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Inspection on 06/05/09 for Ambassador Care Home

Also see our care home review for Ambassador Care Home for more information

This is the latest available inspection report for this service, carried out on 6th May 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We had a walk around the building and found it clean and kept to a high standard so that people are comfortable, one person who lives at the home said, "There always redecorating something in the home". One staff member responsible for keeping the home maintained said, "We continue to improve the decoration and furnishings all the time". Training opportunities and development of staff is excellent to ensure people have the skills and competencies to provide the care and support residents need. One staff member wrote in a survey, "I was helped to do my National Vocational Qualification (NVQ) level 2 which helps a lot". Comments we received from people spoken to were very pleased with the quality of food and meals provided. We saw the cook preparing lunch, baking home made pies and using fresh fruit and vegetables to ensure people have a wholesome nutritious diet. We spoke to the cook who said, "Today is home made scones the residents love them". Other comments from people who live at the home included, "Absolutely fabulous". Also, "No-one can complain its good and you get plenty". We spoke to one resident about to have his lunch who said, "Always a choice whatever you want". We sat and talked to residents in the lounge and watched people coming and going throughout the day and found routines to be relaxed and informal with staff talking and helping residents and visitors when they entered the home. One relative spoken to said, "The staff and manager are great, nothing is to much trouble". The staff and manager are very good at providing social entertainment and help people follow there chosen interests, this was confirmed through talking to people and records kept. Records show evidence of previous events such as, a valentines party and Christmas events. Pictures were around the home of people enjoying them selves at social events which take place on a regular basis and help to provide stimulation and enjoyment for people who live at the home. One staff member spoken to said, "We make a fuss of every event , such as Christmas and Easter". One person who lives at the home said, "At Halloween we dressed up it was fun". Another said, "The staff make an effort to provide social events".

What has improved since the last inspection?

There continues to be improvements made to the decoration and refurbishment of the home. The radiator in the lounge has been covered to ensure people are kept safe. Some bedrooms have been refurbished and redecorated to provide pleasant surroundings for people. One person who lives at the home said, "My bedroom is decorated lovely".

What the care home could do better:

