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Inspection on 06/09/05 for Adeline House Nursing Home

Also see our care home review for Adeline House Nursing Home for more information

This inspection was carried out on 6th September 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is well managed ensuring the safety and protection of service users. There is a stable staff group who have worked at the home for a good length of time, and they spoke positively about their positions at the home. Staff have shown commitment to their own learning and should be commended for their efforts to obtaining NVQ qualifications, and retaining the `Investors in People` award which recognises a commitment to training and developing the workforce.

What has improved since the last inspection?

Outstanding training required on the previous inspection has now been undertaken by staff at the home, including intermediate food hygiene and adult abuse training. The registered providers continue to improve the decoration and refurbishment of the building, following a fire at the home earlier this year. The corridor of bedrooms has been totally refurbished and service users said they were happy to be back in their own bedrooms. Other bedrooms have also been decorated enhancing the areas for the service users to spend their time.

What the care home could do better:

The staffs at the home has worked hard to maintain the quality of care provided to those who choose to live at the home, and have now met all outstanding requirements. Service users are able to exercise choices with regard to their lives and how they spend their time. Where this may endanger other service users steps must be taken to minimize risks. Service users who choose to have their bedroom doors open must be risk assessed in consultation with the fire officer. Arrangements for the safe disposal of medication at the home are currently being made. The registered manager must ensure the secure storage of medication and records are maintained until the medication is safely disposed Of.

