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Inspection on 25/08/05 for Adey Gardens Care Home

Also see our care home review for Adey Gardens Care Home for more information

This inspection was carried out on 25th August 2005.

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.

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

What has improved since the last inspection?

Care plan documentation has improved in that the individual care plan now tells you what the aim of care is and what the resident needs and how staff are to help the resident.

What the care home could do better:

The recruitment process needs to be completed in a robust way to ensure the residents are not put at risk by employing staff that should not be working with vulnerable people. Also the induction of new staff needs to be carried out to make sure staff have the right information to know how to do their job when they first start working at the Home.

CARE HOMES FOR OLDER PEOPLE Adey Gardens Care Home South Street Newbottle Houghton le Spring DH4 4EH Lead Inspector Sharon McDowell Announced Thursday 25 August 2005 at 9:30am 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. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Adey Gardens Care Home Address South Street Newbottle Houghton le Spring DH4 4EH 0191 512 0544 0191 512 0527 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) Rolamgold Limited (Muscat Walker & Hayim) Mrs W A Walker Care Home 37 Category(ies) of OP Old age - 34 registration, with number DE (E) Dementia over 65 - 3 of places PD Physical Disability - 25 Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st March 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 Houghtonle- 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 B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over seven hours during which time the inspector met with the Registered Manager, Registered Provider, registered nursing staff, care staff, residents and visitors. Prior to the inspection the Registered Manager submitted a pre-inspection questionnaire to the Commission for Social Care Inspection providing information, such as, staff training, maintenance schedules for the Home, duty rotas and general dependency needs of the residents. A number of documents were reviewed including three residents care plans, two staff personnel files, activity programmes, menu, complaints records and Protection of Vulnerable Adults information and staff induction programme. The inspector sat with the residents on the first floor of the Home and ate lunch with them. The Commission for Social Care Inspection received no resident or visitor survey comment cards. What the service does well: Without exception, residents and visitors commended the staff in the Home demonstrating that good relationships are promoted between staff and the people living at the Home and their friends and families. Comments were made such as, ‘the staff are lovely’. The general standard of décor and furnishings presents a clean and homely place to live for the residents. One visitor commented on how they had looked at several other care homes but liked the entrance to the Home and the décor. They said their relative has lived in a nice home so they wanted them to be cared for in a nice home. Whilst there are some comments in the report about some aspects of the mealtime practice there was no doubt that the cooks were greatly appreciated by the residents. Indeed the meal on the day was very tasty and the home baked scone was very good. The residents said the food was always good and is mainly home made. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.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 Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.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 The Home obtains sufficient information about prospective residents to assure residents and relatives that care staff can meet their assessed needs. EVIDENCE: There is evidence in the residents care plans that the Home receives preadmission assessment information from appropriate agencies, such as, NHS nurse assessors and care managers, which enables them to decide if the Home can meet the residents assessed needs and to develop a plan of care of care for the resident when they come to the Home. The Registered Manager confirmed a letter is given to the resident confirming the Home can meet their needs. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 8 Care plan documentation is completed in sufficient detail to demonstrate the resident’s health, personal and social care needs are assessed and guidance is available for care staff to meet the resident’s needs. EVIDENCE: Care plans are held electronically and have been a topic of debate in previous inspections. However, the Registered Manager has improved the records, which now demonstrate a plan of care for the residents assessed needs, which is easily understood. The records can be printed of for the resident to have a copy if they wish. Currently there are hard copy versions of falls, pressure care and nutritional risk assessments. The Registered Manager advised these would be transferred to the electronic care plan when the computer programme is updated. The staff make good use of resources provided from the Local Authority and local health trusts. The tissue viability specialist nurse visits the Home to see a resident with a pressure area who was admitted from another care home. Records are maintained of visits by doctors and other health professionals. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 & 15 Residents are offered a range of social activities to participate in therefore have the opportunity to lead fulfilled lives. Visitors are welcomed to the Home therefore residents can be assured they can keep in touch with their friends and family. Residents are offered a varied, wholesome and nutritious choice of meals, which contributes to their health and wellbeing. However some aspects of mealtime practice do not ensure residents receive the right level of assistance to maintain their independence. EVIDENCE: The Home employs and activity person for thirty hours a week. The residents enjoy a range of activities including entertainers visiting the Home, clothes parties, knitting and crochet groups, dominoes, bingo, armchair aerobics and floor skittles. Two of the residents liked baking sessions and had recently made fairy cakes. Shopping trips outside the Home are organised to places like Washington Galleries and into the local village of Houghton. The Registered Manager advised the residents had enjoyed a visit by an company called ‘Zoo Lab’ who brought a variety of exotic and domestic animals to the Home including snakes, spiders and rabbits. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 11 Visitors are welcome to the Home and were seen coming and going throughout the day. Relatives spoke highly of the staff in the Home making comments like, ‘Staff are lovely’, ‘the residents are well care for’ and ‘it’s lovely, he wouldn’t be here if it was no good’. Menu booklets are provided in the resident’s bedrooms and can be provided in large print if required. The menu is changed every three months taking account of seasonal changes. The main meal is served at lunchtime with a light meal and hot dessert for the evening meal. The menu offers a good range of meals. Several residents and staff praised the quality of the food and the ability of the cooks and made comments such as, ‘the cook is fantastic’ and ‘the meals are well presented’. On the day of inspection there was a choice of chicken pie or sausage with potatoes and vegetables. Dessert was a choice of home made scone with cream, yoghurt or ice cream. The meal served was tasty, hot and of good portion size. It was pleasant to see the residents had their own mugs for hot drinks rather than a corporate teacup, which helps them maintain an element of individuality. During the meal, two residents had their food served on small plates. They both had difficulty keeping the food on the plate. When the carer was asked the reason for this, they explained it was due to the meal looking too big on a large plate. Guidance was given to the carer that small plates make the meal portion look larger. When asked if there were plate guards available to help keep food on the resident’s plates, it was thought that these were only for residents who had suffered a ‘stroke’. One resident appeared to be having difficulty with her meal as they were finding it hard to keep the food on the cutlery given them. The carer commenced feeding then, which is taking away the residents independence particularly if they could have managed with specialised cutlery. Another resident who seemed to be eating very slowly and having some problems with their food was helped by a carer in-between tasks, which meant their food was going cold and they were not having consistent attention to help with their meal. It was also noted they seemed to be having problems with solid food and when given a yoghurt they ate this with no difficulty. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 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 standard(s) 16 & 18 The Home has a satisfactory complaints procedure in place therefore residents and relatives can be assured their concerns would be addressed appropriately. Staff have sufficient knowledge of Protection of Vulnerable Adults. However the Registered Manager and Registered Provider have not implemented adequate measures to ensure that staff are suitable to work with vulnerable adults therefore residents safety and wellbeing might be at risk. EVIDENCE: There have been no complaints recorded in the complaints register and the Registered Manager advised no complaints have been made to the Home. Relatives stated they would have no hesitation in speaking to the Registered Manager or the Registered Provider and appreciated they were available in the Home to speak to if they needed. A copy of the complaints procedure is within the service user guide and is available in the reception area of the Home. It has been printed onto yellow paper for people with sensory impairments. The current procedure states the complaint will be resolved in seven days, which does not give a lot of time for a complaint investigation. However this conflicts with the policy, which states if the complaint is not resolved within twenty-eight days then the complainant should approach the Commission for Social Care Inspection. The Home has not had reason to activate the Protection of Vulnerable Adults alert procedure. All but four staff have completed Protection of Vulnerable Adults training. The local Protection of Vulnerable Adults procedures are Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 13 available in the home for staff reference and the Home policy has been updated to reflect local guidelines. When reviewing staff personnel records it was found the staff had been employed without Criminal Record Bureau and Protection of Vulnerable Adults first checks being carried out. The Registered Manager confirmed that several staff had not had appropriate checks carried out but could not confirm how many. An immediate requirement notice was issued instructing the Registered Manager to make applications for all staff within the following two weeks and to forward names of staff who did not have a Criminal Record Bureau to the Commission for Social Care Inspection. Following the inspection the Registered Manager faxed a list of staff to the Commission for Social Care Inspection, which identified twenty-eight staff without appropriate clearance. She has now made application to the Criminal Record Bureau for all staff currently have contact with the residents at the Home. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 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 standard(s) 19 Environmental issues were not reviewed during this inspection and will be reviewed at the next inspection. However two issues were noted during the inspection, which require attention. EVIDENCE: Some residents and relatives made comment about problems with water coming into the conservatory particularly during heavy rain, which means this area is not available for use when it is raining. Some people said they get wet if they are in the room and as it is the smoking room they have to go upstairs to use the first floor smoking room. It was noted that some bedroom doors had observation windows, which had been covered with opaque fablon. Some had curtains in place and a one or two had no curtains, which means the residents privacy might be affected. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 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 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) 29 Policies and procedures are available for the recruitment process however they are not implemented in a robust manner to offer safeguards to ensure the residents are supported and protected by appropriate staff. EVIDENCE: Issues have been raised in standard 18 of this document regarding Criminal Record Bureau clearance. A comprehensive induction programme is available. However in the staff files some key issues had not yet been covered for a staff member who had been employed at the Home for over four months, for example, Protection of Vulnerable Adults, telephone courtesy and another employee did not have an induction checklist therefore it was not possible to know if they had received induction training. The Home has a policy and a checklist for the recruitment and interview process but the Registered Manager advised these have not yet been implemented. There is no set questionnaire for interviews, which might make the interview process easier and would implement a fair system for the interviewees. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 16 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) nil These standards were not reviewed at this inspection and will be reviewed at the next inspection. EVIDENCE: Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 17 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 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x x x x x x x x Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 18 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. 2. Standard OP15 OP18 Regulation 12 & 14 19 Requirement Residents mealtime needs must be assessed and appropriate assistance given. All staff must have Criminal Record Beareau clearance prior to commencement of employment. The conservatory must be repaired to ensure there is no water ingress to the interior of the building. All bedroom doors must have window coverings to protect the privacy of the resident accommodated. A sluice disinfector must be provided for the nursing unit. (previous timescale of 31/7/05 not met) Recruitment and induction procedures must be implemented in a robust manner to ensure safety of residents. Service user satisfaction surveys must be conducted on a regular basis to elicit their views about care services in the Home. (previous timescale of 31/7/05 not met) Timescale for action 31/10/05 25/8/05 3. OP19 23(2) 31/10/05 4. OP19 12(4) 31/10/05 5. OP26 13(3) 31/10/05 6. OP29 18 & 19 25/8/05 7. OP33 24(3) 31/10/05 Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 19 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 OP29 OP29 Good Practice Recommendations An interview questionnaire should be utilised to ensure equal opportunities are implemented during the interview process. 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. Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 20 Commission for Social Care Inspection Baltic House Port of Tyne Tyne Dock South Shields 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 Adey Gardens Care Home B52 B02 S18185 Adey Gardens V219495 25 Aug 05 Stage 2.doc Version 1.40 Page 21 - 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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