CARE HOMES FOR OLDER PEOPLE
Adamscourt Residential Care Home 7 Talbot Avenue Talbot Woods Bournemouth Dorset BH3 7HP Lead Inspector
Tracey Cockburn Unannounced Inspection 12:35 6 December 2005
th 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 DS0000043290.V270564.R01.S.doc Version 5.0 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. DS0000043290.V270564.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Adamscourt Residential Care Home Address 7 Talbot Avenue Talbot Woods Bournemouth Dorset BH3 7HP 01202 529855 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) eileencockwell@ntlworld.co.uk Mrs S Burden Mrs Eileen Cockwell Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places DS0000043290.V270564.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. That only mobile residents be accommodated on the second floor. Date of last inspection 30th June 2005 Brief Description of the Service: Adamscourt is registered as a care home for older people and 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 a 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 car 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. DS0000043290.V270564.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 2.5 hours in the afternoon. There were 25 residents accommodated at the time of the inspection. The purpose of this inspection was to review the requirements and recommendations of the previous inspection. Care files, rosters, and policies were examined. Three care workers and the cook were spoken to and 14 residents seen during the course of the inspection. A tour of the premises was also undertaken. What the service does well: What has improved since the last inspection? What they could do better:
At the conclusion of this inspection there were 3 recommendations. To ensure that all residents are able to make decisions about their lives information should be recorded appropriately to ensure that all staff are aware of the action they should take. The home should arrange for the premises to be assessed by a suitably qualified person such as an occupational therapist to
DS0000043290.V270564.R01.S.doc Version 5.0 Page 6 ensure that the home is providing all the appropriate environmental adaptations to meet residents’ needs. The home should continue to work towards 50 of their workforce achieving NVQ level 2 or above. 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. DS0000043290.V270564.R01.S.doc Version 5.0 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 DS0000043290.V270564.R01.S.doc Version 5.0 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 the following standard(s): These standards were not assessed at this inspection. EVIDENCE: DS0000043290.V270564.R01.S.doc Version 5.0 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 the following standard(s): 8&9 Good communication systems ensure that when health care needs are identified they are acted up quickly, ensuring that appropriate professionals meet residents’ health needs. The home has policies and procedures in place to ensure that residents are protected. EVIDENCE: During the inspection a resident was taken ill during lunch and the staff responded swiftly and contacted the health care professionals. Care files seen detailed the care needs of the residents, including health needs such as oral hygiene. There was also detailed information covering the visits by GP’s and District Nurses. There was some inconsistency in one file, in the details such as information not being transferred from the daily log to the residents file. All staff have training on how to handle medication safely, and the manager said that she would not allow any staff to dispense medicine until they had successfully completed the course. At the time of the inspection no resident managed their own medication. One resident said she preferred the staff to do it. The home uses the Boots monitored dosage system.
DS0000043290.V270564.R01.S.doc Version 5.0 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 the following standard(s): 14 & 15 Residents are able to have choice and control over their lives, through maintaining their preferred routines and interests. Residents receive an appealing diet, which is mindful of their nutritional needs and provided in familiar surroundings. EVIDENCE: Residents spoken to said that they are able to maintain the routines that they prefer such as when they go to bed and when they get up. This information is recorded in their personal file. They also said that they are able to maintain control of their finances if they wish, many said that they have relinquished control to their families or a solicitor. One resident said that they could manage their own medication but choose not too preferring the staff to manage it for them. Many of the residents spoken to said that they were able to bring in their own possessions including furniture into the home. During the inspection, all the residents spoken to said that the food in the home was excellent. No one had anything but praise for the quality of the food served. The cook explained that menus are made up for two weeks. The cook checks with residents on a daily basis while serving morning coffee to see if they enjoyed the previous days meal. She makes changes to the menu regularly. The main meal is served in the middle of the day. Hot and cold
DS0000043290.V270564.R01.S.doc Version 5.0 Page 11 drinks are on offer whenever residents want something to drink. Sherry is also served on special occasions. The menu was not on display, however the manager explained that staff will take the menu round the home to explain to residents what the choices is for the day. One resident said that if she does not like what is on offer she can have something different. The cook said that she has a very good idea of what some people will or will not eat. The inspection took place at the start of lunch and residents were seen to be leaving at different times as they finished their meal. Some residents were eating in their rooms. The cook was also washing up the lunch dishes. The home has a dishwasher but it was not being used on the day of the inspection. There was no sign on the dishwasher to say it was broken. DS0000043290.V270564.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 16,18 The home’s complaints policy should give residents and their relatives confidence that their complaints will be taken seriously and action taken. The home has policies, procedures and training for staff, which should ensure that residents are protected from abuse. EVIDENCE: There have been no complaints to the home or the commission since the last inspection. The home has a straightforward complaints procedure in place. The manager explained that all the staff receive adult protection training in house. The manager who is a qualified trainer provides this. There have been no allegations of abuse. The home has a policy and procedure for adult protection based on No Secrets. The manager said that the home does not manage any resident’s finances; each resident has a petty cash for personal items, which is stored in the home’s safe. All receipts are kept. DS0000043290.V270564.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 19,22,26 The home is safe and there is evidence that the environment is maintained to a good standard. Specialist equipment is in place for residents who require it, maximising their independence. Unpleasant odours have been eliminated from residents rooms giving a better imrpession to visitors. EVIDENCE: The home will be having some work done to the outside of the building, the garden will be landscaped and railing and a gate are going to be installed to the rear of the home. This work is expected to start in the early part of the New Year. The grounds are tidy; the paths around the home were covered in fallen leaves, on the day of the insepction, which could be slippy in wet weather. The home employs a gardener to ensure that the paths are kept clear and the owner and manager explained that he visits regularly to remove the leaves from the path.