CARE HOMES FOR OLDER PEOPLE ADELINE HOUSE Queen Street Thorne Doncaster DN8 5AQ Lead Inspector Valerie Hoyle Unannounced 6 September 2005 09:00. 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. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Adeline House Address Queen Street Thorne Doncaster DN8 5AQ 01405 815112 01405 813594 None County Healthcare Limiteda wholly owned subsidiary of Four Seasons Health Care Ltd Mrs Vivienne Castle Care Home with Nursing 40 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) Category(ies) of OP Old Age: 40 registration, with number PD(E) Physical Disability: 40 of places ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two specific service users under the age of 65, named on variation application dated 1st April 2003, may reside at the home. Date of last inspection 01 February 2005 Brief Description of the Service: Adeline is situated in the heart of Thorne village, and is in easy reach of local shops and amenities. Grounds are well maintained usually by the handyman and a gardener and the drive leading to the entrance is block paved leading to the conservatory entrance. A quadrangle in the centre of the home is easily accessed by a sloping ramp and is a popular location for service users, and visitors.The home has three lounge areas; one is designated as the smoking area. The main entrance is a conservatory area with domestic type seating including sofas and coffee tables. All lounges have comfortable chairs with a television and domestic type lighting in all communal areas. There is a reception leading to the main areas of the home.The home provides both nursing and residential care. Qualified nurses provide the necessary care to those with nursing needs, and trained care staff provides care to the residential service users. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours where a partial tour of the buildings was undertaken. The inspector examined three service users care plans and supporting documentation. Seven service users and six staff were spoken to during the visit. The inspector was able to speak to two relatives, to gain their views on how the home is run. What the service does well: What has improved since the last inspection? Outstanding training required on the previous inspection has now been undertaken by staff at the home, including intermediate food hygiene and adult abuse training. The registered providers continue to improve the decoration and refurbishment of the building, following a fire at the home earlier this year. The corridor of bedrooms has been totally refurbished and service users said they were happy to be back in their own bedrooms. Other bedrooms have also been decorated enhancing the areas for the service users to spend their time. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 6 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. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 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 ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 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. Service users are not admitted into the home without a full needs assessment undertaken by the registered manager, to ensure their needs are met. Service users can visit the home prior to their admission to assess if they want to live there. EVIDENCE: The placing authority provides information to the home prior to admission and the registered manager is able to make an initial judgement about the suitability of the service user, and assess if the staff are able to meet their care needs. Information is gained from relatives and health professionals to assist with this process. Three assessment documents examined included sufficient information to ensure care needs can be met by the staff at the home. Two visitors to the home said that they only considered Adeline house to provide care for their mum as their mum had lived in the area for a considerable number of years and they had been told the home provided good care. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 9 One service user receiving respite care at the home said she/he was able to visit the home prior to her/his admission to look at the bedroom and meet other residents. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10. The care planning systems are sufficiently detailed to enable staff to deliver the care to service users who have specific identified needs. Arrangements for dealing with service users health issues are adequately met by staff at the home, with support from health professionals. Medication policies and procedures are well managed and qualified nurses have responsibility to administer the medication to service users, ensuring their safety and protection. Staff have the necessary skills and knowledge to ensure service users are treated with respect and dignity. EVIDENCE: Three care plans examined and these were comprehensively written with clear methods of staff intervention. There is sufficient evidence to confirm staff on a regular basis reviews the care plans and comprehensive risk assessments ensure service users can maintain their independence while remaining in a safe environment. Staff are comfortable with their abilities to meet the needs of service users and they are well informed and trained to deliver the care. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 11 Records examined and discussion with the staff confirmed service users healthcare needs are met. The qualified nurses are able to carry out nursing requirements for those service users who fall into the nursing category. District nurses also attend the home to carry out injections, take bloods and attend to dressing for service users who are residential. An audit of medication stocks and records was examined and were found to be correct ensuring the health and safety of service users. Qualified nurses have responsibility for administering medications and the local pharmacist is contracted to undertake periodic checks to ensure the stock levels are maintained and procedures are followed. Changes to the disposal of medication in nursing homes are currently being reviewed at the home. A company has been identified and contracts are to be agreed. The registered manager must ensure that medication waiting for disposal is securely stored and records maintained. There were many examples of good practise by staff and on many occasions there were good interactions between staff and service users and the visiting relatives. Most service users were referred to by their first name and this was with the approval of users, and was also stated in their care plan. One service user said that she/he chose to live at Adeline House and would not consider living anywhere else. Service users spoke fondly about the staff saying that they were very kind and always sorted things out for them. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 15. Social activities are arranged by the home and service users are able to participate if they wish, to enhance their lifestyle experience. Mealtimes are well managed and the facilities promote a calm environment with dining areas to accommodate all service users. Service users are encouraged by staff to bring in personal items of furniture and ornaments to help them settle into their own bedroom. EVIDENCE: The home employs an activities organiser, she spends time in small groups or individually to ensure all service users have an opportunity to be involved in some form of activity. Several service users were able to confirm arrangements for trips out including Cleethorpes and the lavender fields and there is also a planned trip to Bridlington. There is evidence that service users have access to daily newspapers and magazines. Posters displaying forthcoming events were seen, including photographs of recent outings. Service users are able to make choices with regard to meals and meal times, joining in activities and the time that they go to bed and get up. The inspector ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 13 observed service users spending time in their own bedrooms, watching T.V and spending time with their visitors. The Inspector joined service users for lunch and they said it was well cooked and presented. Staff was observed assisting service users appropriately and the meal was unhurried. Some service users choose to have their meals in bed and staff are well organised to accommodate this. A new surface in the dining area enhances the environment for service users to enjoy their meals. A partial tour of the building provided evidence that service users are able to personalise their bedrooms, many had brought in small items of furniture and pictures of their family. One service user who liked to spend time in his/her bedroom said he/she enjoyed watching television and talked about his/her collection of soft toys brought in by family and friends. Another service user enjoyed painting landscapes and he/she showed the inspector some, which he/she had on the bedroom walls. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18. Service users and their relatives are provided information to enable them the raise concerns about the home and their care. Adult protection Policies, procedures and training of staff ensure the protection of service users from abuse. EVIDENCE: There is a complaints procedure that is available to service users and visitors. The procedure is also referred to in the service users guide, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection is included in the procedure. There is a comprehensive Adult Abuse and Whistleblowing and staff follow the procedures to those standards. The registered manager would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The registered manager holds discussions with staff to talk over issues and how to recognise different forms of abuse. Training has been provided to staff as required from previous inspections. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26. The registered provider continues to improve the décor and furnishings at the home creating comfortable and safe environments for service users. The home is clean and free from odours and there is sufficient domestic staffs to maintain good hygiene standards. EVIDENCE: The home is located well within the community of Thorne and the single storey building ensures that service users have easy access to all parts of the building. Grounds are well maintained usually by the handyman and a gardener and the drive leading to the entrance is block paved leading to the conservatory entrance. New front doors enhances the approach to the home and provides added security to ensure service users are safe. A quadrangle in the centre of the home is easily accessed by a sloping ramp and is a popular location for service users, and visitors. A fire in part of the building in May 2005 has meant that total refurbishment has taken place on one corridor of bedrooms. The registered providers have carried out this work to a high standard and service users have been able to ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 16 return to their own bedrooms. One service user said she/he has been able to have all her/his own furniture back and her/his room is back to how it was before the fire. Staff are commended for their efforts during this time ensuring that service users were protected and cared for with the support of relatives and friends. The home was clean and free from offensive odours and service users said that their bedroom was always kept clean and tidy. The domestic staff are commended for their efforts in maintaining the cleanliness of the home. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27, 28, 29, 30 Staff have the skills and knowledge to fulfil their roles within the home, and a stable staff group ensures continuity of care by staff that knows the service users. Recruitment policies are followed ensuring the safety and protection of service users. EVIDENCE: Staff rotas examined demonstrated there is sufficient nursing and care staff to meet the needs of service users. Training in a number of areas has been undertaken since the last inspection, including intermediate food hygiene, first aid and adult abuse. The staff at the home have achieved the required 50 NVQ level 2/3 and are commended for their efforts. The registered manager has demonstrated a continuing commitment to developing the workforce, including attaining ‘Investors in People award’ Discussion with the manager regarding the recruitment of staff demonstrates clear understanding of the procedures to ensure the safety and protection of service users. There is a stable staff group who have a clear understanding of the needs of service users. No new staff has been employed at the home since the previous inspection. Staff said they enjoyed working at the home and found the manager approachable and supportive. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 18 Examination of nurses PIN and qualifications confirmed that the nursing needs of service users are met. The registered manager said that the nursing staff continue with their own development and attend courses as required by their registration. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31, 35, 36, 38 The registered manager is skilled and experienced to manage the home to ensure the safety and protection of the service users. Procedures are in place to ensure the financial interests of service users are safeguarded. Staff and service users follow health and safety procedures and records provide evidence of servicing of essential equipment. Staff are provided with formal supervision required to ensure they have the opportunities to develop new skills and knowledge. EVIDENCE: The registered manager has a wealth of experience and knowledge and is able to demonstrate her ability to manage the home. She holds a nursing qualification and is working towards the required management qualification. She operates an open door policy to ensure she is accessible to staff and service users. Service users spoke highly of the manager and said she was ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 20 very caring. Staff receives supervision and the manager undertakes all yearly appraisals, to ensure staff have to opportunity to discuss their development. Service users are able to manage their own finances, although most prefer the manager to assist with dealing with their personal allowances. A number of service users pocket money records were checked and these were accurate. Accident reports are analysed by the manager to ensure risk assessments are developed where required. Maintenance and service records examined were up to date and current to the services provided. The manager has the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures are in place and service records were examined and were current, ensuring the safety of service users. ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x 3 3 x 3 ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 22 YES 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. Refer to Standard OP31 Good Practice Recommendations The manager must gain the appropriate management qualification in 2005 ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 23 Commission for Social Care Inspection First Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 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 ADELINE HOUSE 20050905 Adeline House UN Stage 4 S15848 V188213 J55.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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