Inspection on 04/05/10 for Astor Lodge View

This is the latest available inspection report for this service, carried out on 4th May 2010.

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.

Other inspections for this house

Astor Lodge View 17/05/07

Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Key inspection report Care homes for older people Name: Address: Astor Lodge View Lamb Street East Cramlington Northumberland NE23 6SF     The quality rating for this care home is:   two star good 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: Anne UrwinBrown     Date: 0 4 0 5 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 26 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 26 Information about the care home Name of care home: Address: Astor Lodge View Lamb Street East Cramlington Northumberland NE23 6SF 01670735012 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): astorlodgeview@schealthcare.co.uk Southern Cross OPCO Ltd Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 29 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 ome are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 29 Date of last inspection Brief description of the care home Astor View Lodge is a purpose built home in a rural area of Northumberland on a site which has two homes Astor View and Astor Court. Both homes are operated by Southern Cross Opco Ltd. Astor Court was not part of this inspection, having its own separate registration. The village of East Cramlington is a short distance away, with a small range of local amenities including shops, public houses, a post office and Church. The area is served by public transport and the coastal areas of Northumberland and Care Homes for Older People Page 4 of 26 Over 65 29 0 Brief description of the care home the town centres of Cramlington and Blyth are within easy reach by bus or car. Astor View is registered to provide care to 28 older people and 1 person under the age of 65 with a physical disability. All areas internally and externally are accessible to wheelchair users and all people living at the home are able to enjoy single bedrooms with en suite facilities. Externally, generous car parking is available. There is a Statement of Purpose and Service User Guide in place to inform prospective residents and their relatives about the service provided at Astor Lodge. Care Homes for Older People Page 5 of 26 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: The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit we looked at: Information we have received since the last visit. How the service dealt with any Care Homes for Older People Page 6 of 26 complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The Visit: An unannounced visit was made on 4 May, 2010. The inspection visit lasted a total of seven hours. During the visit we: Talked with people who use the service, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 26 More effective systems are needed to ensure that items such as the assisted baths and the hot water boiler are replaced speedily so that the service to the people living in the home is not affected. This means that people have access to aids and equipment they need in their day to day lives. 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 9 of 26 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 26 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. Clear information and assessments processes enable residents to make a positive and informed choice before moving into the home. Evidence: The Statement of Purpose and Service User guide provide good information about what it is like to live at Astor Lodge. From talking to people living in the home it is clear that the home has good systems in place for planning admissions. People are treated as individuals and have enough information to make an informed choice about living at Astor Lodge. A pre-admission assessment is completed by senior staff before a person moves into the home to ensure that his or her needs can be met. Information from the assessment and from relatives and/or from the care manager is also used to prepare an individual plan outlining each persons care needs. The home understands the importance of having good information about peoples needs before agreeing a Care Homes for Older People Page 11 of 26 Evidence: placement. Two people said that they were satisfied that staff knew what they needed help with when they first came to live at the home. Care Homes for Older People Page 12 of 26 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. Health and personal care needs are met by appropriately trained and qualified staff. Evidence: Each person has a personal plan in place that clearly outlines their care needs and how these are met to suit their individual needs. These plans are well recorded and have improved significantly since the last key inspection. Personal support is person centred reflecting peoples individual needs and preferences. Information in individual plans and in daily records showed how peoples personal care, physical and social and emotional needs are met by staff. Assessment tools are used to identify changes in peoples needs and care plans are updated to reflect any changes. Other health care information is well recorded and evidence was available that good systems are in place to ensure that individual needs are met. Evidence was available that privacy and dignity is respected and that staff are sensitive to personal preferences. Staff are aware of equality and diversity and this has been included within staff training . During the inspection two people said they get good care and support from staff. They said that staff were kind and always available