Inspection on 13/02/06 for Adey Gardens Care Home

This inspection was carried out on 13th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Adey Gardens Care Home 14/10/09

Adey Gardens Care Home 23/10/07

Adey Gardens Care Home 22/08/06

Adey Gardens Care Home 25/08/05

Adey Gardens Care Home 21/03/05

Adey Gardens Care Home 07/07/04

Adey Gardens Care Home 16/12/03

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Adey Gardens Care Home South Street Newbottle Houghton Le Spring Tyne & Wear DH4 4EH Lead Inspector Sheila Head Unannounced Inspection 13th February 2006 09:45 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 Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Adey Gardens Care Home Address South Street Newbottle Houghton Le Spring Tyne & Wear DH4 4EH 0191 512 0544 0191 512 0527 wendy_walker@btconnect.com 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) Rolamgold Limited (Muscat Walker & Hayim) Mrs Wendy Anne Walker Care Home 37 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (34), of places Physical disability (25) Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th August 2005 Brief Description of the Service: Adey Gardens is registered to accommodate up to 37 older people, 12 on the first floor who require personal care, including up to 3 people with dementia over the age of 65, and 25 people who require nursing care aged 50 and over are accommodated on the ground floor. This is a purpose built home situated in the village of Newbottle in Houghton-le- Spring. It is of traditional brick, two storey building set in pleasant, secure landscaped gardens on the edge of the village green. Nearby there are two restaurants and several public houses, a hairdressing salon, shops, a newsagent and post office. The bus stops outside the home, and transports to all local areas as well as to the cities of Sunderland and Durham. The home has a large reception area, leading to a spacious conservatory. Service users have access to a variety of lounges and dining areas with a separate designated smoking area. There is easy access to the home for those with disabilities, a passenger lift services both floors and there is a large car park provided. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six and a half hours during which time the inspector met with the Registered Manager, staff, residents and visitors. During the inspection documents were reviewed including maintenance records, training records, medication records and financial records of residents. The inspector walked around the building and also had lunch with some of the residents. What the service does well: What has improved since the last inspection? Residents receive the right level of assistance from staff to maintain their independence during mealtimes and to make sure that they are able to eat the plentiful, nutritious meals they are offered. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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 Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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): 6 This standard was not assessed during this inspection, as this home does not offer immediate care. EVIDENCE: Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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): 9 and 10. Medication procedures followed ensure the safety of residents and staff. Staff support residents with dignity and respect their privacy through their friendly respectful approach. EVIDENCE: The home uses a Monitored Dosage System to manage the administration of medicines to the residents. There are two medicine trolleys, one for each floor, containing the medicines that are supplied in individual blister packs. Medicines are given out by a senior care assistant who has had training in the Safe Administration of Medicines to the people who live in the residential unit upstairs and by a qualified nurse to the residents who live in the nursing unit on the ground floor. Both trolleys were clean and tidy and all medicines were stored securely ensuring safety for residents. The records of administration sheets were complete and correct ensuring that residents were given their medicines at the correct time and as prescribed by the doctor. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 10 The staff deserve praise as the system in place is carried out efficiently and safely so that the residents needs are met. A document showing names, signatures and initials of staff that give out medication should be compiled and kept in the medication administration record folder so that the person who gives out medication can be easily identified. The home has an audit tool available for monitoring the medication system that must be used and records kept to ensure the safety of residents is safeguarded through regular checks. In discussion with staff they were able to show that they respected the residents privacy and maintained their dignity. One member of staff said ‘Its one of the reasons I like working here, all the residents have their own rooms so that if they need help changing their clothes or if they need the toilet they can go into their own room and be private.’ Staff were observed knocking on doors before entering bedrooms and the domestic staff were seen knocking on bathroom and toilet doors to make sure residents were not using them before entering to clean. All the residents were wearing their own clothes that were well laundered. One resident said ‘ I send my clothes to the laundry every day and they come back lovely. I always have clean clothes to wear and I choose what to put on.’ Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 and 15 The residents are supported and encouraged by staff so that they have control over what they do. Residents are offered a balanced, wholesome diet with plenty of choices so that their nutritional needs are met. EVIDENCE: Each resident has their own room so that when they come to live in the home they are able to choose how they want it decorated and they are encouraged to bring personal items with them. Looking around the home many bedrooms had personal items such as ornaments, small pieces of furniture, display cabinets and photos so that a homely environment was created for the residents. Staff were observed asking residents where they wanted to sit after lunch and giving them the choice of where to be for the afternoon. One resident said ‘ I do what I want really, no one has ever stopped me from doing something.’ Residents were all complimentary about their meals. One resident said ‘the food’s lovely’ another ‘there’s a choice but they will always make you something if you don’t like it.’ Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 12 The inspector shared lunchtime with the residents that live on the first floor in the residential unit. The tables were well laid with tablecloths, condiments milk and sugar. Residents were offered a choice of juice, tea or coffee before, during and after lunch. Some residents would possibly have benefited from having a teapot on the table and staff should assess the risk and ask the residents if that is what they would like so that their independence is maintained and encouraged. There was a choice of ham salad or chicken casserole with mashed potatoes, fresh green cabbage and fresh swede that was plentiful and nutritious for the residents. The care staff served the meal from a heated trolley. The meal was served immediately the trolley arrived from the kitchen ensuring the meal given to the residents was hot and looked appetising. Residents would benefit from having menus suited to their capability and understanding on their tables as many had forgotten the meal that they had chosen earlier that morning and would have benefited from a subtle prompt. The staff were chatty and kind and the lunchtime experience was calm and unhurried, with no distractions so that the residents could focus on eating their meal. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 There are policies and procedures in place but as staff have not received training in Protection of Vulnerable Adults there is the potential that residents are at risk. EVIDENCE: Staff have heard of POVA and in discussion said ‘I think I will be going on some training’. The manager must ensure that staff receive appropriate training to ensure that they can demonstrate they would take correct action in investigations of alleged abuse so that the potential risk for residents is lessened. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home provides a well-maintained environment that is safe for residents to live in. The home is clean and comfortable and residents’ rooms meet their needs. EVIDENCE: On touring the home it was observed to be light and airy and free from odours with a domestic staff team that complies with policies and procedures, which are in place to prevent and control the spread of infection. One regular visitor said ‘the domestics keep the place spotless, they work hard and they are always happy’. The home has a large laundry with washing machines and drier. There is also a ‘dry’ laundry where staff iron clothes and put them into individual baskets to be returned to residents or process linen and return it to a clean store cupboard. There is a member of staff working in the laundry every day so dirty washing is processed quickly which lessens the chance of cross infection. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 15 The hairdressing ‘salon’ shares the ‘dry’ laundry room. The basin area is in one corner of this room whilst, although the hairdryers are stored here, residents who need their hair dried are sat under the drier in the corridor. A change in working practice needs to be investigated by the manager, in order to promote a more dignified and enjoyable experience for the residents. In the last inspection report a requirement was made for a sluice disinfector to be provided for the nursing unit. This requirement has not been met and is still outstanding. The conservatory has not yet been repaired and continues to leak. This was also a requirement from the last inspection that has not been met. These two requirements will be included in this report. The manager must submit a plan of action plus timescales for achieving compliance to these requirements so that the safety and comfort of residents is not compromised. Bathroom and toilet areas are showing signs of wear and tear and are looking tired. These areas would benefit from redecoration and some imaginative use of colour to make a more homely environment for the residents. Observation windows in residents’ bedroom doors have been covered so that privacy of residents is protected. Residents living upstairs may benefit from directional signs and nameplates for their bedroom doors as the corridor is long with no distinguishing features so that they could find their way around more easily. At the moment there are only numbers on the doors that are not easily identifiable for residents and give the home an institutional feel. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 The numbers and skill mix of staff ensure that residents’ needs are met. Staff have not received training in health and safety to make sure the residents are safe. EVIDENCE: The manager said that there are only two qualified staff to work the day shift throughout the week. This staffing includes the manager and deputy manager. The manager works opposite shifts to the deputy manager. This practice leads to the deputy manager routinely working a twelve- hour shift for a minimum of six or seven days. The manager then works as the qualified nurse so the deputy can take time off. They said that this has been the situation for three months due to poor recruitment. These staffing levels are inadequate as there is not enough staff available to cover holidays and sickness. Plus the rota is only drawn up two days before it is due to start so staff are not able to plan ahead. It is issued on a Saturday to begin on the Monday so staff have to ring the home on their days off to find out their next weeks rota. Problems with staffing