Inspection on 08/08/06 for Albany House

This inspection was carried out on 8th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Albany House 19/01/10

Albany House 19/11/09

Albany House 04/08/09

Albany House 24/07/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Albany House Albany House The Square Tisbury Salisbury Wiltshire SP3 6JP Lead Inspector Karen Mandle Key Unannounced Inspection 8th August 2006 10:00 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 Albany House DS0000065877.V307409.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 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. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albany House Address Albany House The Square Tisbury Salisbury Wiltshire SP3 6JP 01747 870313 F/P 01747 870313 albanyhouse@bmcare.plus.com www.bmcare.plus.com BM Care Limited 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) Mrs Janet Matthews Care Home 21 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (21) of places Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Albany House can accommodate one named service user with Dementia however, the registered person must notify CSCI if the service user is no longer accommodated. This condition will then be removed. 26/08/05 Date of last inspection Brief Description of the Service: Albany House is an older detached building, which is situated in the village of Tisbury, Wiltshire. The home benefits from a good location within the centre of the village, within walking distance of the local amenities. A main line station from Waterloo to the west country is also located in Tisbury and again within walking distance of Albany House. Accommodation is provided on 2 floors of the home with the majority of the bedrooms provided being single. The home provides two communal areas and a large conservatory, which leads to a pleasant patio area and garden. Albany House is registered to provide personal care for 21 older people. The home was purchased by BM Care Limited in Jan 2006. The registered manager of the home is Janet Mathews. . Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this key inspection took place on the 8th August 2006 commencing at 9.30am. The Manager Janet Mathews was available to assist the inspector. The inspector was able to freely tour the building, visit with many service users, and observe the staff interacting with service users. Prior to the site visit-taking place, the inspector sent five service users surveys to the home to gain the opinions from the service users regarding the service provided by the home. All five surveys were returned providing positive comments about the service provided at Albany House. The inspector was able to speak with many of the service users who were complimentary of the care and support offered by the home. At the time of the inspection many of the care staff were receiving “First Aid” training at the home form an outside training provider. However the home was calm and organised. The home had met 6 requirements out of 9 given from the previous inspection, 3 further requirements were set following this inspection and 4 good practice recommendations. The judgments contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: What has improved since the last inspection? The home has worked hard to make good improvements to the medication procedure, which is now assessed as safe practice. Some improvement was noted to the care plans but further work is required. A range of activities are now provided which service users reported as enjoyable. All activities provided Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 6 are clearly documented and identify an outcome of the activity for each individual service user. Under the new ownership of the home, the manager is able to spend more time at the home and has now implemented “Residents Meetings” and service users survey as part of the quality control system. 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. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 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 Albany House DS0000065877.V307409.R01.S.doc Version 5.2 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): 1 and 3 Whilst a Statement of Purpose is provided it is not up to date due to the change of ownership. All service users are assessed prior to admission to ensure that the home is able to meet the individual care needs of the service user. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. EVIDENCE: Each service user is assessed by the manager Janet Mathews prior to admission to Albany House to ensure that through the assessment process the home is able to meet the personal care and social care needs of the service user. Two-pre admission assessments were seen which provided information of the service users care needs. The manager informed the inspector that, if a perspective service user is currently living along distance from Albany House that she will gain information from relatives and any other agencies who are currently involved with the care of the service user as part of the an assessment process. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 9 The Statement of Purpose will need to be revised to reflect the change of ownership, which took place during the end of 2005/2006, and to ensure that the document contains all relevant information relating to the service provided by the home. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 10 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, 8, 9, and 10 Service users are provided with care plans, however not all care needs are identified through the care plans and care records are not being reviewed monthly. Health care needs are monitored. The medication procedure has much improved and there are safe systems in place for the storage of drugs. Service users are treated with respect by the staff. Quality in this outcome area is judged adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care records of five service users were reviewed. Whilst an improvement had taken place to the standard of the care records from the previous inspection, further improvement is needed to ensure that all relevant care needs are fully identified and that a care plan is in place to support the care need. The care plans will also need to be reviewed monthly and when care needs change. Some information in the care plans was unnecessarily duplicated which is increasing work for care staff and could possibly lead to some confusion as to the care needs of the service users. For example 1 care plan had 3 manual handling risk assessments in place. As required from the previous inspection a pressure area risk assessment tool has not yet been Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 11 implemented ensuring that all service users have been assessed for the risk of pressure damage and appropriate pressure relieving equipment has been provided. However clear nutritional risk assessments