Inspection on 02/06/09 for Admorre House

This inspection was carried out on 2nd June 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Admorre House 04/09/09

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Admorre House 2 Fountain Head Bank Seaton Sluice Whitley Bay Tyne And Wear NE264HT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Karena Reed     Date: 0 2 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Admorre House 2 Fountain Head Bank Seaton Sluice Whitley Bay Tyne And Wear NE264HT 01912376141 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Raj Nahal Name of registered manager (if applicable) Mrs Linda Fairhurst Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Admorre House is a residential care home registered to provide personal care to seventeen service users. Nursing care is not provided .The Home is situated on the coast in the village of Seaton Sluice, and is next to a bus route .The house overlooks the sea front and is close to the nearby village which has some shops, there are also some pubs and cafes nearby. The building is of an older style and does not provide a passenger lift to the first floor but single bedrooms are available on the ground floor Care Homes for Older People Page 4 of 29 0 13 2 0 Over 65 0 13 2 2 Brief description of the care home for less ambulant service users. All bedrooms are for single occupancy. There are two lounges and a dining room. There are two bathrooms one which contains bath equipment that can be used to assist with getting in and out of the bath. Other aids and adaptations are available around the home to help more physically dependent people. There is a well-tended garden to the rear of the property. A Statement of Purpose and service user guide are available for prospective residents and their relatives to give them information about the services provided by the home and the relevant charges. CQC inspection reports are also available at the home detailing the quality of care provided. Fees payable for living at the home at the time of inspection in June 2009 are £449. Additional charges are payable for hairdressing, private chiropody, excursions and personal newspapers. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this is one star. This means that the people who use the service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated,it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit, we looked at information we have received since the registration of the home, how the service dealt with any complaints and concerns since registration, the views of people who use the service and their relatives, staff and other Care Homes for Older People Page 6 of 29 professionals. The Visit: An unannounced visit was made on June 2nd 2009. During the visit: We talked with people who use the service, the proprietor, staff and the manager. We looked at information about the people who use the service and how well their needs are met . We looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean,safe and comfortable. We told the manager what we found. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 29 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good procedures in place to ensure that prospective residents are making an informed choice about living at the home. Good arrangements are also in place for assessing the needs of people before they are admitted into the home. This provides staff with the information they need to safely care for people living at Admorre House. Evidence: The homes Statement of Purpose and service user guide were examined. They contained the necessary information as required by the Care Homes Regulations 2001.They were comprehensive and referred to the changes in ownership and the new management arrangements. In surveys received people who live at the home and their relatives felt that they got enough information from the home and other agencies to make a decision about whether to use this home. Comments from people living at the home include: Care Homes for Older People Page 11 of 29 Evidence: After inspection found this home to be the best for myself and family. Records for four people who live at the home showed that when they were admitted to the home an assessment of their care needs had been carried out before their admission. A copy of the social services assessment and care plan for each person had been obtained before they moved into the home. The manager or senior staff carry out a pre-admission assessment to ensure that it can meet each individuals needs.The person living at the home and relevant people are involved in the assessment. The homes assessment form encourages staff to explore issues relating to equality and diversity as it refers to gender, culture, religion and spiritual preferences. It also looks at mood, speech, behaviour, mental health and risks. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A prospective resident may come for meals, have overnight stays and be introduced to other people who live at the home at a pace suitable to the individual. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements in place to ensure the health and personal care needs of people living at the home are met by staff. Evidence: After a person has moved into the home a care plan is designed around their assessed needs so that staff know how to provide the right amount of support . Care plans detail the night time needs of people living at the home. Care plans cover areas such as continence, personal hygiene, mental health and social care needs. The sample of care plans examined were written in a respectful way that promotes the individuality and dignity of the person living at the home.The sample showed that all care plans had been evaluated regularly. The care files of people living at the home contained much historical information which was not needed for daily use.This made the files bulky and difficult to find the care plans which were needed for every day use, to provide staff with the information about the up to date