Inspection on 26/08/09 for Aynsley Nursing Home

This is the latest available inspection report for this service, carried out on 26th August 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.

Other inspections for this house

Aynsley Nursing Home 05/06/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Aynsley Nursing Home 60-62 Marlowe Road Wallasey Liverpool CH44 3DQ Lead Inspector Julie Garrity Key Unannounced Inspection 26th August 2009 09:00 DS0000069375.V377394.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aynsley Nursing Home Address 60-62 Marlowe Road Wallasey Liverpool CH44 3DQ 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) 0151 6384391 0151 6384402 S.J. Care Homes (Wallasey) Limited Julie Catherine Rossiter Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 28 Date of last inspection 13th August 2008 Brief Description of the Service: Aynsley Care Home with Nursing is a two storey converted house situated in the residential area of Wallasey. It is registered to provide nursing care and support for up to 28 older people. There are three main lounges and a conservatory attached to the dining room. Bedroom accommodation is provided in both single and shared rooms, some of the bedrooms have en-suite facilities. There is a passenger lift that services all the floors and assisted bathing facilities and shower facilities available. The front garden area is paved with shrub borders and a seating area for people who live in the home to use. There is also a secluded garden to the rear of the home. Parking is available at the front of the building. The home is close to the town centre, which has shops and other community amenities. Public transportation links such as the bus service are close to the home, rail links are a 10-minute drive away. The home is not far from the Wallasey tunnel and is easily accessed from Liverpool. Main motorway links to the rest of the Wirral area are a 5-minute drive away. A copy of information about the service is available in the managers office. Fees for the home are £567.53 (this includes the component paid for nursing care. Fees cover all spending of people who live in the home including hairdressing and toiletries as examples. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. The visit was carried out over a period of one day, starting at 11:15 and left at 20.30. The inspector spoke with twelve people who live in the home, four relatives, six staff and the manager. We completed the inspection by a visit to Aynsley Nursing Home, a review took place of many of the records available in the home and our offices. These included individuals care plans, assessments, accident records, staff rota, staff files, maintenance records, menus, staff rota, questionnaires, staff training, medications, information sent to us by Aynsley Nursing Home and a self-audit completed by the home known as an AQAA. This visit included discussions with people who live in the home, staff and management. . All of the Key standards were covered in this visit, these are detailed in the report, additional standards were identified before and during the visit these were also reviewed and detailed in the report. Feedback was given to the manager during and at the end of the inspection. The arrangements for equality and diversity were discussed during the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs, promote independence and support to make informed decisions in line with individual choices. What the service does well: The manager has been in post for several years and is able to support a stable and caring staff. The people living in the home, their relatives and staff have confidence in her ability to support them and manage the home appropriately. Relatives spoken with told us my mum is very well looked after her. I can go home knowing she is safe and happy. People living in the home told us, Im very happy, Its a really nice place to live and the staff here are faultless. I could not ask for a nicer place to be. There is a variety of communal areas such as a dining room and alternative sitting rooms. People are supported to spend their time wherever they like and to participate in the activities available, as they would wish. The decoration in the home is domestic in nature and makes it feel welcoming and homely. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 6 Individuals living in the home are supported to bring in their favourite ornaments, furniture and photographs to decorate their bedrooms. What has improved since the last inspection? What they could do better: There are a number of areas of record keeping that are in need of further development. This includes making sure all assessments have sufficient information recorded to support the staff to decide if they can meet an individuals needs. Risk assessments for people managing any area of their medications need to be developed and regularly reviewed to maintain people who live in the homes safety. Policies and procedures such as the safeguarding of adults need to be developed and available to staff working in the service. There are a number of areas in the building that are in need of redecoration or replacing. This includes wallpaper, damaged wood work, carpeting and fire doors that do not work correctly. These need to be reviewed and corrected in order to maintain the safety of people living in the service. Staff training in particular moving and handling and fire training needs to kept up to date at all times and records maintained that staff have completed the training. As part of an on-going development of quality the provider needs to visit the service monthly. A record of this visit and their findings, including discussions with people living in the service and staff made with a copy given to the manager. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 7 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. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 8 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 Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were: 1, 3, 4 and 5 standard 6 is not applicable People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the service were confident that they had been given the opportunity to decide if the service could meet their needs. EVIDENCE: The AQAA from the service told us that we are always happy to show people around the home. No appointment is needed. We spoke to people living in the service who told us my family came to look and liked it and I did not come too look around but my daughter did. She told me that she thought I would like the home and the staff were lovely. We looked at four assessments of people living in the home. All but one had had an assessment done that had the potential to look at their needs. Of the assessments viewed one had not been completed contained very little Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 10 information about the person and did not give the staff enough information to decide if they could meet the persons needs. The other three assessments were available but had some missing details on them all. They were not always signed and dated by the person doing the assessment which meant that it was not possible to check that the