency assessments had not been carried out. These should be completed to help ensure staff understand and follow the medicines policy. Having trained and competent staff will help to ensure medicine are safely handled helping to protect peoples health and wellbeing. What the care home does well: 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 2. Care Homes for Older People Page 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 3 14 The registered provider must 12/01/2009 ensure that pre admission assessments identify all of the prospective service users needs. This will ensure that service users needs will be clear and a decision made to offer a place to the prospective service user will be based on the service knowing they will be able to meet their individual needs. 2 7 15 The registered person must ensure that the care plans are updated to reflect the changing needs of the residents. This will enable staff to monitor residents closely and inform other staff of any changes in the treatment or management of the resident. 12/01/2009 3 7 15 The registered person must 12/01/2009 ensure that all service users have a care plan that reflects their assessed needs. This will inform staff how to manage the residents needs effectively. 4 9 13(2) Staff must ensure that all controlled drugs are stored and recorded correctly to 26/10/2007 Care Homes for Older People Page 6 of 10 ensure residents healthcare needs are met. 5 15 16(2)(i) Menus must be provided at 30/11/2007 the home detailing choices of meals available. Residents should be involved in devising these menus in order to promote choice. The registered person must ensure that all complaints are recorded, investigated and outcomes for the complainant are evidenced. This will ensure that residents complaints are being listened to and acted on. 12/02/2009 6 16 22 7 18 13 The registered person must 16/02/2009 ensure that staff attend Adult Protection training. This is an outstanding requirement. This will ensure that residents are protected. 8 18 13(6) 18(1) (c) (i) The manager and all staff must receive training in and be familiar with Local authority adult protection procedures. To ensure that all staff are able to identify and respond to abuse appropriately. (Not examined at this inspection; timescale remains 01/07/07) 26/10/2007 9 19 19 A detailed plan for upgrading 26/10/2007 of the home including timescales must be provided to ensure that the environment is improved for the benefit of people using the service. (Not examined at this Page 7 of 10 Care Homes for Older People inspection; timescale remains 15/06/07) 10 26 23 The registered person must ensure that the service is kept clean. This will ensure that residents live in a hygienic environment. 12/01/2009 11 29 19 The registered person must ensure that all pre employment records are in place prior to commencing work. This will ensure that residents are protected. 12/01/2009 12 30 18 The registered person must 16/03/2009 ensure that staff are up to date with mandatory training and that this is evidenced in staff files. This will ensure that staff are skilled and trained to meet the residents needs. 13 30 18(1)(a) Staff must receive training 01/01/2008 on infection control to ensure the needs of residents are met. The registered person must ensure that residents are canvassed for their views about how the service is run and these views are published. This will inform the service how they could improve or change the service so that the needs of the residents are promoted. 02/02/2009 14 33 24 Care Homes for Older People Page 8 of 10 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 1 9 The medication policy should be reviewed and expanded to provide clear guidance to staff in the safe handling of medicines at the home. Medicines audits and competency assessments should be carried out to help ensure medicines are well manged. There should be written information about the use of when required medicines and for external preparations (e.g. creams) to help ensure staff know when they may be needed. Where medicines are regularly not taken doctors advice should be sought to help ensure people get the best treatment. Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. 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