the home have the potential to cause risk to the residents. An immediate requirement was made at the time of the inspection that required staff to receive training in fire procedures within five days of the requirement being issued, as there was no record of training being given within the last year so residents were at risk. Staff have not received training in Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 17 health and safety, moving and handling, control of infection and food during the last year. The manager could produce no training programme outlining future training. Discussions with the manager confirmed that training had not been a priority due to pressures of workload from shortage of qualified staff. Training files are incorporated into staff personnel files and there was evidence from certificates that staff had training in the past but not during the past year. New staff to the home had not received fire training or POVA training and could not provide evidence of induction training with completion timescales. Staff said some training was given informally by the manager ‘we do it as things arise’, but documented evidence was not available. Residents cannot be confident that staff are adequately trained to look after them safely. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35 and 38 The manager promotes health and safety for the residents however there are areas of potential risk that need to be addressed. The manager is suitably qualified to ensure the home is run in the best interest of the residents and the residents are safeguarded by the financial procedures and systems in place. EVIDENCE: The manager confirmed there was only the annual questionnaire system in place for checking how residents, staff and families view the home or if they are happy. There was no evidence of responses to questionnaires or any analysis. One visitor said ‘No, we never have meetings to discuss anything but I know I can go to the staff at any time. It would be nice to have meetings and make it a bit of an occasion for the residents.’ The manager does have contact with the residents when she is on duty and was observed having a good rapport with the residents. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 19 Residents said ‘I know if I have a word things get done’ and ‘You only have to ask and the manager will come’ There are no records of staff receiving supervision or appraisals and the manager confirmed that these had not been implemented so there is no forum to discuss development and identify and plan their training needs. A plan needs to be made and actioned. The manager also stated that she had not had sight of the last inspection report from the Commission. Each resident has an individual balance sheet with an individual wallet that holds his or her money. The system raises an invoice for each resident for each debit made such as if the resident has been to the hairdressers. Their account will then be debited that amount. The system is audited by the manager every two months and documented so that any errors can be found quickly and rectified. The home has only one resident for which it is responsible for the pension book and this is because there are no family members to take responsibility. It is the homes policy to encourage families to be responsible for financial matters if the resident cannot do so. Balance sheets and contents of wallets were checked at random and found to be correct, the recording is clear and precise so residents can be confident the home has robust systems in place to safeguard their finances. The manager confirmed in discussion that there were areas that action needed to be taken in order to protect residents’ safety. Records of accidents do not include enough information to demonstrate how staff have responded. Training records are not up to date and a training programme must be developed to make sure staff receive the necessary training to look after the residents properly and safely. Recordings of when checks are carried out on the nurse call system need to be clear and water temperature checks need to be recorded weekly. Air temperatures need to be checked and similarly recorded to ensure the environment is comfortable for the residents. Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 3 x x 2 Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? yes 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 OP19 Regulation 23(2) Requirement The conservatory must be repaired to ensure there is no water ingress to the interior of the building.(previous timescale of 31/10/05 not met) A sluice disinfector must be provided for the nursing unit. (Previous timescales of 31/7/05 and 31/10/05 not met) Recruitment and induction procedures must be implemented in a robust manner to ensure safety of residents.(Previous timescale 25/08/05 not met) Service user satisfaction surveys must be conducted on a regular basis to elicit their views about care services in the Home. (Previous timescales of 31/7/05 and 31/10/05 not met) Staff must receive training appropriate to the work they perform. An annual training plan must be developed and made available to the Commission Timescale for action 31/05/06 2. OP26 13(3) 31/05/06 3. OP29 18 & 19 30/04/06 4. OP33 24(3) 30/10/05 5. OP30 18 (1) (c) 30/04/06 Adey Gardens Care Home DS0000018185.V270537.R01.S.doc Version 5.1 Page 22 6. OP18 13(6) 18 (1)(c)(i) All staff must receive updated training in Protection of Vulnerable Adults 30/04/06 7 OP19 23 (2)(b) All immediate requirements must 18/02/06 Be addressed within the given timescales 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 OP19 OP29 Good Practice Recommendations Numbering and identifying bedrooms could be made more clear using names or pictures instead of just numbers so that residents can find their way around more easily. Key timelines should be added to the induction programme to show that some subjects need to be taught to staff earlier than others when they first start working at the Home. 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