had been implemented. A service user with a history of falls did not have a falls risk assessment in place ensuring that the risk of falls had been reduced as much as possible. The health care needs of the service users are monitored. By reading the daily statement written in the care records, it was evident that any changes in health care needs were promptly addressed by contacting the GP to arrange a visit to the home. The community nursing team addresses any nursing care needs, as the home is not registered to provide nursing care. A GP was observing making a visit during the morning of the inspection as were the local community nursing team who were at the home to mainly provide treatment for dressings to the service users. All service users are registered with a local GP practice that visits the home on a regular basis. Two Service users who were very frail and spending the majority of time being cared for in bed had frequent care charts in place providing evidence of the care and dietary intake both service users were receiving. The charts were maintained throughout the day and night. Appropriate pressure reliving equipment had been provided to both service users. Service users had not been weighed monthly but this was partly due to the sit on scales not being available. However the manager informed the inspector that new scales were due to be delivered. A good improvement to the medication procedure was seen with a medication trolley now used to support safe administration of medications. The morning medication round had been changed from the night staff administering the morning medications to the day staff, which is considered as safer practice. Medications were stored correctly with limited stock available. The medication administration records were up to date. However when a handwritten medication order is documented on the record the order should be counter signed by two members of staff ensuring the accuracy of the medication ordered. An up to date medication reference manual will need to be provided to ensure that the staff are able to reference medications. Where a service user wishes to self medicate, this should be supported by a self -medication risk assessment. The inspector was able to visit with many of the service users some of which by choice spent much of their time in the privacy of the own rooms. These service users expressed how much they appreciated that the care staff fully respected their privacy and dignity and that they were not made to do anything they did not wish to, such as attending activities or having meals in the dining room. Service users confirmed that all personal care was provided in the privacy of their bedrooms or bathrooms, which was also observed taking place by the inspector whilst touring the building. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 12 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): 12,13 and 15 Albany House has put a lot of work into developing appropriate activities for service users. Service users are supported to maintain links with family and friends. The food provided is of a good standard with varied menus supporting the dietary needs of the service users. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The activities programme provided for service users has improved with an activities person providing a range of activities twice a week. An art class was taking place during the afternoon of the inspection, which proved to be popular with service users. The artwork completed by the service users was nicely displayed around the home. A clear record of all activities and who participated was kept which was inclusive of a written statement of the outcome of the activity for the individual service user. Service users who did not wish to participate with the activities were able to spend time reading, watching TV and listening to the radio. Service users are also supported to visit the village amenities for personal shopping. Service users when asked felt that the amount of activities provided was sufficient, as they did not wish to do activities all day every day. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 13 Service users were able to confirm that they could receive visits from family and friends at any time, in the privacy of their bedrooms or in one of the communal rooms. A record is maintained of all visitors to the home. Five service users attend a local day centre in the next village weekly, which they reported they enjoyed. The chef showed a good understanding of the dietary needs of the service users and knew the likes and dislikes of the individual service users. Under the new ownership of the home, the chef reported that she is now able to do all the ordering of food supplies, which is inclusive of fresh local meat and fresh fruit and vegetables. Plans are in place to refurbish the kitchen, however the kitchen was clean and organised. The main hot meal of the day was served at lunchtime, which was well presented and nicely cooked. Service users were complimentary of the food provided with no complaints received regarding the quality of the food. A pleasant dining room is provided which many of the service users were seen using, however service users were also able to receive their meals in the privacy of their bedrooms if they wish. Service users needing support with their meals were provided with one to one assistance by a carer. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 14 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 A clear complaints procedure is in place. The manager and staff are informed of the local vulnerable adults procedure. Quality in this outcome area is judged to be good. This judgment has been made using the available evidence including a visit to this service. EVIDENCE: The manager maintains a complaints register, however the home has not received any formal complaints. A clear complaints policy and procedure is in place and is clearly displayed for service users and visitors. Through conversation it was evident that the manager had a clear understanding of the local vulnerable adults procedure and how to implement the procedure in the event of receiving an allegation of abuse. The manager reported that the staff had recently received training in “Adult Protection”. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 and 26 Albany House is a well-maintained home offering a homely environment for service users to live in. The bedrooms are personalised and well furnished. Infection control measures are in place. Quality in this outcome area is judged to be good. This judgment has been made using the available evidence including a visit to this service. EVIDENCE: Albany House a large older detached building well situated in the centre of the village close to all the local amenities that the village offers. The home is well maintained throughout offering a homely environment for service users to live in. The communal areas are furnished with domestic furnishings and provide comfortable living space for the service users. It will be recommended that the entrance hall be refurbished as the carpet is worn and some of the paintwork is dull and chipped in comparison to the rest of the home. During the tour of the home is was observed that several divan beds are in use which were low and it would be difficult to use with a lifting hoist if required for the service user to be transferred from a chair to the bed. It will be Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 16 recommended that the manager audits the divan beds in line with the individual service users manual handling needs and replace the divan beds where necessary. A new call bell system has recently been installed. The inspector was able to visit many of the bedrooms, which vary in shape and size, as the home is not purpose built. The bedrooms were well furnished and personalised according to the choice of the service user. The bedrooms are provided with a small en-suite facility. The home was clean throughout to a good standard with two cleaners on duty. The laundry facility was clean and organised, with systems in place to ensure the separation of potentially infected laundry. Infection control measures were in place with hand-washing facilities well provided for care staff. Disposable gloves and aprons seen being worn by care staff. All clinical waste was dealt with appropriately. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 The recruitment procedures ensure the safety of service users as much as possible. The staffing levels provided meet the care needs of the service users. All mandatory training is provided. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The staffing level provided during the inspection and according to the staffing rotas was: The manager and 4 carers during the day shift period, 3 carers during the evening shift and two waking night staff. Domestic staff, kitchen staff and a handyman are also provided. The manager did report that agency staff are used at times during the weekend, however the manager is trying to recruit more staff for the weekends. With speaking to the service users it was evident that the level of care staff provided met with the personal care needs of the service user, as the service users were very complimentary of the care provided by the staff. The home although busy during the visit was organised, with call bells and personal care being attended to in an appropriate amount of time. The employment files of four members of staff were reviewed. The employment files were of a good standard with all appropriate police checks made, at least two references obtained with some files having three references. The records of two overseas staff were reviewed which had good Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 18 detailed information relating to previous employment overseas and references written in English. At the time of the inspection staff that were not on duty were receiving “First Aid” training by an outside training provider. All staff had recently received training in “Adult Protection”. Evidence that all mandatory training had been provided was available. A clear training plan for all staff was displayed in the managers’ office. The manager supports staff with NVQ training.31 Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 19 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): 31, 33, 35 and 38 Quality assurance systems are in place ensuring the views of the service users are gained. The home will not manage personal money. The home has systems in place to meet health and safety issues apart from the weekly testing of fire alarm system. The manager fully understands her responsibilities. Quality in this outcome area is judged to be adequate. This judgement has been made by using available evidence including a visit to this service. EVIDENCE: Janet Mathews has been the registered manager at Albany House for approximately three and a half years. Janet Mathews has recently experienced a change in ownership of the home, however she has responded positively to the new providers with reports of good relationships between her self and the providers. Janet has a clear understanding of the care needs of the service Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 20 users in her care. Service users reported that they always found Janet to be help. Further development has taken place to the quality control assessments with resident’s meetings regularly being held, providing an opportunity for service users to express any concerns or improvements they would like to see to the service provided by the home. Service users surveys had been conducted gaining the views and the opinions of the service users. The home will not take any responsibility for service users personal money. Albany House is generally well maintained providing a safe environment for service users to live in. The Manager reported that the home has 1 lifting hoist and that a stand-aide hoist was on order to help support the manual handling needs of the service users. All staff had received fire training. However the fire alarm system had not been tested weekly. The emergency lighting had been tested monthly. All electrical equipment is tested annually ensuring the safety of service users. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 21 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 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4 Requirement The Registered Person will ensure that the Statement of Purpose is up to date in line with the change of ownership. The Registered Person will ensure that care plans are reviewed monthly. Inspector Comment. This has been met in part as many of the care plans had be reviewed but not consistently. The Registered Person will implement a pressure area risk assessment. This has not been addressed. The Registered Person will ensure that all service users are weighed monthly. The Registered Person will ensure that duplication of assessments and documents within the care records are removed. The fire alarm system will be tested weekly. Timescale for action 20/10/06 2 OP7 15 28/09/06 3 OP7 15 28/09/06 4 5 OP8 OP7 12(1,a) 15 28/09/06 28/09/06 6 OP38 23(4,c) 08/08/06 Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP22 OP19 OP9 OP9 Good Practice Recommendations The manager should audit the use of divan beds in line with the manual handling needs of the service users. The entrance hall should be refurbished to the standard of the rest of the home. An up to date medication reference manual should be provided. When a medication order is handwritten onto the medication record this should be counter signed by two members of staff. Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Albany House DS0000065877.V307409.R01.S.doc Version 5.2 Page 25 - 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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