Inspection on 11/12/07 for Athelstan House

This is the latest available inspection report for this service, carried out on 11th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Athelstan House 30/08/05

Athelstan House 21/04/05

Athelstan House 27/10/04

Athelstan House 21/04/04

Athelstan House 21/04/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Poldhu

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Athelstan House Athelstan House Priory Road Bodmin Cornwall PL31 2AE Lead Inspector Mike Dennis Unannounced Inspection 11th December 2007 10:00 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 Athelstan House DS0000008954.V352696.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. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Athelstan House Address Athelstan House Priory Road Bodmin Cornwall PL31 2AE 01208 72713 01208 76497 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) Cornwall Care Ltd Mrs Christine Day Care Home 42 Category(ies) of Dementia - over 65 years of age (8), Learning registration, with number disability over 65 years of age (3), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (8), Old age, not falling within any other category (42), Physical disability (6) Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Room nos. 39 & 40 which are situated on 2nd floor of the home may only be occupied by residents who can manage the stairs and means of escape unaided. Service users to include one named person outside the normal age range of the home for Rehabilitation/Intermediate Care only Service users under the category of PD must be over 50 years of age on admission 25th October 2006 Date of last inspection Brief Description of the Service: Athelstan House is one of 18 care homes registered by Cornwall Care Ltd. Cornwall Care Ltd. are registered in respect of Athelstan House to provide personal care and accommodation for up to 42 older persons, some of whom may also have a mental or physical disability. The accommodation is offered in 38 single rooms and some shared accommodation is available. A passenger lift assists service users moving between the ground and lower ground floors. The two rooms located on the first floor are accessed by stairs. Athelstan House is situated close to local shops, community facilities and public transport links. The home is a large building situated in well maintained grounds with car parking facilities available. In addition to the registered care home, various community services are organised from the home and a day centre accommodating up to 35 older people is provided on the lower ground floor. The fee level at December 2007 ranges from £335 to £425 per week. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 11th.December 2007 over a seven and half hour period. We met with the Registered Manager, and a selection of staff from all departments. Eight residents were spoken to during the course of this inspection. During the course of the day we observed groups of residents engaged in a number of activities. Staff were observed to be tending to residents needs whilst respecting their dignity. Various records, policies and procedures were inspected. We visited all parts of the building, and noted a satisfactory standard of hygiene and maintenance. Residents commented favourably on the overall service received. Positive outcomes in all areas were noted. What the service does well: What has improved since the last inspection? The general appearance of the home has been maintained to a good standard. Maintenance is ongoing and improvements to the décor and furnishings have been made Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 6 Reports from relatives were extremely positive, particularly in respect of the care and attention their loved ones received when nearing the end of their lives. The presentation of food and appearance of the dining room is appealing. Meal times are unhurried. The home continues to present as clean, homely and well maintained. 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. Athelstan House DS0000008954.V352696.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 Athelstan House DS0000008954.V352696.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): 1, 2, 3, 5. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents receive the information they require in order to make an informed choice about residing at Athelstan and their needs are assessed so that they can be assured that the home can provide the care required. EVIDENCE: The Statement of Purpose has been revised to reflect changes in the management of the home. It is also available on audio cassette. The CSCI address as listed on the complaints section requires updating to reflect the address of the Ashburton office. Contracts and/or statements of terms and conditions of the home are in place in respect of each resident. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 9 Managers visit prospective residents and complete a needs assessment. Cornwall Care Ltd uses a standard format for assessment and care planning. When completed in sufficient detail, this record covers the assessment issues specified in the standard and the diverse needs of prospective residents. All the residents’ records case tracked contained needs assessments completed by the home’s managers. The records contained summaries of social work assessments, and joint assessments from local health agencies and Cornwall Department of Adult Social Care. The assessment records for recently admitted residents recorded their assessed needs in detail and included their views and preferences. The home’s assessments state who was present at the assessment. This provides evidence that the prospective resident and their family, or representatives, were involved in the assessment to ensure that their diverse needs were recorded. Relatives felt that the home involved them in the resident’s care arrangements. Residents and relatives informed us that they were given the opportunity to visit the home prior to moving in. This home no longer provides Intermediate Care. Athelstan House DS0000008954.V352696.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, 10. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health, personal and social care needs are set out in individual plans of care which are regularly reviewed and amended. Medication procedures are appropriately followed EVIDENCE: Four Individual Plans of Care were inspected. They were seen to contain full and relevant information, to include Risk Assessments, pertaining to the health, personal and social care needs of that individual. In addition information is gathered regarding the service users past life experiences and interests. This information is used to promote an Active Care programme for that individual. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 11 We spoke to some of the residents who have been at the home for several years. They appreciated the changes that have occurred due to the introduction of dementia care and were very sympathetic. They did however feel that at times their own care was, or at least contact with the staff team, was not as regular as it had once been. This is an area that needs to be kept under review. The “hour glass” project whereby key workers spend quality time with residents can help to ensure that the ‘independent’ residents are given equal attention. The home’s medication policies are adhered to by all staff. The manager and assistant managers are the nominated persons who administer medication. The majority of the drugs are in blister packs. All medication including controlled drugs was recorded correctly as received, administered and disposed. All hand written entries made to the Medication Administration Record must be witnessed by two signatories. Residents told the inspector that they were satisfied with the care they receive and that the staff treat them with dignity and respect their privacy. The policies and procedures of the home indicate that residents and their families are treated with care, sensitivity and respect. Athelstan House DS0000008954.V352696.