DS0000043290.V270564.R01.S.doc Version 5.0 Page 14 The building complies with the requirements of the fire service and environmental health. Since the last inspection the management have installed railings down both sides of the ramp leading from the sun lounge. Residents have access to all parts of the communal areas of the home. There is evidence of grab rails and other aids including hoists. There are also assisted bath seats and raised toilet seats. The home has a call system, which is accessible. One resident said that there had been a problem with his call bell as it was ringing on the wrong number on the panel, which had caused some confusion for staff, but he was happy it had been sorted out and all staff knew what to do until it had been fixed. The home has not yet had an assessment by a qualified person such as an occupational therapist; however all residents who have been identified as needing assistance have had individual assessments. At the previous inspection one of the bedrooms had a very strong unpleasant odour. This has been rectified and the room has no odour. The manager explained that she has sourced a cleaning product which has eliminated the smell and that care workers are very vigilant and dedicated and work hard to ensure that the home smells pleasant. DS0000043290.V270564.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 The home provides sufficient staff to meet residents needs. Ensuring that there is the right number of staff with the skills needed to provide a stimulating and caring environment. Good induction and training provide care staff with knowledge and skills to care for residents safely however not all staff have been trained to National Vocational Qualification level 2. The home has a good training programme encouraging care staff to be responsible for developing their skills and enabling them to be competent at their jobs. EVIDENCE: At the time of the inspection there were 3 staff on duty and the manager, as well as the cook. During the inspection one member of staff accompanied a resident to hospital. Another member of staff was asked to stay on. At the time of the inspection there were the same number of staff on duty as the roster suggested there should be. The staff on in the afternoon are responsible for preparing the evening meal. The home might want to consider an extra member of staff in the afternoons to prepare the supper. The manager said that several members of staff are currently in the process of completing their NVQ 2. Two members of staff have recently completed their awards. The maanger has also employed 2 staff from overseas who have a
DS0000043290.V270564.R01.S.doc Version 5.0 Page 16 professional qualification from their country of origin, the manager said she will establish whether or not their qualification is equivelent to NVQ level 2. The home does not have 50 of their staff with this qualification. The home provides in house training and induction training follows the induction standards. DS0000043290.V270564.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35,38 The manager of the home understands the needs of the people living in the home and works hard to ensure that the home is well run. The home’s policy means that service users are encouraged to seek legal support to manage their finances thus ensuring that residents’ financial interests are safeguarded. Polices and practices of the home promote the health, welfare and safety of the residents and staff. This means that the staff have the information and guidance they need to provide a good service to residents. EVIDENCE: The manager is currently undertaking the Registered Managers Award. The registered manager has been in post for some time now and has introduced changes and improvements including regular staff meetings. The manager has clear lines of accountability with the registered provider. The manager said
DS0000043290.V270564.R01.S.doc Version 5.0 Page 18 that she has worked night shifts and does spot checks on the staff. She said that she has found this very helpful and gives her an overview of the home. The registered manager does not get involved in the finances of the residents. The manager is not the appointee for any resident. All staff have received training in moving and handling, first aid, food hygiene and infection control. The registered manager maintains a record of all accidents and incidents and reports them to the commission. Safety notices are posted in the kitchen and laundry room. DS0000043290.V270564.R01.S.doc Version 5.0 Page 19 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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 2 x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 3 DS0000043290.V270564.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No 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. 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 OP8 OP22 OP28 Good Practice Recommendations To ensure that residents health needs are monitored and staff understand what to do information should be recorded appropriately. The premises should be assessed by a qualified person such as an occupational therapist 50 of staff should be trained to NVQ level 2. DS0000043290.V270564.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Poole Office 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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