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Inspection on 05/05/10 for Anne Residential Home (1)

Also see our care home review for Anne Residential Home (1) for more information

This is the latest available inspection report for this service, carried out on 5th May 2010.

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

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

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

This home is in a bungalow and all rooms are therefore on one level which provides better access for people with restricted mobility. The owner manager is a Dietician and provides meals that are very well balanced nutritionally and contain specific higher areas of nutrition when poor health requires. The people who use the service and relatives have consistently confirmed that meals at the home are pleasant and enjoyable. People who use the service have been consistent in their comments that they like living in the home, and like their rooms, meals and how they are treated. Life story books are produced to exercise and maintain memory. Relatives are encouraged to and do maintain contact with the home and other people using the service following the death of the relative concerned. It is seen as good practice that the home does not manage anybodys money and it is to be commended for pursuing alternative solutions. This home is very well maintained and clean. At this and all unannounced inspections, it has been reassuring to see that the home was particularly clean and hygienic. There have been no changes in the full time staff since the 2006 inspection. This provides people with consistency and staff that know them well.

What has improved since the last inspection?

Bacterial analysis testing of the water supply is occurring regularly. More staff are now qualified. Staff supervision is now better recorded.

What the care home could do better:

There were no requirements for improvements set at the time of this inspection

Key inspection report Care homes for older people Name: Address: Anne Residential Home (1) 80 Coombe Lane West Kingston Upon Thames Surrey KT2 7AD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Barry Khabbazi     Date: 2 8 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 20 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 20 Information about the care home Name of care home: Address: Anne Residential Home (1) 80 Coombe Lane West Kingston Upon Thames Surrey KT2 7AD 02089428378 02089423861 gzgorska@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Krystyna Gordon Name of registered manager (if applicable) Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 4 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 Dementia - Code DE(E) (of the following age range: 65 years and over) Date of last inspection Brief description of the care home Anne Residential Home 1 is a two-storey building set back from a main thoroughfare connecting Kingston and New Malden. Two service user bedrooms are located on the ground floor, the third is located on the first floor and accessed via a set of stairs. There are few amenities within walking distance of the home, but Kingston town centre Care Homes for Older People Page 4 of 20 Over 65 4 4 0 0 Brief description of the care home is a few minutes drive away by car. The home is registered for adults aged over 65 years of age who have Dementia. Staffing of Anne Residential 1 is provided to ensure that, in addition to the manager, there is one staff member per shift on duty at the home. At night, one member of staff sleeps in at the home and is available on-call if needed. Each of the three service user s has a call-bell, which can be activated if they require support in the night. The home is a short distance from the owner s other care home. There continues to be an emphasis on integration between the service users from the owner s other home. The fees are currently GBP330 to GBP495 per week. Care Homes for Older People Page 5 of 20 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: three star excellent 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 overall quality rating of the service is 2 star. This means the people who use this service generally experience good outcomes The key Standards identified throughout this report were assessed at this inspection. This inspection also focussed on following up on previous requirements and recommendations, and any new issues arising. This inspection was unannounced. During this inspection the manager owner was interviewed. We spoke to the people who use the service, Records, care plans and the building were examined. People were generally relaxed and happy during the inspection period The care of the people who use the service is maintained to a high standard. This has been consistently confirmed by people who use the service themselves and by the Care Homes for Older People Page 6 of 20 Commissions communications with relatives. We spoke to people who use the service. Comments from them on this occasion included: There very nice here, the food is lovely. Some comments by relatives were I am very pleased with the care my relative receives here, and my relatives physical health has improved since coming to this home, the food is very good and staff treat my relative with respect and genuine care. Both the surveys returned stated that y the home did well in providing care, that they knew how to make a complaint, and 1 said that the food was always suitable, and 1 said usually. Written comments included, They give personal attention to my needs, in a friendly atmosphere, with good home made food. And, The home is exhalant in every way. No negative comments were received in any questionnaires sent by the Commission since over the last 5 years of inspection. There have been no care related complaints received by either the home or the Commission. Care Homes for Older People Page 7 of 20 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 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 8 