CARE HOME ADULTS 18-65
Albany House Albany House 129 Albany Road Redruth Cornwall TR15 2JB Lead Inspector
Lowenna Harty Unannounced Inspection 30th November 2006 09:30 Albany House DS0000067808.V321879.R01.S.doc Version 5.2 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 Albany House DS0000067808.V321879.R01.S.doc Version 5.2 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 Adults 18-65. 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. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Albany House Address Albany House 129 Albany Road Redruth Cornwall TR15 2JB 01209 210526 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) Susan Patricia Kennaugh Mr Michael Peter Kennaugh Care Home 4 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection Brief Description of the Service: Albany House is a small registered home providing accommodation and personal care for up to three adults. Three may have a learning disability and one may have mental illness excluding a learning disability or dementia. The registered providers live on site and provide all the care and support necessary to the service users who live there. No staff are employed. The home is located in the town of Redruth and is conveniently situated for all the amenities of a small town, including shops and public transport. The home is a domestic-style building, with service users’ accommodation on the ground and first floor. On the ground floor service users are able to make use of a large, modern kitchen with separate utility room, a comfortable shared lounge with satellite TV and DVD player, a dining room and shared bathroom with shower. Outside there is a large, paved garden. All of the service users have their own bedrooms. One is located on the ground floor and the other three are upstairs. There is an additional shared bathroom on the first floor. None of the bedrooms have en suite facilities. The home is not specifically designed for people with physical or sensory disabilities but adaptations could be made if necessary to facilitate access. Fees are set at £350.00 per week, per service user, which are all inclusive. The registered provider submitted this information at this inspection. The home has a statement of purpose, which was submitted as part of the home’s application for registration. In addition service users each have a service users’ guide, which sets out the services and facilities that the home provides. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first inspection of Albany House, which is a newly registered home. It took place on 30 November 2006 and lasted for approximately three hours. The purpose of the inspection was to ensure that service users’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that service users’ placements in the home result in good outcomes for them. The inspection included interviews with two of the service users who were at home at the time and telephone contact with two relatives and a social worker, who provided information about the care provided to people living in the home. There were opportunities to directly observe aspects of two of the service users’ daily lives in the home and the registered providers’ interaction with them. Two of the service users were out at their day placements in the community, so were not interviewed on this occasion. Other activities included an inspection of the premises, examination of care, safety and employment records and discussion with the registered provider. The principle method of inspection was “case tracking”. This involves interviews with a select number of service users and their representatives and examination of records relating to their care. This provides a useful impression of how the home is working for service users overall. Two service users were case tracked at this inspection. What the service does well:
All of the service users have lived in the home for several years and are familiar with the services provided to them there. Those who were interviewed, their relatives and social worker were all in agreement that they are well placed and happy in the home. They each have an individual care plan, which sets out the goals of their placements in the home so that they maintain and develop their independence and are able to enjoy a good quality of life in a homely, community setting. They are encouraged to make decisions for themselves about things that are important to them, such as how to spend their money and what to wear. They all have keys and can come and go from the home freely, whenever they wish and two of them were observed doing this at the time of the inspection. They are supported to take managed risks so that they develop their confidence and skills. All of the service users access the local community and use public transport independently. Those who were interviewed confirmed that they are satisfied with the activities provided for them, and two were out at their day placements
Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 6 at the time of the inspection. They and their relatives confirmed that there are no restrictions on visiting and relatives said that they are always made to feel welcome in the home. Service users go out to local social clubs and the pub in the evening, if they wish. The home has a large screen TV with satellite channels and service users also have televisions in their own rooms. Service users are provided with information packs that clearly set out their rights and responsibilities as residents of a care home. They are also given information on how to access local advocacy services and a variety of local community groups and organisations that they can go to for assistance if they wish. Service users are able to access the kitchen independently to make meals and snacks for themselves. They are provided with home prepared meals each evening and those that were interviewed said that they are satisfied with the food provided to them. The home has two, lockable bathrooms, which service users were observed accessing independently. Those who were interviewed and their relatives confirmed that they are appropriately supported with regard to their personal care and their dignity is respected. They also confirmed that they are supported to access health care services when they need them so that they stay well. Some are able to manage their own medicines, whilst others are supported in this respect. Both the service users who were interviewed said that they are satisfied with the care and services provided to them and that they would feel able to approach the registered provider if they had any concerns or complaints. Their relatives agreed with this. They said that they feel safe in the home and because they regularly access a wide range of facilities outside of the home they are not isolated there and would be able to talk to someone else if they wanted to. Service users and their relatives confirmed that the home is comfortable and pleasant to live in, well maintained and always clean and tidy. It provides them with an opportunity to live in an ordinary community setting so that they can enjoy full and fulfilling lives. The home does not employ staff and the registered providers are able to provide service users with the care and support they need. All of the service users and their relatives said that they feel the home is well run for the benefit of the service users living there. What has improved since the last inspection?
Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 7 This was the first inspection of the home since its recent registration. 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. The summary of this inspection report can be made available in other formats on request. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good Service users are well placed in the home but initial assessment information about them needs to be obtained so that the registered provider has sufficient information about their backgrounds and histories to inform current care planning. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No new service users have been admitted to the home since it was registered and the service users who are currently living there have been resident in the home for several years. Prior to the home’s recent registration, supporting people funded them. The service users are very familiar with the services provided to them at the home and the registered provider was anxious to ensure that there was continuity of care for them as the home made the transition towards becoming a registered care home. She said that the service users’ social worker has completed re-assessments of their needs to ensure that their placement in a registered care home is suitable for them, but copies of their assessments had not yet been sent to the home. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 10 Subsequently to the inspection she contacted the Commission to state that she has arranged for the service users’ social worker to send them. Their social worker confirmed this during a telephone interview. Both the service users who were interviewed during the inspection said that they are satisfied with their placement in the home. Relatives and representatives who were contacted by telephone agreed that service users were well placed there, the home is suitable to meet their needs and service users are well matched with each other as a group. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. Service users have detailed written care plans, which address their care and support needs and are regularly reviewed internally. More should be done to ensure that service users and their representatives from outside of the home are actively encouraged to take part in the care planning process so that they are aware of and agreement with the goals of their placements. They are able to make decisions about things that are important to them so that they are able to maximise their independence and control over their lives. They are supported and encouraged to take assessed and managed risks so that they maintain and develop their confidence, skills and independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One of the service users who was interviewed was familiar with their care plan and copies of care plans were available for all of them. Service users had
Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 12 signed them as evidence of their participation and dates have been set for reviews, which are held at least every six months. Both of the service users appeared to be aware of the purpose of their placements in the home and in agreement with it. Care plans consider service users’ personal, health and social care needs. The registered provider is familiar with their needs related to their religion, cultural background, disabilities, age, gender and sexuality and incorporates issues appropriately into the running of the home. One of the relatives who was interviewed said that they had noted a marked improvement in the service user during their time spent living at the home. One service user did not appear to be aware of their care plan. Relatives and the social worker who was interviewed also said that they were not routinely involved in care planning or reviews. Both the service users who were interviewed said that they are able to make choices and decisions about things that are important to them and this was observed in their interaction with the registered provider and independent use of the home’s facilities. They are able to come and go independently from the home and have their own front door keys. Both confirmed that their bedrooms are their own and their doors are lockable. They are able to freely access and make use of all the communal parts of the home, without restriction, including the kitchen, to prepare their own light meals, snacks and drinks. There are detailed written risk assessments for each of the service users on their personal files. Two of the service users were out at their work placements at the time of the inspection and the two who were interviewed both said that they are able to go out into the local community independently. They both said that they feel safe in the home and the local community. The registered provider said that she aims to provide as normal a home as possible for them and encourages them to develop their skills and independence in risk managed ways. Service users’ relatives and representatives said that they are satisfied that service users are safe in the home. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good Service users take part in activities in and out of the home in accordance with their individual needs and choices so that they enjoy a good quality of life. They are supported and encouraged to maintain valued relationships with people they know from outside of the home so that they are not isolated there. Their rights are respected and they are informed of their responsibilities so that they know what they can expect from the home and what is expected of them. Service users are well fed and nourished so that they stay healthy and enjoy their meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 14 Two service users were out at their day placements at the time of the inspection and the two who were present in the home were making preparations to go out later on in the day, to visit the local town and go Christmas shopping. Activities are age appropriate for service users and the two service users who were interviewed said that they are satisfied with them. Their daily care records provide evidence that their care plans are carried out on a day-to-day basis. All of the service users are able to access the local community independently and this was observed during the inspection. The home is conveniently located and service users are able to make use of public transport on their own. The registered provider said that service users are able to go to local social clubs and visit pubs and local shops, which those who were interviewed confirmed. Relatives of service users who were interviewed said that the home actively supports them to maintain contact with service users placed in the home. There are no restrictions on visitors and they said that they are always made to feel welcome there. There are facilities for service users to make telephone calls in private if they wish. Service users all have full information packs, which contain copies of their service users’ guides that set out their rights and responsibilities as residents of the care home. These also contain information on access to independent advocacy and a variety of local community groups and organisations that they can turn to for support, if necessary. Service users and their relatives said that they are satisfied with arrangements to assist them to manage their personal finances. The two service users who were interviewed said that they are satisfied with the meals provided to them. They were observed accessing the kitchen independently to prepare breakfasts and packed lunches to take out with them. Menu plans indicate that they are provided with healthy, home cooked meals every day and the service users confirmed that they are able to choose alternatives if they wish. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Service users are appropriately supported with their personal care so that they maintain their independence and dignity. They are assisted to access the healthcare services they need so that they stay well. Systems in place to support service users to manage their medicines need to be improved so that they are better protected from medication errors. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The two service users who were present at the time of the inspection appeared smartly and appropriately dressed. They were observed making use of the home’s bathrooms, which are both lockable, independently. Both service users confirmed that the registered providers support them with regard to their personal care and respect their privacy and dignity. Relatives confirmed this during telephone interviews. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 16 Service users’ care plans consider their healthcare needs and the registered provider described how she supports them to access local NHS healthcare providers as necessary, including specialist support. Service users confirmed this, as did their relatives and the social worker who was interviewed. Some of the service users manage all or part of their medication for themselves and there are written policies to support this. Both the registered providers have undertaken training in the safe handling of medicines and there are satisfactory facilities for the safe storage of medicines. Systems in respect of medicines that the registered provider manages however need to be backed up by improved record keeping and a review of the home’s written procedures for managing medicines. This should include retention of original prescriptions and patient information leaflets, for example. The home should also obtain a drugs manual, which lists the effects of various medicines and potential side effects. The registered provider made immediate arrangements to address this, so a formal requirement has not been made on this occasion. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. There are formal and informal systems in place so that service users can influence the day-to-day running of the home. They are well protected from abuse so that they feel safe in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have not been any formal complaints made to or about the home since it was registered earlier this year. Service users are provided with copies of the home’s complaints procedure in their information packs. Those who were interviewed said that they are satisfied with the care and services provided to them at the home and would feel confident about making a complaint if necessary. Their relatives confirmed this. The registered providers have attended multi-agency training on protecting vulnerable adults from abuse. The home has copies of the local authority procedures for safeguarding vulnerable adults in addition to its own internal procedures and service users have been given easy read versions of the local authority procedures. Service users who were interviewed and their representatives said that they are well protected from abuse in the home. All of them have good access to a variety of local resources outside of the home so they are not isolated there. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 26 Quality in this outcome area is good. The home is comfortable, safe and homely so that service users can develop independence through living in a local community setting. The home is kept clean so that service users are suitably protected from risks of cross-infection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users and their representatives said that they are satisfied with the accommodation provided to them. The home is a domestic-style building, conveniently located to access local community facilities. It appeared well decorated and tastefully furnished throughout at the time of the unannounced inspection. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 19 The home looked clean and tidy throughout at the time of the inspection, which was unannounced. Service users and their representatives confirmed that it is always kept this way. The registered provider is trained in basic food hygiene and aware of the risks of cross-infection. She described the systems in place to protect service users from this. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor) The home does not employ staff, as the registered providers are able to run the home themselves, so these standards were not inspected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good The home is well run for the benefit of the service users so that they can enjoy safe and fulfilling lives in a local community setting. There are formal and informal systems in place so that service users can influence the day-to –day running, planning and development of the home. There are satisfactory systems to maintain health and safety in the home so that service users can feel safe there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission has registered both the providers as fit and competent to run a care home. The registered provider described training they have recently
Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 22 undertaken or are booked to undertake so that they keep their knowledge and skills up-to-date. Service users and their relatives said that they feel the home is well run, in their best interests. The registered provider said that she regularly talks to service users about their needs, views and wishes. Service users confirmed this and it was observed throughout the inspection. There are copies of questionnaires on service users files as evidence of a formal consultation exercise during which they were asked about the quality of the services the home provides to them. Service users and their relatives all said that they feel the home provides good quality care and services. The registered providers have undertaken training to ensure they are able to maintain a safe home for the service users and copies of their certificates are available as evidence of this. There are copies of written risk assessments in respect of the home’s general environment and fire safety and records of fire safety equipment checks and alarm tests were up-to-date. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Service users, their relatives and social services representatives should be more actively involved in drawing up and reviewing their care plans on a regular basis so that they are aware of and in agreement with the goals of their placements in the home. Albany House DS0000067808.V321879.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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