person doing the assessment was trained to do so or that the relevant areas of the assessment had been done before the person moved into Aynsley Nursing Home. All assessments need to be completed by a person competent to do so, before the person moves into the home in enough detail to decide in the service can meet the persons needs. Information in the home known as the statement of purpose (what services Aynsley will provide) and a service users guide (how they will provide these services) were looked at. The statement of purpose was out of date and did not contain all the relevant information. The service users guide was also in need of updating. There was one copy of this information available in the service in the main office. The manager told us that copies are given to people when they come to look around, this is mostly relatives and a copy is not given to people when they move in. The manager also told us that they can do this in large print for people who have sight impairment. People living in the home need to have information about the service in formats to suit their needs. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were: 7, 8, 9 and 10. People using 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. Medical care needs were met, with the service accessing individuals doctors as needed. Individuals received their medications as prescribed. There were some areas of medication management that need to be improved in order to fully maintain the safety of people living in the home. EVIDENCE: Medications were reviewed. There are areas of good practice that includes photographs available of individuals, checking on painkillers. An check on medications showed that in general people received their medications as prescribed and in a manner that met their individual needs. There are other areas that need to be developed. When we looked at the medication records we noted that thick and easy (used to thicken fluids) was not written on the medication records. All prescribed medications need to recorded on the records in order to make sure that they are given correctly. Additionally risk Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 12 assessments were not available for people managing all or some area of their medications. It is good practice that the service supports people to have an input into their own medications. The safety needs of the person and the other people living in the home need to be looked at in order to make sure that potential risks are determined and minimised. We looked at how the service recognised and planned to meet peoples individual needs. We noted that care plans were available for each person in the home. When we looked at detail at the care plans we noticed that these were not always detailed enough to provide staff with the correct instructions that they need to deliver the correct support. Care staff spoken with told us that they do not read care plans and have no input into how they are written. People living in the home also told us that they had not read their care plans. General comments from people living in the home were positive in nature and included the staff here are very good. They dont all do things the same way and sometimes I have to explain again but they really try very hard to make me comfortable and happy. I am happy living here. Staff have a lovely attitude nothing is too much and they always want to help. We looked at how the service managed peoples wounds and noted that each person now had a care plan that detailed where the wound was and what treatment was in place. The service did not have clear monitoring in place such as wound mapping or photographs and records did not state the grade of wound which is used to help determine if the treatment in place is helping to heal any wounds. People living in the service also told us If I need a doctor they make sure that this happens. I only have to look a bit off colour and the next thing is the doctor is here. The AQAA for the service told us that, we always refer to chiropodist and physiotherapist. We looked at how the service contacted external professionals such as doctors. We noticed that when an external professional visits the service staff record what treatment they have recommended and include this in care plans. This is good practice and makes sure that a written record is available for staff to follow in order to maintain people who live in the services, health and welfare needs. Staff observed during the day were respectful and very kind to the people who live in the. The individuals spoken with were very positive about the staff and the care that they received. One resident said “staff are wonderful”. In general there is a pleasant relaxed atmosphere and many of the people living in the home were comfortable with the staff and able to respond very well to light hearted banter. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were: 12, 13, 14 and 15. People using 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. A range of activities is available within the home and community mean the individuals do have opportunities to participate in stimulating and motivating activities EVIDENCE: The AQAA for the service told, Aynsley nursing home is a happy very happy home. We group the client users into what they want to do and regular updates are done by the activities co-ordinator. We spoke to people living in the home who told us there are things to do if you want to. We have been on trips out and I like going on them. I like living here I do what I want when I want to. Relatives spoken with told us there are different things to do. Some off them my mum has interest in but they are available. We looked at records in each care plan, this showed what activities each individual had taken part in. There was no particular plan in place that detailed individual’s likes and dislikes. There was a social assessment available in Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 14 peoples care records but of those views none had been completed or were up to date. We discussed with five individuals if they were aware of an activities programme all said that they had not seen a programme or a newsletter but were aware that there were activities available. A notice board with these details is available but is not in an area that is accessed regularly by people living in the home. Records of “residents” meetings were not available. The manager told us they did hold them but not that regularly. Staff spoken with said that there has not been any meetings staff or people living in the home for several months. There was no written evidence that individuals contributed to the activity programme. Throughout the day of this visit individuals were occupying themselves by reading, watching TV or knitting. In the afternoon there was a piano recital that several of the people living in the home attended and told that they enjoyed it. Menus have been reviewed and show and alternative for meals. They did not show alternatives for specialised diets. The choices available do not always provide a full choice for some specialised diets in particular those who need a semi-solid or liquidised diet. Staff were keen to say that if someone does not like something they can be given a choice that is not on the menu/ People who live in the home told us that staff will make something else such as sandwiches if theres nothing you fancy. Care staff and the kitchen assistant said that someone goes around the day before and asks people what they want. Records reflected that this was correct and also showed different choices given out. There is no record of individual likes and dislikes regarding food so it is not possible to determine what input individuals have had into determine the meals available. The cook and manager told us they decide on the menu based on what they think people like to eat. A copy of the menu is available for the people who live in the home. The mealtime observed was relaxed, people were assisted to eat as needed. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were: 16 and 18. People using 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. People living in the service and their relatives are confident that they can raise any concerns and these will be dealt with. EVIDENCE: A complaints procedure was available in the home in the main office. All people spoken with said that they felt safe, listened to, and able to speak to the staff and manager if they were not happy about anything to do with their care. Relatives visiting the home told us that they had every confidence that they could raise any concern and the manager would be approachable and happy to rectify any issues. The AQAA for the service told us that a copy of the complaints procedure is available in full view when relatives enter the home. Individuals spoken with said, “If I have a problem it is dealt with” and “good staff sort anything”. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 16 Staff spoken with were able to give examples of complaints they had received and how they had been dealt with. All thought the complaints policy was in the office but they had not looked at it for some time. We looked at the surveys sent to relatives last year and some recently returned ones for this year from Aynsley nursing home. Both sets of surveys raised some minor concerns. The service had not recognised these concerns as a potential complaint and had not dealt with them as a complaint. None of the relatives who took part in the survey had been contacted to discuss their concerns further. The manager told us that in hindsight these minor issues should have been dealt with as concerns and a discuss held with the person who mentioned them. The service did not have safeguarding adults policy available. The manager was in the process of updating all policies and had recently paid a substantial amount of money for new policies. She had asked for a policy regarding the safeguarding of adults but this had not been received. The policy from social services regarding how they deal with safeguarding referrals was available. Without their own policy staff in the home will not know how concerns regarding the protection of adults need to be dealt with. Records showed that safeguarding adults training had been given to the staff. Four staff spoken with said that they had training. Staff spoken with had a basic understanding of the action to be taken if an allegation was made but there were some gaps in their knowledge of this subject. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were: 19, 21, 23, 24, 25 and 26. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Aynsley was presented as a homely environment decorated in a style in keeping with what individuals would have in their own home. Several areas were in need of redecoration and maintenance in order to make sure that people living in Aynsleys nursing home safety is maintained. EVIDENCE: We looked around the service and noticed that the service has recently refurbished the kitchen. Kitchen staff told us that they were very happy with this as there was plenty of workspace. There are also plans in place to replace the cooker in the near future. Two shower rooms have also been Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 18 refurbished and provide a clean, safe area to help people maintain their hygiene needs. The service is general decorated in the same manner as some one might have in their own home. There were a number of maintenance areas noticed. These included wallpaper peeling on some walls, damage to wood work, main corridors carpets wearing thin and needing to be taped. Carpets were also starting to show extensive staining. We also noticed that furniture throughout the service was starting to show signs of wear and tear. We checked the fire doors and noticed that a significant number were not closing properly, these were in bedrooms and in the main corridors. Fire doors need to close correctly in order to maintain the safety of people living in the service in the event of a fire. Staff told us that they had received training in infection control. Gloves and plastic aprons were available in the service and were seen to be used by the staff. The service had not planned for reducing the potential risk of swine flu which is currently rated as a world wide pandemic. There was no policy in place for staff to report symptoms either theirs or people who live in the home. The service had also not made arrangements for people to wash their hands on entry into the service or to refrain from visiting if they suspected they had symptoms of swine flu. The manager was aware that this needed to be in place and was planning to put relevant actions in place over the next few weeks. We looked at how the environment was maintained. The handyman regularly checks a number of risk areas such as fire alarms and emergency lighting. The call system was checked on a yearly basis and this is not enough to make sure that people living in the home can summon help if they need it. The service has a dining/ conservatory and three lounges, which helps people decide where they want to spend their time. All bedrooms seen had some personal items in that made it a more welcoming space. People living in the home told us that the service had encourage them to bring in their own items of furniture and ornaments to make the bedrooms feel like theirs. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were: 27, 28, 29 and 30. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff training is out of date for some staff and training specific to the needs of people living in the service is not always available. Both the people living in the service and the staff felt that there was enough staff to meet their needs. EVIDENCE: We looked at four staff files and noted that all staff had had proper checks in place before they started working in the home. This included references and a police check. This helps the home make sure that staff are suitable to work in the home. Induction records were available in some of the files seen. These were very brief and did not cover the needs of individuals living in the service. The manager told us that she intends to put into place a full induction that covers training and orientation to the service and that provides staff with good knowledge. Training records were unclear staff training in moving and handling for six people was out of date. The manager told us that the training had cancelled at the last minute and they rescheduled her to come three months later. The service did not risk assess the lack of this training or action another trainer staff without of date training continued to move and handle people in the Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 20 service. The records for fire training were unclear and it was not possible to determine what staff had received training in fire safety. One member of staff has been designated the fire marshal, training to support them to fulfil this role has not been put in place. Training for assessed needs of people living in the home such as epilepsy, diabetes, development of pressure ulcers, mental health needs as examples is not in place. Staff spoken with detailed that they had received training in health and safety and the prevention of abuse. Two people living in the home told us, “the staff are lovely, really nice and caring cant fault them”, “nothing is too much for the staff” and “I really like the staff” Staff said that in their opinion at the moment there was enough. Although three of the staff (care) spoken with two said that they thought more time with people living in the home was needed. The homes own surveys also included comments from relatives who felt that more staff were needed to spend more time with the people living in the home. People living in the home said that they rarely had to wait for staff and felt that staff respond well to their needs. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed were: 31, 32, 33, 35, 36 and 38. People using 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 management has increased its ability to provide a quality service and regular supervision for the majority of staff is now in place to help them develop their skills. EVIDENCE: The manager is registered with us to be the manager of Aynsley nursing home. She has many years of nursing and management experience. Both individuals living in the home and staff and staff were complimentary about the manager and the rest of the senior management team. Staff spoken with thought that the manager and deputy were “always happy to help. People Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 22 living in the home and their relatives spoken with said “all the staff are great, (the manager) is lovely as are they all. Nothing is too much they are always happy to help. The service checks on a number of areas to recognise and improve quality. These include checking on medications and questionnaires to relatives. Questionnaires to relatives in the home were available. These had been looked at last year and their results made available in the main foyer of the service. The majority of comments were positive and showed that relatives were happy with the majority of the service supplied by the service. Questionnaires were not available from people who live in the service or staff. People living in the home are included in the management of it in an informal way. Examples include, they are asked what meals they would like from the menu, supported to personalise their bedrooms and have a variety of different spaces within the service offering them a choice in which to spend their time. Staff told us that they have not had staff meetings for some considerable time and there were no minutes available. The manager has started supervision for the care staff who are now having formal supervision three monthly this has not been put into place for nursing staff who also need regular supervision. Supervision is used to provide staff with support, guidance and the opportunity to develop their skills. As part of their role the provider of the service needs to visit the service monthly, talk to people who live in the home and staff, check on quality and provide the manager with a written report. The manager says that the owner does visit regularly but there are no written reports available for review, A number of risk assessments are in place such as falls, moving and handling and risk of developing pressure ulcers. Falls risk assessments are available and do identify in some instances high risk of falls. The service also has its own fire risk assessment that is done by an external company. This is not shared with staff and people living in the home and as such they are not aware of the guidelines shown in the assessment. The home does not have legal responsibility for money belonging to the individuals, they hold small amounts left by relatives for the people who live in the home. The service covers the majority of the costs for people who live in the service such as hairdressing and chiropody people living in the service as such large amounts of additional funds are not needed. Records regarding these funds are held by the home on behalf of the individual and were clear and accurate. Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 23 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 2 X 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X 3 3 2 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 2 Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 24 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 OP3 Regulation 14 Requirement Assessments need to be completed for all people prior to moving into the service. In order to make sure that the service can meet peoples individual needs. The environment needs to be reviewed and any areas such as carpets and fire doors that are detrimental to the health and welfare of people living in the service corrected. Consultation needs to be made with the relevant organisations as needed such as the fire officer for the Wirral. The provide needs to undertake monthly visits to the service speaking to people who live in the home and their families. A written record needs to be given to the manager as part of the development of quality in the service. Risk assessments need to be in place that recognise and reduce risks. This is particularly relevant for people managing any components of their own DS0000069375.V377394.R01.S.doc Timescale for action 09/10/09 2. OP19 23 09/10/09 3. OP33 26 09/10/09 4. OP38 13 21/10/09 Aynsley Nursing Home Version 5.2 Page 25 medications. This needs to be done in order to maintain the safety of people living in the service RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations Information in the home such as , care plans, activities and menus should be written in formats that are easily accessible by the residents and relevant stakeholders. A service users guide and statement of purpose need to be developed that includes all the areas as detailed in the Care homes regulations 2001. Staff training needs to be monitored in order to make sure that staff training is not allowed to go out of date. Where training is rescheduled arrangements need to be made to maintain the safety of staff and people living in the service. The service needs to make sure that they regularly check the environment including fire doors and call systems in order to maintain the safety of people living in the service. 2. OP27 3. OP19 Aynsley Nursing Home DS0000069375.V377394.R01.S.doc Version 5.2 Page 26 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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