Care Homes for Older People Page 13 of 26 Evidence: when they needed them. One person said in a survey returned The home is good, staff are nice. Another person said Staff are always there when needed, can go to bed with a free mind. Staff are pleasant and friendly. Three surveys returned suggested that at times there were not always enough staff. One relative said that he was very satisfied with the care and support provided at Astor Lodge. The medicines policy supports good procedures and practice. Staff training has been provided for all staff responsible for administering medicines. Medicines records are well completed, were up to date and contain required entries. There are regular checks of medicine practice by the manager or deputy manager and records were available to show this. Arrangements for the storage of medicines are satisfactory. Care Homes for Older People Page 14 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines around daily living are flexible and provide people with good opportunities to retain control over their lives and engage in activities of their choice. This enables them to make choices about how they live their daily lives. Evidence: Peoples lifestyle and routines are organised to suit their individual needs and two people said that staff support their choices and preferences. Records showed that account is taken of peoples preferences. Information about individuals social care needs are recorded in care plans and these show peoples interests. Activities are planned with the people living in the home and they are encouraged to make suggestions. Most residents said the food was good and alternatives were available at each meal time. In surveys returned two people said that they felt the food could be better and that there could be more variety. The lunch served at the time of the inspection was well cooked and presented and people were seen to be enjoying their meal. Four peoples aid that they could get something else to eat if they did not like what was on the menu, but had never had to ask for that. The menus provide a good variety of food and takes account of healthy eating principles. The food comes from the kitchen Care Homes for Older People Page 15 of 26 Evidence: in Astor Court next door and is served in a small kitchen off the dining room. A number of issues were identified concerning the cleanliness and suitablity of this kitchen that are discussed further in the Environment section of this report. Staff records showed that they have completed Food Handling training. Drinks are provided regularly through the day and there was tea, coffee, or cold drinks of either juice or milk. There were biscuits provided. Fruit was also available. Individual bedrooms are personalised according to the taste of the resident. People said they were happy with their rooms and that they had a lot their own personal items around them. People have visitors at any time and are able to use their own rooms, or the lounges to see them. Care Homes for Older People Page 16 of 26 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. A satisfactory complaints procedure is in place to ensure that complaints are dealt with effectively and to the satisfaction of the complainant. Good arrangements for protecting people using the service are in place. Evidence: Good policies and procedures are in place for dealing with complaints. Systems are in place for recording complaints, the investigation and outcome. One complaint has been made in the last year and this was fully investigated. People said that they felt able to speak to the manager or the staff if they had any concerns and were satisfied that their concerns would be taken seriously. Staff know how to help people to make a complaint. All staff have completed safeguarding training. Policies and procedures are in place for dealing with any allegations and the manager has a copy of the local authoritys procedures. The manager and her staff are aware of the action to be taken in the event of an allegation being made. Good systems for the recruitment of staff are in place to protect people living in the home. A whistle blowing policy is available for staff to use if they see any poor practice. Care Homes for Older People Page 17 of 26 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. Astor Lodge provides a safe, generally well-maintained environment that encourages independence. Good quality accommodation is available for individuals in single rooms with en-suite toilets. The home is clean, pleasant and hygienic. Evidence: The home is purpose built, spacious and provides ground floor accommodation in single en-suite rooms for the people living there. There is a garden area and parking to the front of the building and to the rear there are lawns. The accommodation is generally well maintained with a programme of redecoration in place. Since the last inspection a room that was formerly for smokers has been redecorated and is now used as a quiet lounge, while the former quiet area is used for smokers. Two bathrooms were not being used and had not been for some time as the assisted baths were not working. This had been reported to the estates section of the organisation, but the baths had not been replaced. At this inspection the line manager was contacted and it was agreed that both baths would be replaced within ten days of this inspection. The Care Quality Commission was informed before this report was written that this work had been completed. It was noted that the lock on the door of toilet one was broken and this was brought to the managers attention. The shower room had a fusty smell, that could be caused by the tiles needing to be replaced. Aids and equipment (other than assisted baths) is available in bathrooms to assist people Care Homes for Older People Page 18 of 26 Evidence: living in the home. Systems are in place for reporting repairs or maintenance. Records are kept to show this. While these records provide good information it is not evident that this system worked in resolving the issues with the assisted baths and as a result people were only able to have showers for a considerable length of time. Bedrooms are well furnished and spacious. Rooms are redecorated as necessary and evidence that this is happening as a planned programme was seen. The bedrooms seen were personalised with pictures and other items from peoples previous homes. This kitchen next to the dining that is used to prepare hot drinks and snacks is also used to serve meals brought over from the main kitchen in Astor Court. It is fitted with a range of units, some of which were damaged and stained. Staff reported that they were not able to clean the shelves in some cupboards because the surface had been damaged and was now ingrained. The cooker was dirty and required urgent cleaning and the microwave also was dirty inside. A new hot water boiler was in place, but not working. The use of the existing boiler did not comply with good health and safety standards and staff were regularly using jugs to transfer boiling water to tea pots and other drinks. The laundry is now done in Astor Court. Arrangements are in place to ensure its prompt return. Good infection control procedures are in place and staff have had appropriate training. Care Homes for Older People Page 19 of 26 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. Sufficient well trained staff are available at all times to meet the needs of the people living in the home. Evidence: Staffing levels are adequate to meet the needs, activities and wishes of individuals living in the home. During the visit to the home there were enough senior staff, carers and ancillary staff. The deputy manager is based in Astor Lodge and is supernumerary for two days per week and the manager is responsible for this home and Astor Court, which is on the same site. Staff said that they feel well supported by the manager and the senor staff team. They said that there is good communication within the staff team and that they feel able to speak to the manager or deputy manager if they have any concerns. Good staff recruitment procedures are followed for appointing new staff that take account of equality and diversity principles. The manager recognises the importance of effective recruitment in providing good quality care and to protect people living in the home. Appropriate checks including obtaining two references, Criminal Records Bureau are carried out and records are in place to confirm this. Staff receive good training to equip them to meet the needs of the residents. Training is focused on achieving better outcomes for people living in the home. Staff said that Care Homes for Older People Page 20 of 26 Evidence: they get enough training opportunities and are well supported by the senior staff. Individual training records are in place and are kept up to date. The manager is aware of the need to encourage staff to undertake qualifying training. A staff supervision programme is in place and staff confirmed that they receive good support. Staff said that they are able to raise issues and concerns and their views are taken seriously. Care Homes for Older People Page 21 of 26 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. Good management and quality assurance systems are in place to allow people living in the home to contribute their views about the operation of this service. Evidence: The manager has been in post for more than one year and was previously the manager in another Southern Cross home. She is experienced and qualified. The deputy manager has recently been appointed and is undertaking a degree course relevant to her role. The staff team spoke positively about the team. The manager communicates a clear sense of direction and is well informed about the organisations values and priorities. She is committed to ensuring the service respects peoples individuality and provides person centred care. Staff said they felt well supported and there are good communication systems in place to ensure that people living in the home get the care they need. Quality auditing systems are widely used in the home to regularly assess the effectiveness of the service. Systems are in place to ensure that people living in the Care Homes for Older People Page 22 of 26 Evidence: home are consulted about the service and the manager described how their views are taken into account when planning any changes. Resident and staff meetings are held regularly. Money held on behalf of residents is recorded and a running balance kept on computer. All transactions are recorded. Health and safety procedures are in place and regular updating training is provided for staff. Records confirm this. Care Homes for Older People Page 23 of 26 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 24 of 26 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 19 Attention needs to be given to ensuring the kitchen provides appropriate facilities for the preparation and serving of food. The current water boiler requires replacement to ensure that health and safety standards are not compromised. The cooker and microwave should be kept clean. The replacement of the existing assisted baths should be given priority to ensure that people have the facilities they need. 2 22 Care Homes for Older People Page 25 of 26 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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