CARE HOMES FOR OLDER PEOPLE
Adamscourt Residential Care Home 7 Talbot Avenue Talbot Woods Bournemouth BH3 7HP Lead Inspector
Tracey Cockburn Unannounced 30 June 2005 10:00 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 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. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Adamscourt Residential Care Home Address 7 Talbot Avenue, Talbot Woods, Bournemouth, Dorset, BH3 7HP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01202 529855 clive.burden@talk21.com Mrs S Burden Mrs Eileen Cockwell Care Home only 25 Category(ies) of OP - 25 registration, with number of places Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: That only mobile residents be accommodated on the second floor. Date of last inspection 27 January 2005 Brief Description of the Service: Adamscourt is registerd as a care home for older people it is currently registered to accommodate up to 25. The home is located in the Talbot Woods area of Bournemouth. Accommodation is provided mainly on 2 floors, there is a passenger lift. There are 3 bedrooms on the 2nd floor which are accessed via flight of stairs. 18 of the rooms have en-suite facilities and 4 bedrooms are registered as doubles. The mature garden has some seating for residents. There are two communal lounges and seating in the small conservatory. The dining room is adjacent to the smaller of the two lounges. There is a small area for care parking at the front of the home. The home is situated on a main road into Bournemouth and close to public transport links into the neighbouring town of Poole. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on the 30th June 2005 over 3 hours from mid morning to early afternoon. The purpose of this inspection was to review the requirements and recommendations from the previous inspection. During the inspection care records for 2 new residents were reviewed, staff files for 2 new members of staff were examined as were staff rotas, the premises were also toured and 10 residents and the registered manager and 2 members of staff spoken to briefly. What the service does well:
Pre-admissions assessments are completed on all prospective residents, which means the home will know whether or not their needs can be met before someone moves in. Prospective residents are also given assurance that the home can meet their needs. All prospective residents are given the opportunity to visit the home before they make a decision. One resident said she left the decision to her relative and was very happy. The manager said that prospective residents are encouraged to visit for afternoon tea before making a decision to move in. Each resident has a care plan, which outlines their care needs and how this needs to be provided. The manager has introduced life history questionnaires, which have been sent out to all relatives of residents, this provides information on previous jobs, relationships, likes, dislikes, family relationships and hobbies. This means that the home has a better understanding of their residents previous lives and they understand how this information can impact on the care they receive now. Residents are encouraged to visit family and friends and occasions such as summer fetes are organised for everyone to attend. Residents said they feel respected one said that “staff will spend time talking to you”. Bedrooms are decorated with resident’s own possessions if they wish and are comfortably furnished. The home has a good training programme for staff and is encouraging care staff to pursue relevant training. There is a residents group in the home, which meet monthly and feel that they contribute to the running of the home. The information from this group is used as part of the homes process of ensuring it is running the home in the best interests of its residents. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 5, standard 6 was not inspected as the home is not registered to provide intermediate care. Pre-admission assessments mean that no one moves into the home without their needs being assessed and being reassured that the home can meet those needs. People are able to visit the home before making a decision about whether it is right for them or not. EVIDENCE: The care files for 2 residents demonstrated that they both had pre-admission assessments completed before they moved into the home. The manager explained that prospective residents are able to come to the home for afternoon tea visits before they make a decision about the home. One resident said that she thought she had visited the home with her family before moving in and another residents said that she left the decision to her family. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,10 Individual plans of care detail how a person’s health, personal and social care needs will be met whilst living in the home. This ensures that care staff understand the care they need to provide to each person. The home makes sure residents feel respected and have their privacy. EVIDENCE: Residents have individual plans of care which detail their care needs and specify the action needed to be taken to meet their care needs. 3 files were looked at on the day of the inspection. The care plans seen detailed how care needs would be met and there was evidence of reviews taking place. There was also evidence in the daily records that tasks were being completed according to the care plan. Several residents spoken to say that they felt their privacy is respected. One or two said that some staff are better at ensuring privacy than others but on the whole staff were very good and usually knocked on their door before entering. One person said that care staff were very thoughtful and had contact family after a storm to say their relative was ok, as they knew that family would be worried about her. A member of staff was observed reassuring a resident of where she was, and why she was there in a gentle and respectful manner.
Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13, The lifestyle in the home, meets the expectations of the residents who live there providing a variety of experiences, which meet their social cultural and religious needs and interests. Residents are able to maintain contact with the people they want and need to. EVIDENCE: On the day of the inspection the residents were expecting an entertainer in the afternoon, the staff and residents were also talking about a summer fete, which was organised for a weekend in July. Residents said that there were activities taking place if they wanted to get involved. One resident said that there was not much happening in the home. Another resident said that she went out with her family at the weekends. There is communion in the home for those who wish to participate. The manager of the home has sent life history questionnaire to every resident’s family. This is proving to be quite successful in the information that is being returned is informing the activities and interests of the residents. At the time of the inspection several residents had visitors and some were waiting to be taken out. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection EVIDENCE: Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,24,26 Individual residents have the equipment they need to be independent however the premises lack some aids for resident’s safety. Residents have comfortable rooms with their own possessions, which enable them to settle into a new environment. The home is clean and pleasant giving a good impression to prospective residents. However care should be taken to ensure that all bedrooms are free from unpleasant odours. EVIDENCE: Throughout the home there is evidence of aids and equipment for the residents use from walking aids, the hoists, wheelchairs and bath aids. There is a ramp from the doors of the conservatory however there are no rails at the side of the ramp and one resident was concerned that she would not be able to use the ramp on her own, she said that staff help her but she would like to be able to go out by herself. The registered manager and provider explained their plans for the outside of the home at the front and back. Surfaces are going to
Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 13 be re paved and trees cut back they also plan to add grab rails where necessary. But until these plans are realised this is a potential danger for residents. All rooms are decorated to individual taste and residents said they are able to bring in items of furniture. All room have personal possessions in evidence such as pictures, ornaments and other personal items. The home was clean on the day of the inspection. One room smelt strongly of stale urine and this was discussed with the manager on the day. A rug was removed from the room, cleaned and replaced, at the end of the inspection the room smelt much fresher. The laundry room is small but has an industrial washing machine. All items of clothing for the residents are washed on the premises. One resident was concerned that she has had items of clothing such as underwear goes missing. The manager explained that all clothing has the room number of the individual on the clothing tag. A relative also expressed concern that clothing has gone missing. Sometimes she received clothing that is not her own. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,29 Training and development in the home is encouraged to ensure that residents are in safe hands. Recruitment practice within the home ensures that management are confident that residents are supported and protected by the right calibre of staff. EVIDENCE: At the time of the inspection the registered manager who is an NVQ assessor was in the process of working on some of the care staff’s practice work for their NVQ level 2. There are currently 2 members of staff on the course at the moment. The manager said that there are no members of staff currently employed by the home who require a work permit. The file for one new member of staff was examined and all the appropriate information was available such as two references, proof of identification, CRB check. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 There are systems in place to ensure that the views of residents are sought and acted upon which means that the home is run with their interests in mind. EVIDENCE: The manager said that the outcome of the resident and relatives survey had been analysed and written into a report, the Commission has not yet received a copy. Residents said that they feel they are listened to. There are resident meetings, which discuss issues they feel strongly about. Minutes are taken at the meetings and circulated. The manager is in the process of improving the quality assurance process and has sent a short report based on the information received from the survey in December 2004. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION x x x 2 x 3 x 2 STAFFING Standard No Score 27 x 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x x x x x Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 17 NO 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 Regulation Requirement Timescale for action 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. 3. Refer to Standard 22 26 28 Good Practice Recommendations The premises should be assessed by a qualified person such as an occupational therapist The bedrooms should be free from unpleasant odours. 50 of staff should be trained to NVQ level 2. Adamscourt Residential Care Home D55 S43290 Adamscourt V229101 300605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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