Care records of people who live at the home looked at had not been reviewed on a regular basis to ensure any changes in health and social needs are recorded and acted upon and care needs information updated. Care plans should be reviewed monthly toreflect this. We looked at how staff had been recruited and found not all the checks for employment were in place before people started to work. All Staff checks should be in place before they start to work to ensure only suitable people are employed.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ambassador Care Home 670/672 Lytham Road Blackpool Lancashire FY4 1RG     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: Kevan Royston     Date: 0 6 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 25 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 25 Information about the care home Name of care home: Address: Ambassador Care Home 670/672 Lytham Road Blackpool Lancashire FY4 1RG 01253406371 01253400990 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) : D M Care Limited care home 31 Number of places (if applicable): Under 65 Over 65 31 old age, not falling within any other category Additional conditions: 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 wihtin any other category - Code OP The maximum number of service users who can be accommodated is: 31 Date of last inspection Brief description of the care home The Ambassador Care Home provides accommodation for older people of both sexes. The home is a large detached property situated in the south area of Blackpool close to the airport and Highfield Road shopping centre. Local bus and tram routes are accessible and close by. The accommodation comprises of two lounges, a large dining area and a recently built conservatory. The front and rear garden areas provide seating for the residents and at the rear of the property there is a lawned garden area. The bedrooms are en-suite with aids and adaptations to the communal bathrooms and toilets situated on the three floors of the premises. There is a passenger lift to all three floors. There is a statement of Purpose/Service user Guide, which is given to all prospective Care Homes for Older People Page 4 of 25 Brief description of the care home residents. This written information explains the care service that is offered, who the owners and staff are and what the resident can expect if he or she decides to live at the home. The range of fees are £326.50- £366.50 per week. Additional charges are for hairdressing and chiropody. Care Homes for Older People Page 5 of 25 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: This unannounced visit was part of the key inspection process and took place on the 16/04/09. We spoke to people who live at the home, relatives visiting at the time of our visit, staff, the manager, owner and a group of residents in the lounge. Financial, maintenance and other records were looked at as well as a walk around the building. As part of the inspection process we talked to people using the service and asked staff about those people needs. we also looked at their rooms, care plans and daily notes, this is called case tracking. Other people who live at the home were invited to pass their opinions to us if they wish. We had responses from surveys/ questionnaires sent to people who live at the Care Homes for Older People Page 6 of 25 Ambassador and staff for their views on how the home is run. Comments we did receive were positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of their service they provide and to make an assessment of the quality of their service. This document is called an Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus our inspection activity. What the care home does well: What has improved since the last inspection? What they could do better: Care records of people who live at the home looked at had not been reviewed on a regular basis to ensure any changes in health and social needs are recorded and acted upon and care needs information updated. Care plans should be reviewed monthly to Care Homes for Older People Page 8 of 25 reflect this. We looked at how staff had been recruited and found not all the checks for employment were in place before people started to work. All Staff checks should be in place before they start to work to ensure only suitable people are employed. 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. 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 9 of 25 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 10 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission and assessment procedures were clear to ensure care needs of residents are met. Evidence: We looked at assessment information for two residents, comprehensive information was contained, completed by Social Services and the manager of the Ambassador before people moved in. A care plan had been developed from the information to ensure health,social and welfare needs are identified and the care and support needed can be met. There was evidence of family involvement to gather information so that all needs of residents are assessed. One relative visiting at the time of the visit said, We liked it as soon as we walked in. We spoke to members of staff and they understood the importance of getting the right information and meet potential residents before they move in, so that they are sure Care Homes for Older People Page 11 of 25 Evidence: they can provide the care and support required and meet the needs of the people. One member of staff said, We make sure we can care for people before they are admitted. Standard 6 was not assessed as the home does not provide intermediate care. Care Homes for Older People Page 12 of 25 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. People who live at the home have there health and personal care needs met by staff who respected their privacy and dignity. Evidence: We talked to residents sitting in the lounge area and people on there own in bedrooms, all comments were positive in the way they were treated by the staff and the care and support given to them to ensure they are kept well and comfortable. One person who lives at the home spoken to about the care received said, Good helpful people A survey returned by a person who lives at the home said, They know what needs doing to help me and they get on with it. We looked at records of care for people living at the Ambassador, each had a plan setting out what support was needed and action to be taken by staff to make sure health, social and personal needs are met and monitored regularly. Relatives and residents have a say in the care provided and the best way to support people,one relative we spoke to said, Any concerns with what my dad needs and I am consulted. Care Homes for Older People Page 13 of 25 Evidence: Each person has a risk assessment in place and we confirmed these are updated when necessary to reflect any changes that may have occurred in the building or individually ensuring people are protected and safe. The care for residents is reviewed however not on a monthly basis, care plans should be reviewed monthly to ensure the right care is given and any health needs are recorded so staff are aware of what each individual requires. We watched medication being given out of people we case tracked with the manager and found safe practices in place to ensure residents receive the right medicine at the right time and they are protected by the procedures in place. One member of staff spoken to said, Senior staff only give out medicines. The manager explained to us they have good a good relationship with the pharmacist who visits at least twice a year to offer guidance and training so that people who live at the home are protected and safe with good procedures in place for administering medicines. We watched staff treating residents with respect and dignity by the way they talked to people, knocking on doors before entering rooms and offering support in a sensitive manner when needed. One staff member said, The