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): 12, 13,14, 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to follow a lifestyle, which accords as far as possible with their own choices and preferences. The diet provided is varied and nutritious with attention to individual preferences. EVIDENCE: The residents individual care plan has a detailed section regarding their interests and choice, and activities are planned to encompass these interests. The home arranges and facilitates visiting entertainment and in-house activities. Regular outings are arranged. Planned activities are displayed on a notice board. Flexibility is achieved throughout all aspects of daily living. Social Profiling or Active Care is promoted at this home. This in turn allows staff to target individual residents with activities most likely to provide stimulation The above statements were confirmed by residents and staff. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 13 Visitors are made welcome. We observed visitors in the home and the visitors book indicated that relatives and friends frequently visit the home. Contact with the community is maintained in various ways. Residents are supported to venture into the community by way of group outings or as an individual. Various organised groups also visit the home from time to time. The midday meal was observed and appeared appetising. Residents informed us that they enjoyed the food provided. A varied menu is displayed each day giving choice. Mealtimes are unhurried and flexible. Athelstan House DS0000008954.V352696.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, 18. People who use the 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 has a satisfactory complaints procedure that would ensure that complaints are listened to and acted upon. There are arrangements to protect service users from abuse. EVIDENCE: A comprehensive complaints policy and procedure is kept within the home. This procedure includes timescales and who will deal with the complaint. The home also keeps a complaints log for ease of reference. Residents indicated that they were aware of the procedures. The home has a comprehensive policy and procedure in place to protect residents from abuse. Policies are also available in regard to physical and / or verbal aggression from residents. Staff are made aware of these procedures during the induction period. The registered manager is also aware of the local social services procedure within “No Secrets” to investigate any complaints regarding the suspected abuse of any service user. CRB and POVA checks are undertaken, with Cornwall Care being the umbrella body to obtain these checks. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 15 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): 19 to 26 People who use the 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 generally well maintained and provides a safe environment. The premises are clean and hygienic providing a pleasant environment and reducing risks to residents. EVIDENCE: The home provides a safe and well-maintained environment for the residents. The registered manager discusses refurbishment and development issues with the company at the annual finance meeting. This results in a maintenance and improvement plan being implemented. The home employs a general assistant who deals with minor defects and maintains general standards within the home. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 16 It was noted that, on inspection of the premises, all was found to be clean and tidy. Equipment was working correctly and in order. Policies and procedures for the control of infection were available and in order. Specialist equipment is available for those who require it. Communal and personal living areas are well decorated and suit residents tastes. Individual bedrooms are personalised according to the occupants wishes. Residents and relatives commented favourably on the décor and facilities within the home. Fire prevention equipment is in place and evidence was seen to indicate all has been appropriately serviced. The kitchen and laundry areas are well maintained. Since the last inspection several areas of the home have been decorated. New carpets have also been laid and general maintenance continues. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 17 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, 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures support and protect the service users. Staff are trained and competent to meet the needs of residents. The staffing levels are generally satisfactory. EVIDENCE: The senior staff team consists of Registered Manager and 4 assistant managers. A restructuring program is planned which will result in the home having a manager, deputy manager and a number of care coordinators. At least 85 of the care staff hold an NVQ qualification. The administrator, catering and domestic staff are also suitably qualified or experienced. The staff team shows a positive regard for residents and appears very organised. Additional staff are on duty at peak times of activity during the day. In addition to the duty managers, the care staff, domestics, catering staff, laundry staff, and general assistants are on duty. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 18 Staff recruitment is conducted in line with the home’s policies and procedures. Evidence obtained from staff files indicates that references, CRB and POVA checks are taken up prior to interview. All staff undertake Induction Training. . NVQ training is encouraged as demonstrated by the majority of staff having obtained awards at various levels. Individual training profiles for staff are kept up to date with accurate information of progress made. Staff are receiving supervision and an appraisal system is in place. There has been some staff changes of late. Management are aware that in a few cases supervision has fallen behind and they are taking steps to bring this area of work up to date. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 19 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, 32, 33, 35, 36, 37, 38 People who use the 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 provider has appointed an experienced and qualified manager who maintains the care delivery to meet the homes stated purpose and objectives. The health and safety of residents and staff is promoted. EVIDENCE: The manager is qualified and experienced. She has spent 34 years in the caring profession, 20 of these as an assistant manager at Athelstan. Her qualifications include, Registered nurse, Higher Diploma in Management of Care Services, Dementia Care certificates levels 1, 2, and 3. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 20 Internal audits of quality assurance are undertaken at 12 monthly intervals. A survey taken from a cross section of residents and carers/relatives plus opinion from District Nurses provides the information. An annual development plan for the home is drawn up between the company and the registered manager and priorities are agreed. The health, safety and welfare of service users and staff is promoted and protected. The registered manager has a good awareness of the legislation regarding health and safety. Statutory checks are made by appropriate agencies as evidenced from various service contract documents. Staff are trained in health and safety, manual handling, fire safety, first aid, food hygiene and infection control Fire records are up to date. Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 21 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 3 3 3 X 3 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 3 Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13 Requirement Hand written entries to MAR sheets to be witnessed by two signatures Timescale for action 01/02/08 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. 2 Refer to Standard OP36 OP1 Good Practice Recommendations Continue to bring staff supervision up to date. The Statement of Purpose should detail the CSCI Ashburton address Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Athelstan House DS0000008954.V352696.R01.S.doc Version 5.2 Page 24 - 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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