Inspection on 13/06/07 for Adderley Care Home

This inspection was carried out on 13th June 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

Adderley Care Home 01/07/09

Adderley Care Home 06/04/06

Adderley Care Home 10/11/05

Adderley Care Home 09/08/05

Adderley Care Home 02/02/05

Adderley Care Home 10/08/04

Adderley Care Home 29/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Adderley Care Home Adderley House 23 London Road Long Sutton Lincs PE12 9EA Lead Inspector Tobias Payne Unannounced Inspection 13th June 2007 08:40 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 Adderley Care Home DS0000002653.V338561.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. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Adderley Care Home Address Adderley House 23 London Road Long Sutton Lincs PE12 9EA 01406 364309 01406 364938 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) Adderley House Ltd Joan Auton Care Home 46 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (27), Old age, not falling within any other of places category (17) Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Adderley Care Home is registered to provide personal care with nursing to male and female service users who fall within the following categories: Old age, not falling within any other category (OP) 17 No one falling within the category OP should be admitted to Adderley Care Home when there are already 17 persons falling in this category accommodated in the home. Dementia over the age of 65 years (DE(E) 27 No one falling within the category DE(E) should be admitted to Adderley Care Home when they are already 27 persons falling within this home. Date of last inspection 6th April 2006 Brief Description of the Service: Adderley Care Home provides nursing and personal care for up to 46 people. There are 17 places for older people over 65 years of age, 27 for people over the age of 65 years who have dementia and 2 places for people under the age of 65 years who have a dementia. On the day of the inspection there were 18 people receiving personal care and 27 nursing. There is a dedicated self contained unit in the home specifically for people who have a dementia. The home is situated in the small market town of Long Sutton and is part of a complex, which includes a separately registered home providing personal care with some self contained flats in the same grounds. The home is close to shops, banks, post office and other facilities. Accommodation is purpose built with single and double bedrooms on the ground and first floors. There are 32 single bedrooms (5 with en-suite) and 7 double bedrooms. The first floor is served by stairs and a shaft lift. There are accessible gardens and car parking is available at the front of the home. The philosophy of the home includes encouraging people to exercise Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 5 their rights to the full, to treat each person as an individual and to respect privacy at all times with the aim to create a warm, caring and friendly atmosphere. The fees at the inspection visit on the 13/6/2007 ranged from £394 to £566 each week. Extras are for hairdressing which range from £4.50 to £5.50, chiropody £8, toiletries, personal newspapers and magazines. Information about the home can be obtained from the manager of the home. The statement of purpose, service user’s guide, most recent inspection report and leaflets can be found in display shelving in the entrance to the home. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.30 am. It was undertaken using a review of all the information available to the inspector about Adderley Nursing Home. We spoke with 8 residents, 5 staff and manager. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Adderley Care Home DS0000002653.V338561.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 Adderley Care Home DS0000002653.V338561.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): Standards 1, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was information available to enable residents to make a choice as to whether or not to enter the home. People received an assessment, which resulted in their needs being met. EVIDENCE: The home had a statement of purpose and service user’s guide. Both documents were up to date and included details about the increased number of beds. A copy was given to each resident when coming into the home. There was a detailed admission procedure, which described the needs of residents coming into the home. All residents were assessed before entering the home and written confirmation was sent to them that the home was able to meet their needs. The home did not provide intermediate care. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and welfare needs of people living in the home are fully met. Medication is safely administered. Residents are cared for in a manner, which promotes their privacy, dignity and respect. EVIDENCE: Each person had a care plan outlining their needs and support required. This included assessment details, care needs, medication, social activity plan, care plan with assessment/need, instructions/action and evaluation/outcome together with review date, inventory of clothing, risk assessment including agreement to the use of bed rails, likes and dislikes and daily report. There was also a contract but it referred to outdated legislation and old registration authorities. Records were well maintained and up to date and showed that wherever possible they were written with the involvement/agreement of the resident/family. Medication was administered by nurses who had been assessed as competent to do so by the manager. A medication round was observed and it was done in a professional manner. There were no concerns. Throughout the inspection Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 10 staff went about their work in a calm, relaxed, friendly and sensitive manner and all residents we spoke with commented about the “kindness of the staff”. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 11 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): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities were varied and provide daily stimulation and interest for people living in the home. Visitors were made to feel welcome. Meals provided were nutritious and varied. EVIDENCE: A member of staff provided activities Monday to Friday. There was a written activities programme which was outlined in the service user’s guide and included, movement to music, Bingo, discussions/quizzes, crafts, games, reminiscence, beauty therapy and sing a longs. There were also trips out in the home’s mini-bus. There was a white board with details of trips during June 2007 to a Parrot sanctuary, Hunstanton and the Bay Tree Garden Centre. The home also had a cat and dog, which gave pleasure to the residents. There was open visiting except during meal times. There was also a visiting hairdresser and details of religious services. The activities person wanted to further develop activities for the people who had communication problems as well as dementia and was to discuss this further with the manager. Comments were made in the home’s survey by residents about the lack of access to the gardens and this was to be addressed once the extension/building work had been completed. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 12 The last Environmental Heath Officer’s inspection by South Holland District Council was on the 30/8/2006 and as a result, the home was awarded a 2 Tulips (good) award for its catering service. The award was displayed at the entrance to the home. There was a choice of menu. The kitchen was clean, tidy, well organised and well stocked with meat, fresh fruit and vegetables. There were clear up to date records of menus, food temperatures and cleaning rotas. However there were no records being kept of food provided and this was discussed with the deputy manager who agreed to address this. Breakfast and Lunch was observed in the 2 dining rooms. No resident had any complaints about the food. It was well served and residents were not hurried. Comments were, “I like to have a grapefruit, toast and coffee at breakfast and that is what I get”. The menu was displayed on the wall. Staff attended to residents who needed assistance. This was done in a discreet and sensitive manner and staff sat by the side of the resident feeding/encouraging them. Since the last inspection “finger food” had been introduced to enable residents to have independence and control over their lives. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 13 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints received were treated properly and residents and visitors knew that any complaints they had to make would be addressed and taken seriously. Staff were recruited correctly to ensure that residents were protected from abuse. EVIDENCE: There was a complaints procedure displayed on notice boards throughout the home and each person received a copy of the complaints procedure in the service user’s guide. The home and the commission had received no complaints since the last inspection. No one had any complaints about the home during the inspection. Residents felt they could approach staff if they had any concerns and staff had received training on communication in order to offer a better/more sensitive service to those people who had poor communication. Comments were, “I am very content” and “I can’t fault the staff”. Staff confirmed they had been correctly recruited with a check by the Criminal Records Bureau. Staff also knew about abuse and what they should do if abuse was suspected. We saw throughout our visit staff being polite and respectful when talking to or undertaking care duties with residents. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 14 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): Standards 19, 22, 23, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in clean, well decorated, homely and safe accommodation. Any maintenance is promptly addressed. EVIDENCE: The home was clean, tidy, well decorated and odour free throughout. There was a decoration programme and new furniture had been provided. A 14 bed extension was being built and hoped to be open in September 2007. Although there was considerable building work going on during the inspection visit the noise/disturbance was minimal and site control well managed. There were lounge and sitting areas throughout the home. These areas had been broken down into zones to give choice. These were (a) a quiet zone for reading, (b) a chat zone for meeting and (c) a listen and viewing zone for TV and radio. The dementia unit was colourful and had orientating colours and signs for toilets, bathrooms. Each person’s room had their name on it with pictures reflecting their life and family for orientation purposes. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 15 All the residents spoke highly of the accommodation and how much they liked their bedrooms. Comments were, “my room is lovely” and “my room is cleaned every day and the home is immaculate”. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 16 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was adequately staffed with employees who were experienced, competent and educated to care for older people. Residents are protected by robust recruitment practices. EVIDENCE: All staff spoke of working as a team. Staff and residents felt there were sufficient staff in the home. The manager monitored dependency and was able to employ more staff where required. Training had included, moving and handling, fire safety, abuse prevention, dementia awareness with the Alzheimer’s Society (30 staff had attended), food hygiene, health and safety, catheterisation, management of falls, communication, risk assessment and infection control. Two staff were studying to be assessors and the deputy manager was to start studying for a management qualification in the future. There was a wide range of training provided which had covered National Vocational Qualifications. There were 60 of staff who had obtained or who were studying for NVQ. There was a named nurse and key worker system operating in order to give individual care to the residents. The home continued to be a placement for nursing students and adaptation nurses. All staff spoke of the training provided and how the training had given them confidence and improved their skills. Comments were “we work well together” Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 17 and “I have never worked in a home which so much training provided”. Throughout the inspection visit staff went about their work in a calm, friendly and professional manner. Staff records examined showed each person had a folder with an application form, 2 references, criminal records bureau check, contract and an induction in line with Skills for Care, which covered abuse prevention and once completed had a certificate of completion. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 18 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): Standards 31, 32, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well lead by a competent and committed manager. This had resulted in a confident, supported and trained staff team. Records show that residents’ health and general welfare and safety are promoted. The home ensures that that the residents have the opportunity to voice their views and opinions. EVIDENCE: The manager had extensive care and management experience. In addition to her nursing qualifications she had qualifications in management, care of older people and those who had a dementing illness. She was supported by a deputy manager. Staff and residents had confidence in the manager. Comments were, “Joan is gorgeous” and if I have any concerns or worries I can turn to the staff”. Staff Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 19 received supervision regularly and spoke of the support received from the manager and deputy manager. The last service user’s survey in which there were 18 returned in May 2007 gave the majority of responses from good to excellent. There were comments regarding the need for a garden and this was to be addressed after the extension has been completed. Since May 2007 a comprehensive internal quality assurance system had been introduced covering all aspects of management, care and services in the home. There were comprehensive and up to date policies and procedures including clinical procedures. There was a weekly fire audit. There were comprehensive risk assessments and health and safety policies. Records of resident’s monies were being kept with receipts and running totals. There was a detailed equal opportunities policy, which referred to discrimination, disability and discrimination and racial harassment but it was felt this needed further expansion to include other issues relating to equality and diversity. There were no concerns about equality and diversity. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 20 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 x 3 x x 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 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 x 3 Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 21 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. 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 Refer to Standard OP4 OP33 Good Practice Recommendations In order to meet all the age, disability, gender, sexuality, race and religious/belief needs of people entering or in the home an equality and diversity policy should be produced. Information about the home should be up to date and not have outdated references to the Registered Homes 1984, National Care Standards Commission and Care Standards Commission in them. This to ensure that people have up to date and correct information. Adderley Care Home DS0000002653.V338561.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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