way we treat people with respect is what I like about this home. A person who lives here spoken to said, They are so polite. The manager informed us in the (AQAA) staff are given instruction around issues of respect, dignity and equality so they are aware of how to treat people. Care Homes for Older People Page 14 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are well managed, creative and provide daily variation and interest for people living at the home. Evidence: Routines observed during our visit looked relaxed and some people were sat in the lounge area, staff were seen chatting to residents and generally supporting people. We spoke to people who live here about activities and comments included There is always something going on, And, They make a lot of effort to entertain us its wonderful. We saw pictures of staff and residents dressing up at Halloween time, Christmas and Easter and joining in with entertainers. One staff member spoken to said, We have a lot of fun on special days. We had a look around the kitchen and found the cook using fresh fruit and vegetables for lunch and tea and plenty of stocks in the fridge and cupboards to ensure people who live here receive a healthy diet with plenty of choice. One member of staff spoken to said, Today I have made home baked scones and beef stew and dumplings. Comments about the standard of food from people who live at the home were very good and included,You get piles of food, Also, Lovely home made meals. The cook Care Homes for Older People Page 15 of 25 Evidence: spoken to confirmed they provide food for diabetics and are able to provide meals if required from any religious cultures. As a course of good practice the staff monitor the intake of food of every person living at the home to ensure and concerns are identified and appropriate action taken. They have a visitors policy at the Ambassador and friends are welcome at any time. We confirmed this by talking to a relative visiting the home who said, We visit any time, they always make us feel welcome. We had walk around the building and were invited into some residents rooms and found personal items around the bedrooms to make sure residents feel at home and are comfortable. Care Homes for Older People Page 16 of 25 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. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Evidence: The manager has a detailed complaints policy and procedure which is available for new residents and families to ensure they know who to speak to should they have any concerns. One person who lives at the home said when asked if he knew about the complaints system, Dont worry I know the procedure. There has been no complaints since the previous inspection. We found through speaking to staff and residents any concerns or grumbles are acted upon before they become formal complaints and issues are addressed. We spoke to staff members and found training has been provided for staff in Safeguarding Adults and abuse issues, through the training programme provided by the manager or National Vocational Qualification (NVQ) courses. One staff member spoken to said, Yes I have attended safegaurding adults training. Care Homes for Older People Page 17 of 25 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 environment is safe and clean maintained to a high standard providing comfortable surroundings for the residents. Evidence: We had a walk around the premises and the outside areas, we found it clean, tidy and maintained to a high standard.Comments we received from surveys and people we spoke to all confirmed how clean and well kept the home is, Comments included, Cleanliness is of a high standard, Also, Its kept clean at all times. One relative we spoke to said, There is never any bad smells. During our walk around the home and from what the manager told us in the AQAA, new carpets have been fitted, bedrooms redecorated and the hallways repainted to ensure residents are kept comfortable and live in pleasant surroundings. The building is well maintained and records are kept of running repairs and if appliances break down, so that they can be put right as soon as possible. There are policies in place for laundry processes and for the control of infection ensuring the home is kept clean and hygienic. Care Homes for Older People Page 18 of 25 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. Access to training is excellent for staff is and helps staff to develop their skills and competencies. Recruitment procedures need to be more robust to ensure only suitable people are employed. Evidence: We spoke to the manager and looked at staffing rotas and found sufficient numbers on duty to be able to support the people who live at the home. One staff member wrote,We have a good staff working relationship. One person who lives at the home spoken to spoken to said, The girls are like friends not staff. Staff training records were made available and confirmed each person has a development programme for training and attending courses relevant to there role to ensure staff have the skills and competencies to care for the residents. Staff are well trained and 95 of care staff have completed a National Vocational Qualification (NVQ) to at least level 2. Now some staff are completing level 3 which will develop their skills and competencies and enable them to provide good quality care. One staff member wrote in a survey, I started as a domestic and was encouraged to do NVQ level 2 and a lot of different courses and now I am to start my NVQ level 3. It was clear from watching staff with residents and speaking to staff they are clear Care Homes for Older People Page 19 of 25 Evidence: about their role and work well as a team to ensure the individual and collective needs of residents are met. One person who lives at the home said, I trust them all they are very good. We looked at staff records of recruitment and found good systems in place, however one staff file only had one reference check before they started to work. We explained to the manager two references should be in place before any member of staff is employed to ensure only suitable people work at the home. Care Homes for Older People Page 20 of 25 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 run well and has policies and procedures in place to ensure the health and safety of staff and people living at the Ambassador are promoted and protected. Evidence: The manager has the skills, qualifications and competencies to run a care home and evidence from staff surveys and talking to people confirm this. Some comments received included, We are fortunate to have a caring manager. And from a person who lives at the home, We have good managers who supports us. We looked at records and they show systems are in place to get residents,families and staff views on how the home is run and suggestions are made and implemented to improve the home for the people who live here. We looked at financial records and found good systems in place for people to control there own money where possible and ensure safeguards are in place for there Care Homes for Older People Page 21 of 25 Evidence: protection. We checked records of health and safety and confirm regular tests are carried out to emergency lighting, fire procedures, gas appliances and electrical equipment,they have been completed ensuring the safety of people living at the home is maintained. Care Homes for Older People Page 22 of 25 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 23 of 25 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 7 The care plans of people who live at the home should be reviewed by care staff at least once a month and updated to reflect changing needs for health and personal care. Two references should be in place before anyone starts to work at the home to ensure suitable staff only are employed. 2 26 Care Homes for Older People Page 24 of 25 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 25 of 25 - 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!