care and support needs of people living at the home. Records were in place to show how the medical and nutritional needs of people living Care Homes for Older People Page 13 of 29 Evidence: at the home were being met. Residents care plans recorded information about their social and leisure needs. Health care records were available on the files of residents to show they are supported to have access to health care services such as GPs, dentists, district nurses and continence advisors. A resident commented: I am very well looked after and the staff are fine. Other comments include: Staff are very caring towards patients. I liase with the G.P and district nurses at all times,when any concerns arise. We act upon all the advice and directions given by District nurses and G.Ps. Risk assessments are in place for residents covering areas such as health care including prevention of falls, continence and nutrition. Moving and handling assessments have also been carried out to show the moving and handling needs of more dependent residents. Technical aids and equipment are available for people who are unable to move independently. The home has a medication policy that is available for staff to read. All medication is stored in an appropriate locked cabinet to which only senior staff have access. Records covering the administration and disposal of medication are kept. The records examined were satisfactory. All staff administering medication have received accredited training. Staff are polite, respectful and courteous to people in their care. All of the surveys returned said that staff gave the care and support required. A staff member commented: Care Homes for Older People Page 14 of 29 Evidence: Clients are cared for with dignity and in the same way as I would care for my own mother and father, with respect and courtesy. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have opportunities to make choices about activities and daily routines so that they may lead a lifestyle that matches their social care needs. Evidence: There is a planned programme of activities within the home. The activities organizer has left and staff are therefore currently given responsibility for organizing activities and outings. They each have the responsibility for a month and then it is rotated to another staff member. At the time of inspection a dancing session was taking place with residents and staff,old time music was playing. There is an active residents committee which make suggestions for activities and outings. Activities include:videos, sing-a-long, manicurist, dominoes,gardening, religious services, hairdressing, memory skills,quizzes,massage,board games,exercise,song and dance,movies,music sessions,family visits,kareoke, Irish dancing, fitness sessions,arts and crafts,gardening,reminiscence,bingo and skittles. Various seasonal parties are arranged which are supported by relatives. Pea and pie suppers, race nights,clothing parties and other social evenings are also arranged in order to boost the residents amenities fund. Residents enjoy sitting in the garden when the weather is suitable. Care Homes for Older People Page 16 of 29 Evidence: They enjoy ice cream and sherry mornings or afternoons.Entertainment is also provided in the home by entertainers such as singers,choirs and other seasonal entertainment. People living at the home have the opportunity to go out with relatives. Local outings are also arranged by the home to garden centres,museums, the coast, the local town centre and whatever is of interest to the resident. Staff support people living at the home to keep in touch with relatives. Residents were positive about the activities provided. A resident commented: I am pleased that the new owner is providing a mini bus to give us more outings. A staff member commented: More outings would be lovely,to take the clients out every day, but resources and budget dont allow it. There are great staff that give to raffles and activities to enhance the clients life, by providing entertainers and activities. Staff ask each resident about their wishes,interests and choices. Training has taken place for the staff team about memory loss. This training should help ensure residents are given more choice in order to keep some control in their lives. Training is planned about how to implement the Mental Capacity Act. Following this training ,the senior staff will look at what choices and decisions each person with memory loss is able to make for themselves. The cook talks with the residents to collect up to date ideas for making the menus and finding out about the food likes and dislikes of residents. At least two hot meals are provided daily and an alternative is available. Residents were positive about the food. On the day of inspection people living at the home were served beef or vegetable casserole followed by apple and Cinnamon sponge cake for their lunch. Tea was sardines on toast and salad and cherry cake and scones. Comments include: I am very well fed. The food is lovely, Im a fussy eater. Care Homes for Older People Page 17 of 29 Evidence: Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints and protection system,which helps to protect people who live at the home. Evidence: The homes complaints procedure is given to new people as they move into the home. The procedure assists and supports them and their relatives to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within the home. There is a complaints procedure on display within the home for the use of residents and their relatives. The home keeps a record of complaints . There have been six complaints received about the home since the last inspection, these have been investigated by the home and resolved.One is a safeguarding issue which has been investigated using the council safeguarding strategy. Surveys returned stated people living at the home knew how to complain if they needed to .Comments from people living at the home include: I have no need to complain. Care Homes for Older People Page 19 of 29 Evidence: The home has a copy of the Local Authorities Vulnerable Adults procedure. This provides staff with clear guidance on how to deal with adult protection concerns. Staff have received training about Protection of Vulnerable Adults, the local authority multi-agency training. Staff have received training about behaviour that may be difficult to work with, this should help them understand the different support needs of individuals. Staff have received training about dementia care course to give staff more insight into the needs of people with memory loss. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and safe environment for those living there. Evidence: The home is accessible and situated on the seafront near to Blyth and Whitley Bay. There is an ongoing programme of decoration and refurbishment around the home. The hallway has recently been decorated. The lounge carpet has been refitted. The office has also been refurbished. A large flat screen television has been purchased. Furniture and fittings were domestic in design and the home was well decorated and comfortably furnished. Comments include: The standard of hygiene is excellent. I always do my best to keep the home as clean as can be. The home has an appropriate amount of sitting, recreational and dining space. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff for the occupancy levels of the home. They are appropriately recruited, and trained to meet the needs of the people living at the home. Evidence: Examination of staff rosters and discussion with the manager,proprietor and members of the staff team showed that staff numbers are as follows: 3 staff members 8.00am - 2.00pm 3 staff members 2.00pm - 9.00pm 2 waking night staff 9.00pm- 8.00am These numbers include the manager. There is a senior staff member on each shift when the manager is not on duty. Other members of staff are employed for duties such as cleaning, food preparation and maintenance work. Staff comments include: All staff training need are currently being reviewed, and mean to ensure all staff will Care Homes for Older People Page 22 of 29 Evidence: have the NVQ level 3 especially seniors. Although it has to be accepted that some care staff are happy with NVQ level 2. There is a good level of staff training. 98 of carers have achieved a National Vocational Qualification(NVQ) at level 2. 4 carers are studying for level 3 with 4 staff members wanting to begin studying for level 3. Staff have received the necessary statutory training and developmental training is planned to ensure that staff can meet the specialist needs of people with memory loss e.g. Deprivation of Liberty training. Other training carried out includes: infection control,moving and handling, first aid, health and safety, food hygiene,fire safety,continence, bereavement,falls awareness, end of life- palliative care, optical awareness,safe handling of medication and mental health training. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home live in a home that is well run and run in their interests and where the welfare of all is promoted. Evidence: The manager has the relevant qualifications for managing the home. The home is well run and there is an ethos of involving staff and residents in the running of the home. The manager is planning for key workers to become more involved in the care planning process for those people living at the home,that they have a special responsibility for. Also to take service users shopping or to be responsible for buying any gifts or clothing they may require.Residents are also involved in decision making in their daily living. Staff meetings take place regularly. Supervisions take place every two months with each staff member,as well as an annual appraisal when staff will help identify their training needs. Care Homes for Older People Page 24 of 29 Evidence: There was a good standard of record keeping and documents detailing fire safety and other statutory records were all up to date ,apart from not all staff files contained proof of identity or staff photographs. There was no record of Regulation 26, monthly visits by the proprietor to the home, to carry out an audit of the care provided, as part of the homes quality assurance process. A sample of staff files were examined.The necessary checks are carried out before a person is appointed to work at the home. Two written references were available on staff files examined. An application form had been completed for each staff member. Employment histories were available. CRB checks are carried out before a person is appointed. Staff photographs were not available on staff files examined. Proof of identity was not available on staff files examined. Lockable facilities are available for residents to keep their own money if they wish. Staff training relating to health and safety was up to date. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 38 26 The registered provider must complete a monthly report on the conduct of the care home. This must be carried out as part of the registered providers legal responsibilities under the Care Homes Regulations 2001. 29/07/2009 2 38 19 A staff photograph and proof 29/07/2009 of staff identity must be kept on staff files. These are required as proof of fitness of the workers in order to protect people living at the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The care files of people living at the home should be Page 27 of 29 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations audited and historical information stored. This will ensure staff have easy access to the most up to date information about the care and support needs of residents. 2 12 Staff should continue to take responsibility on a rotational basis for organizing activities and outings with people who live at the home. Best interest decisions should be recorded on the care files of people who live at the home as required, after training is completed. 3 14 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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