Inspection on 25/01/06 for Afton Court

This inspection was carried out on 25th January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Afton Court 09/06/10

Afton Court 27/01/10

Afton Court 17/12/08

Afton Court 18/12/06

Afton Court 20/04/05

Afton Court 17/01/05

Afton Court 04/08/04

Afton Court 04/03/04

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

CARE HOMES FOR OLDER PEOPLE Afton Court 66-72 Marshall Avenue Bridlington East Riding Of Yorks YO15 2DS Lead Inspector Mr M. A. Tomlinson Unannounced Inspection 09:50 25th January and 1 February 2006 st 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 Afton Court DS0000019640.V277788.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. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Afton Court Address 66-72 Marshall Avenue Bridlington East Riding Of Yorks YO15 2DS 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) 01262 606888 01262 677999 Afton Court Limited Mrs Samantha Jane Berry-Dagnall Care Home 41 Category(ies) of Dementia - over 65 years of age (41), Old age, registration, with number not falling within any other category (41) of places Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20th April 2005 Brief Description of the Service: Afton Court is a three storey property that is in effect the combination of four Victorian terraced houses on Marshall Avenue, Bridlington. It also incorporates two properties on Clarence Road, which backs on to Marshall Avenue. It is conveniently located for all main community facilities including the public transport network. Time restricted on-road parking is available. The home is registered to provide accommodation and personal care for a maximum of forty-one (41) older people who may also have dementia. In the main building, the residents are accommodated in thirty-one single and four twin rooms. Two shared rooms also incorporate a conservatory. The rooms are provided with en-suite facilities that comprise of at least a wash-hand basin and a toilet. Many of the rooms also have a bath or a shower. There are eight separate toilets and two bathrooms with specialist equipment such as a hoist. In addition there is a self-contained ground floor flatlet for the specific use of a married couple. A passenger lift provides access to all floors of the property. A stair lift is installed on one stairway. A variety of aids and adaptations are available to enable the residents to move around more independently including ramped flooring. The home has a dedicated day centre that is used by residents of the care home and members of the community. There is large, enclosed courtyard that provides an appropriate safe outdoor area particularly for those residents with dementia. Nursing care is not provided. Should such care be required then it will be provided by the community health care services. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two statutory inspections undertaken by the Commission for Social Care Inspection during this inspectoral year. The inspection was unannounced. The inspection was undertaken over two days and took a total of five hours including preparation time. The registered provider was available throughout the inspection. The inspection primarily focussed on the Requirements and Recommendations made during the previous inspection along with those National Minimum Standards not addressed on that occasion. This report should, therefore, be read in conjunction with the report of the inspection undertaken on 20th April 2005. Discussions were held with the staff on duty and a number of service users. Several statutory records were examined. Feedback was provided for the Registered Provider on the completion of the inspection. What the service does well: What has improved since the last inspection? The requirements and recommendations made at the previous inspection had been met. Several staff had undertaken a range of training courses including a National Vocational Qualification. The Registered Provider has endeavoured to promote improved social contact for the service users. Afton Court DS0000019640.V277788.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. Afton Court DS0000019640.V277788.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 Afton Court DS0000019640.V277788.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): None EVIDENCE: These standards were not assessed on this occasion. Afton Court DS0000019640.V277788.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): 7, 9 and 10 The service users are provided with meaningful care plans that enable the staff to provide a good consistent quality of care. The dignity and privacy of the service users is given a high priority an any lapses treated in an urgent manner. EVIDENCE: Following the recommendations made during the previous inspection, the following action had been taken by the registered provider to ensure that these standards were fully met: • The service users or their representative had been encouraged to sign the service user’s care plan in agreement. From the records it was evident that this had been done particularly following a review of a care plan. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 10 • The competence of those staff responsible for the administration of medication had been assessed and recorded. The staff concerned confirmed that they had been provided with appropriate training on the safe handling of medication. Two staff now signs the register when administering controlled drugs. Those service users sharing a bedroom had been provided with the option of additional privacy screening. The married couples being accommodated had made a decision not to have such screening. During the inspection it was observed that a member of staff entered a service user’s bedroom without permission and ignored the protestations of the service user concerned. According to the service user this had regularly occurred in the past as some staff had used this room as a ‘short cut’ to another part of the building. The service user said that they had reported it to the registered manager and had received an assurance that all the staff had been informed to cease this practice. The incident on the day of inspection was reported immediately to the registered manager who confirmed that she had told staff not to use this room as a short cut. She immediately identified the member of staff concerned and took action to address the problem. An apology was also provided for the service user concerned. Subsequent to the inspection, the manager has confirmed that the member of staff had been spoken to and that the member of staff had provided a written apology for the manager and the service user. From observation of the staff on the day of the inspection it was evident that they provided care for the service users in a patient and caring manner. It was also evident that any concern regarding a service user’s well-being was immediately reported and acted upon. For example, one service user who looked pale and tired was provided with additional supervision. • Afton Court DS0000019640.V277788.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): 15 The service users are provided with a good quality of meals that incorporates a reasonable level of choice. EVIDENCE: Following the comments made by some of the service users during the previous inspection an internal survey with regard to the standard of meat provided for the main meals had been undertaken. The outcome of this survey had been acted upon with emphasis now being placed on using quality meat that was suitable for the service users. On the day of the inspection a discussion was held with the cook who had considerable experience in the catering trade. She demonstrated a good understanding of the service users’ dietary and nutritional needs. Emphasis was placed on the use of fresh meat, vegetables and fruit. Full fat milk was available for those service users who required it. The menus were reasonably varied and incorporated a degree of choice. Those service users spoken to expressed satisfaction with the quality of the meals. It was observed that the meals were of a good quality and served in ample quantity. It was also noted that the service users were able to eat their meals at their own pace and were not rushed. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 The service users are afforded appropriate levels of protection so that any incident of alleged abuse would be quickly identified and acted upon. EVIDENCE: The home had an appropriate complaints procedure. In addition to being in the Service Users’ Guide, the procedure was also displayed in the service users’ bedrooms and the main entrance hall. The registered manager provided evidence that there had been no complaints received since the previous inspection. The manager held the philosophy that by being readily accessible to the service users and visitors and by being open and transparent in the running of the home, the majority of concerns, issues and problems should be identified and resolved before they become formal complaints. Examples of this approach were provided. The records confirmed that the staff, regardless of role, had received training in adult abuse procedures including the types and indications of abuse. For the majority of the staff this consisted of watching an approved video as part of their induction training. The senior staff had received formal training on the subject. The home had an appropriate adult protection procedure in place. The registered manager demonstrated a good understanding of the procedure and of her responsibilities to protect the service users. The registered manager had cause to use the procedure during the past year. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 13 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): 26 The service users continue to be provided with a homely environment in which they are able to live their lives at their own pace. EVIDENCE: Whilst these standards were not specifically addressed on this occasion, it was apparent that the communal areas continued to maintained, furnished and decorated to an acceptable standard. It was noted that externally some of the window frames at the front of the property had flaking paint. It is, however, the stated intention of the manager to have these windows replaced with double glazed UPVC units. Following comments made by more able service users during the previous inspection regarding the use of communal areas, the registered manager had endeavoured to integrate the service users regardless of need but with only limited success. The more able service users, for example, continued to ‘voluntarily segregate’ themselves, as they were unable to have a meaningful conversation with those service users who had dementia. They also had difficulty in relating to service users who had behavioural problems. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 14 Deviations from the recommended National Minimum Standard, such as having a bed against a wall or a room partially carpeted, had been entered into the appropriate care plans with reasons. It was noted that there was old and unused equipment and rubbish located around the sides and the rear of the property. For example, there was an old shower base and a supermarket trolley outside of a service user’s room on the ground floor and a full black bag in one of the side passages. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 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 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): 29 The staff recruitment and vetting procedure needs to be more robust to ensure that the service users are not placed at risk. EVIDENCE: The administrator had been delegated responsibility for overseeing staff recruitment, selection and vetting. Several staff records were examined. They provided recorded evidence of formal applications, interviews and the vetting process. In some instances where the recruitment of staff was urgent, the POVA First procedure had been used. In such cases the member of staff involved had been appropriately supervised and allocated a ‘mentor’ to supervise them and support them during their induction training. It was evident from the staff records that there had been occasions where a member of staff had been employed before both written references had been received and reliance placed on purely verbal ones. Strictly speaking no one must be employed until after two written references have been received and the vetting procedure completed. One of the problems encountered by the registered manager was the difficulty in recruiting appropriate staff. She was of the opinion that the situation was exacerbated by the fact that the home was located in a seaside resort and consequently was affected by seasonal employment trends. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 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 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 service users are provided with a good level of support from the registered provider and the majority of decisions made are for the service users’ benefit. EVIDENCE: The home had a comprehensive quality assurance monitoring process that culminated in an annual report that identified the strengths and weaknesses of the service provided. The process included an audit of each section of the care home such as the laundry, day centre and catering service. Whilst the manager encouraged the service users or their representatives to retain control of the service users’ personal money, there were four instances where this had not been possible. In these circumstances a record was kept of the service users’ money and of all financial transactions made on their behalf. This included keeping receipts. The problem encountered by the manager was that this money had accumulated. The manager was consequently in the Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 17 process of arranging individual bank accounts for these particular service users in order to bank any excessive money. The records confirmed that the staff had been provided with training on health and safety topics such as moving and handling and fire safety procedures. A commercial company had provided a formal health and safety manual. Risk assessments had been undertaken and periodic servicing had been undertaken on the electrical and gas systems and the passenger lift. A safety check of all electrical appliances had been carried out. The fire record book was examined. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 18 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 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X 2 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 X X 3 X 3 X X 3 Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No 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 OP29 Regulation 19(1)(b) Requirement No person must be employed in the home unless the full vetting process is completed satisfactorily including obtaining two written references. Timescale for action 01/03/06 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 OP26 Good Practice Recommendations Rubbish and discarded equipment should be removed from the outside of the property. Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Afton Court DS0000019640.V277788.R01.S.doc Version 5.1 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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