Inspection on 04/09/08 for Allendale

People thinking about moving in were invited to visit and spend time with an allocated member of staff, the residents and to enjoy a meal. Staff were observed to treat residents with respect. We observed the relationships between staff and residents to be very good and the residents spoken to confirm this. Staff reported that the management team were "very supportive and very helpful".

What has improved since the last inspection?

Care plans are much more detailed and include residents` preferences. There has been some redecoration and bathrooms have been tiled.

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Allendale 53 Polefield Road Blackley Manchester M9 7EN Lead Inspector Sue Jennings Unannounced Inspection 09:30a 4 September 2008 th X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allendale Address 53 Polefield Road Blackley Manchester M9 7EN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 795 3051 Allendale Rest Home Limited Karen Elizabeth Warwick Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies 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. The maximum number of service users who can be accommodated is: 24. 12th September 2007 Date of last inspection Brief Description of the Service: Allendale is a privately owned home that provides accommodation for up to 24 residents requiring personal care only. The home is located in the Blackley area of Manchester, close to Booth Hall Childrens Hospital and North Manchester General Hospital. Local facilities and public transport links are within easy walking distance. There is limited parking to the front of the property. The building is a large extended and converted detached house set in its own grounds. Access to the front of the property is at ground level. There is a ramp access at the rear of the property. Accommodation is provided on three floors, served by two passenger lifts and the home is accessible to residents who use a wheelchair. Grab rails are provided throughout the home. Bedroom accommodation is on the ground, first and second floors. There are 16 single and four double rooms. All rooms provide a wash hand basin. En-suite facilities are provided in 11 of the single rooms and all four of the double rooms. There are two lounges, one of which provides a small dining area and one dining room. Both lounges have patio doors leading out to a well-maintained and enclosed patio area, which enables residents to sit outside in warm weather. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by us (the Commission for Social Care Inspection) in relation to this home prior to the site visit. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we do. The visit was unannounced and took place over the course of seven hours on Thursday, 4th September 2008. During the course of the site visit we spent time talking to the manager, a visiting district nurse, care staff and residents to find out their views of the home. Time was spent examining maintenance records and the residents and staff files. A tour of the building was also carried out. What the service does well: People thinking about moving in were invited to visit and spend time with an allocated member of staff, the residents and to enjoy a meal. Staff were observed to treat residents with respect. We observed the relationships between staff and residents to be very good and the residents spoken to confirm this. Staff reported that the management team were “very supportive and very helpful”. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Information about the home is made available in various formats and people’s needs were assessed before they move in. EVIDENCE: There was an information pack provided to prospective residents that gave enough information for people to make an informed decision about moving in. The information pack gives the current fees and any additional charges. People moving in have a trial period of up to six weeks to see if they like it and to make sure that the service can meet their needs. We saw that there is an admissions procedure and that assessments are completed prior to anybody moving in. Once an individual comes to live there, a care plan is written based on these assessments. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 9 The manager or a senior carer visited the person in their own home or in hospital to carry out a pre-admission assessment. Where possible, a care manager’s assessment was obtained. A care plan was written using the information gathered during these assessments. One resident told us “they have brought me to heaven.” Allendale does not provide intermediate care. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Care plans addressed the health, personal and social care needs of individuals. Medication procedures protected residents EVIDENCE: We looked at the care plans for four residents and the information provided covered areas such as mobility, diet and personal care. We saw improvements since the last inspection and it was clear that they continued to work hard to improve the care planning systems. Each care plan contains information about care needs. Staff added additional information where needs change to make sure the plan is up to date. Risk assessments around areas such as falls, pressure areas and nutrition had been carried out. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 11 All residents were registered with a local GP and, where possible, residents had retained their own GP. Records of visits from other healthcare professionals were held in each resident’s file. Medication was well managed, stored correctly and records were maintained to a good standard, although a number of gaps in recording were noted. The manager stated that she would address this with the person responsible. The gaps were all on the same day and by the same member of staff. They told us that staff had received training in the administration of medication. This reduced the risk of medication errors. Medication stock was adequate and a record was being made of all medication received in to the home and disposed of. The dispensing pharmacist was at the home carrying out a medication audit during the inspection. It is recommended that the policies and procedures relating to medication are made available to staff at all times, regularly reviewed and dated to indicate when the review had taken place. It is strongly recommended that a separate controlled drug cupboard be fitted in the event that any resident at any time could be prescribed a controlled drug, e.g., following a hospital admission. We spoke to a visiting district nurse who told us that “the staff take on board what I tell them, this is definitely one of the better homes.” Residents told us “I like it very much, the staff are smashing.” Another told us “it was too dangerous at home, here I pull the cord and I can ask for the earth, I am sure they would give it to me.” Another resident told us “I have everything I need here” and “I am being well looked after.” One resident told us “the carers are very good, they do a really good job.” Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home offers an adequate range of activities. Residents are able to maintain contact with family and friends. A varied menu is available which provides choices for residents. EVIDENCE: Staff were observed welcoming visitors into the home. There was an open visiting policy and residents were able to see visitors in one of the lounges or in the privacy of their own rooms if preferred. One resident told us their visitors were “always made to feel welcome” and can visit at any time. Other residents said that they were able to have friends and family visit when they liked. One resident told us “I thought I would be taken out but they are very busy, there is not really much going on.” Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 13 Another told us “it’s ok”, “I’ would like a few more activities” and “more outings”. They told us “we have darts, dominoes, card games, table games and music and movement”. They told us that staff had been making birthday and Christmas cards. One resident told us “we have card making”. We saw that care plans could be improved to include more information about social and emotional needs. This could be used to tailor and further improve the activities on offer at the home. This is especially important for the residents who spend a lot of time in their bedrooms. Residents told us that they were able to have friends and family visit when they liked. Menus were based on a four-week rota and were reviewed regularly to take into account residents’ preferences. Residents were able to choose an alternative to the set menu if they did not like the menu choice for the day. People spoken with said, “the food is good” and “the meals are usually very good, very tasty”. Most residents spoken with said that they enjoy the food offered, with comments including “very good”, “excellent” and “ok”. Ministers from local churches visited the home on a regular basis. The manager told us that arrangements would be made to support residents from other religious backgrounds, as and when required. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Individuals are protected from abuse. Concerns about the care provided are listened to and acted on. EVIDENCE: There was a written complaint procedure. All complaints received were recorded. This record included details of the complaint, the investigation and the outcome. Residents told us that if they had a complaint they would “first speak to the manager”. The complaints policy and procedure was displayed in the home and information about how to make a complaint was included in the service user guide. The service has internal policies and procedures for the Protection of Vulnerable Adults (POVA). There was a copy of the Manchester Multi-Agency Policy on the Protection of Vulnerable Adults available for staff to reference. There had been no adult protection referrals made. There was evidence to show that staff received training in safeguarding adults so that they were able to recognise abuse and report it. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 15 There was a whistle-blowing policy so that staff knew that the management would support them. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Residents enjoy a comfortable and homely living environment. The premises are well maintained and kept to a good standard of cleanliness. Improvements are needed to the arrangements for people who smoke to ensure a smoke free communal environment. EVIDENCE: As stated in the previous report, it is of concern that the designated smoking area for residents was located in the front hallway. This area has access doors to all other areas on the ground floor of the home. These doors were held open with automatic closure systems. Cigarette smoke was evident in all communal areas on the ground floor. Residents spoken to said “the home is very clean”, “my room is fine” and “very homely”. Residents told us “its good”, “my room is ok” and “fine”. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 17 One ground floor bathroom near the lounge was also seen to have a number of wheelchairs stored in it. It was recommended that where possible these be stored in residents’ bedrooms. We saw that they were using terry towels and tablet soap in toilets. It was recommended that paper towels and liquid soap be used to minimise the risks of cross infection. We saw that the home generally provides a pleasant and well-maintained place for people to live. Some areas are in need of updating and re-decoration. The communal areas provide a comfortable and well-maintained living environment for residents. Bedrooms are individualised to residents’ preferences. Residents are able to bring personal items, including furniture, with them on admission and are able to have a private telephone line, should they wish. A sample of bedrooms was seen and residents spoken to said “I like my room I spend a lot of time in here”, “the place is very clean”, “it is always very clean and tidy they work very hard” and “I am really happy here”. We saw two bedrooms with an unpleasant smell; they told us this was due to the carpets. They told us the residents in these rooms had continence needs and the carpets were cleaned on a daily basis. We saw that there were satisfactory numbers of domestic staff to keep the home hygienic. The service should however look at replacing carpets if they cannot be kept clean and fresh. Aids and adaptations were provided to assist in moving residents safely, these include two manual hoists. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The numbers and skill mix of staff was sufficient to meet the needs of the residents accommodated and staff have access to a range of training. Recruitment procedures could be more robust. EVIDENCE: A sample of staff files was examined. These were well maintained and contained Criminal Records Bureau (CRB) and checks against the Protection of Vulnerable Adults list (POVA). It was concerning to see that two staff files did not contain references. In order to fully protect residents during the recruitment of staff, the manager must obtain two written references before people start work. Residents told us “the staff are nice kind people”, “kind”, “very good” and “they do their best for everybody”. The manager told us that they had approached Manchester City Council with a view to accessing training for staff. They had however been unsuccessful and told us they had not been allocated one place on a training event run by the council. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 19 The manager reported that regular staff supervision was provided and all staff completed an induction period. There was evidence on staff files to show that staff were given a copy of their job description detailing their roles and responsibilities. A training officer from Skills Solutions was on site during the site visit. They told us that three staff had been signed up for NVQ level III on the morning of the site visit. They told us that staff had not received training on the Mental Capacity Act and its implications. It is strongly recommended that this training be arranged. Staff were caring and approached residents in a polite and respectful manner. Residents told us that staff were “ kind and caring”, “very helpful” and “quite friendly”. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s quality monitoring systems protected residents and the home had systems and procedures in place which safeguarded and protected residents’ financial interests. EVIDENCE: The manager has knowledge and experience of running a care service for older people. Areas for future improvement for the manager to look at include staff recruitment and providing a designated smoking area that meets Regulation 2 of the Smoke-free (Premises and Enforcement) Regulations 2006. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 21 Comments from staff about the management of the home included “good” and “they are nice”. A system for regular individual staff supervision is in place but needs development to make sure that all full time staff receive this at least six times per year. People living at the home and their relatives or representatives are sent questionnaires as part of the quality assurance process. The most recent survey was in 2007 and the results of this are on file in the office. A health and safety policy was in place and risk assessments of the premises and safe working practices had been carried out. This was to ensure that both residents and staff had relevant information to enable them to live and work in a safe environment. Fixed gas and electrical appliances had been regularly maintained and a periodic test of portable appliences and lifting equipment had been carried out and good records are kept. These checks mean that the safety of residents, staff and visitors was given priority. The home’s certificate of registration and public liability insurance were displayed in the office. Fire equipment had been regularly maintained and staff had received fire awareness training. Fire alarm systems are tested on a weekly basis by staff in the home and annually by the local Fire Officer. All records were held securely in locked cabinets in compliance with the Data Protection Act 1998. This made sure that personal information about residents remained confidential. Policies and procedures were in place with regard to managing residents’ finances. Records kept at the home indicate that the financial interests of the residents are safeguarded. A quality assurance and quality monitoring system was in place and blank copies of the quality monitoring questionnaires were in the foyer for visitors and residents to complete. There was an open door policy and residents and staff had access to senior staff at all times. Staff spoken to said that the manager was always ready to listen to concerns and answer questions. Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 13 (2) Timescale for action In order to fully protect residents 12/10/08 during the recruitment of staff, the manager must obtain two written references before people start work. There must be a dedicated 12/11/08 smoking area that meets the requirements of Regulation 2 of the Smoke-free (Premises and Enforcement) Regulations 2006. Requirement 2 OP38 13 (2) Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations It is recommended that the policies and procedures relating to medication are made available to staff at all times, regularly reviewed and dated to indicate when the review had taken place. It is strongly recommended that a separate controlled drug cupboard be fitted in the event that any resident at any time could be prescribed a controlled drug, e.g., following a hospital admission. It is strongly recommended that they take advice from the Infection Control nurses with regard to the use of bar soaps and terry towels in toilets. 2 OP26 Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Allendale DS0000043949.V361998.R01.S.doc Version 5.2 Page 26 - 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. 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