of 20 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 20 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 who use this service experience Good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Peoples needs are assessed before they start at the home to ensure that all needs are known by the staff. This home does not provide intermediate care with a view to return to the community and Standard 6 is therefore not applicable. Care Homes for Older People Page 10 of 20 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 use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Plans of care record health and social care needs to ensure these needs are all known and met. People are protected by the homes health monitoring procedures. People are protected by the homes medication procedures. People are treated with respect and their privacy is maintained Care Homes for Older People Page 11 of 20 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. People who use this service experience Exhalant quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: People experience a lifestyle in the home that generally matches their expectations. People are provided with opportunities to remain part of the local community and are able to take part in appropriate activities. The daily routines and the homes policies promote choice and rights, to ensure equality and that all rights are enjoyed by all. Dietary needs are well catered for and a balanced diet is provided, to ensure health and enjoyment of food. Care Homes for Older People Page 12 of 20 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 who use this service experience Good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Complaints are managed well which should ensure that concerns are listened to and acted upon.. The homes policies and procedures help protect people from abuse and help staff if they need to tell someone about any bad care practice they may see. Care Homes for Older People Page 13 of 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience exhalant quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service Evidence: The home is in very good condition externally and internally, and is well decorated in a homely fashion and very well maintained. This creates a pleasant environment that promotes dignity and emotional well-being. The home is particularly hygienic and clean, homely and comfortable; this environment therefore promotes a pleasant environment, conducive to health, and emotional well-being. Care Homes for Older People Page 14 of 20 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 who use this service experience Good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Staff numbers are of sufficient quantity to meet needs and provide consistency. People are supported by a staff group where 50 or more have the required qualifications. This raises the quality of staff, their knowledge and their practices. The current staff vetting procedure does protect from undesirable staff. Induction and foundation training to National Training Organisations specifications is in place. This ensures a well inducted staff group. Care Homes for Older People Page 15 of 20 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. All previous shortfalls identified in this section had been addressed by the time of this inspection. The owner manager runs the home to a high standard and no management problems have been identified. The owner manager provides consistency and expertise, and has a good relationship with people who use the service. Quality assurance tools currently include questionnaires, and a complaints system. These quality assurance tools have been pulled together into an internal quality assurance system, which includes this information in the homes annual plan where appropriate, and then provides a system of feedback and review involving the people who use the service in the form of feedback meetings. This should allow open measuring of achievement in improving quality. It is seen as good practice that the home does not manage anyones money and it is to be commended for pursuing alternative solutions. Care Homes for Older People Page 16 of 20 Judgement: Systems for maintaining non care related records have been developing, but should continue to develop. The following recommendation is therefore set: The home should continue to look at systems to better manage its paperwork. Infection Control, and Handling and Disposal of Clinical Waste policies are all also included in staff induction. All of the health and safety policies and procedures relevant to this Standard have been seen to be present. Fire Safety, First Aid, Food Hygiene, Infection Control, and Handling and Disposal of Clinical Waste policies are all also included in staff induction. Control Of Substances Hazardous to Health policies and data sheets were available and these substances were all locked away. All of the procedures and testing of systems required in Standard 38 were also present. Evidence: People who use the service benefit from a well run home, with a qualified manager. The home has implemented a quality assurance system and an annual development plan, with both involving people. This should ensure that the home is run in a way that involves peoples and a way that is in their best interests. The financial interests of people are managed in a way that protects their rights. The home promotes the health and safety of the people who use the services, so that practices and the environment do not place their health and safety at risk. Care Homes for Older People Page 17 of 20 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 28 18(1)a The home must continue 01/12/2007 with its training programme to achieve and maintain 50 or more staff with a NVQ2. Care Homes for Older People Page 18 of 20 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 Care Homes for Older People Page 19 of 20 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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