Inspection on 09/09/08 for Albany House

This inspection was carried out on 9th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Albany House 31/10/06

Albany House 04/01/06

Albany House 18/01/05

Albany House 27/07/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

CARE HOME ADULTS 18-65 Albany House 13 Stocker Road Bognor Regis West Sussex PO21 2QH Lead Inspector Ian Craig Unannounced Inspection 9th September 2008 10:05 Albany House DS0000014348.V368980.R02.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 DS0000014348.V368980.R02.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 DS0000014348.V368980.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albany House Address 13 Stocker Road Bognor Regis West Sussex PO21 2QH 01243 822533 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 Philippa Dawn Solan Mrs Philippa Dawn Solan Care Home 17 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (8) Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 8 persons in the category Mental Disorder, excluding learning disability or dementia MD(E) over the age of 65 years to be accommodated. A total of seventeen service users only may be accommodated. Date of last inspection 31st October 2006 Brief Description of the Service: Albany House is a care establishment providing accommodation and personal care for seventeen people with mental disorders, eight of whom may be over 65 years of age. The Registered Provider/Manager is Mrs. Philippa Dawn Solan. The property is situated close to the sea front and a short walk from Bognor Regis town centre with its shops, train station and other amenities. Albany House consists of two large three-storey houses, which have been linked to form one establishment. The accommodation is provided in seventeen single rooms and there are two lounges and a separate dining room. There is a large garden to the rear of the building which is accessible to service users. The weekly fees range from £308.00 to £600.00. The fees include regular hairdressing and chiropody. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection was unannounced and lasted for approximately 5 hours. Discussions took place with the manager during the visit and in a telephone conversation after the inspection visit to clarify evidence found at the visit. Communal areas and several bedrooms were seen. Records, residents’ care plans, policies and procedures were also looked at as part of the inspection. Three residents were spoken to about living at the home. Residents were observed using the home’s facilities. The inspector did not speak to any of the staff in detail. The Commission requires that care services complete an Annual Quality Assurance Assessment. This was completed by the home and information contained in it has been used for this report. The Commission sent surveys to residents, staff and health and social care professionals asking for their views of the service. These were returned by 2 health and social care professionals, 6 staff and 8 residents. What the service does well: Prospective residents are able to visit the home as many times as they wish to help them decide if they want to move in or not. This involves joining the other residents for meals. Each of the residents who returned a survey confirm that they have received a contract for their placement with the home and received enough information about the home to help them decide if it is the right place to move to stay. The residents appear relaxed in the home and are comfortable when approaching the home’s management with any requests. One resident said, “There is always someone to talk to.” Another person said that he/she is helped to manage his/her health needs. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 6 Residents confirm that they receive the care and support they need and that the staff listen and act on what they say. Each survey completed by a resident confirms that residents know what to do if they have a complaint. The surveys from the 2 health care professionals state that the home communicates well with the mental health services and that individual health care needs are ‘always’ met. Both health care professionals state that the home is good at providing individual care and that residents’ privacy and dignity is ‘always’ or ‘usually’ promoted. One professional states the home is good at having a flexible approach. Staff state that the home meets the needs of the residents. The people who live at the home can take part in domestic tasks in the home. Residents are able to choose how they spend their time. Some go out to the shops and to day centres, and others prefer to spend most of their time in the home. Meals are nutritious, varied and made with fresh meat and vegetables. Fresh fruit is available. A choice of meals is provided. Residents state that they ‘always’ or ‘usually’ like the meals. The residents state that they like living at the home. One person described how helpful the manager/owner is in providing support with legal matters and another person referred to the assistance given in arranging appointments. Each person has his or her own room. Bedroom door keys are provided for privacy and there is lockable storage space in each bedroom. Residents are able to personalise their rooms with tea making facilities, ornaments, music playing equipment and items related to hobbies. When bedrooms are redecorated the room’s occupant is able to choose the colour scheme. As most of the residents smoke, there is a ‘smoking’ lounge and a nonsmoking lounge. One person said how much he/she enjoys sitting at the tables in the garden in the summer. Staff have access to a variety of training courses including National Vocational Qualifications (NVQ) in care. Newly appointed staff receive an induction. Staff state that they ‘always’ receive up to date information about the care needs of the residents and the home has enough staff to meet the needs of the residents. The home’s manager has completed the City and Guilds Advanced Management for Care qualification and the Registered Manager’s Award. The home seeks the views of the residents as well as health and social services’ staff who provide professional support. These are analysed and an action plan devised for any improvements as a result of the views expressed. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Assessments of need must be completed before someone moves in to the home so that the home knows whether or not the person’s needs can be met. This includes obtaining information from referring health and social services’ departments. Assessments of risk need to be completed with accompanying guidance for staff on how to manage situations involving identified risks. Daily running records need to be recorded in a format that is confidential to the resident and that adheres to the Data Protection Act. The home needs to be able to show that each person’s social, recreational, educational, leisure and relationship needs have been assessed and that there are opportunities for these to be met. Care plans should be developed for these needs. Surveys from 3 staff and one professional comment that the provision of activities for residents could be improved. Five residents’ surveys state that activities are ‘sometimes’ provided and one person says he or she would like to do more activities. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 8 Residents should have opportunities for agreeing the content of their care plans. Medication classed as a controlled drug for storage purposes needs to be stored in a controlled drug cupboard. Risk assessments regarding the environment need to be carried out for the following: restricted access for residents to the kitchen and for the night storage heaters and electric convector heater in residents’ bedrooms. Fire escape routes between 2 bedrooms mean that it is not possible for either of the two room’s occupants to have privacy and security. The home needs to find ways of addressing this by the use of a specialist lock that meets the requirements of the fire and rescue service. Suitable locks need to installed on toilet and bathroom doors so that staff can gain access in an emergency. Consideration should be given to liquid soap and paper towels in bathrooms and toilets for infection control purposes. A number of areas of the home’s interior décor need attention and these are included in a maintenance plan. Two written references must be obtained before a staff member starts work. 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 DS0000014348.V368980.R02.S.doc Version 5.2 Page 9 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 DS0000014348.V368980.R02.S.doc Version 5.2 Page 10 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): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have opportunities to visit the home to see if it meets their needs before deciding whether or not to move in. Prospective residents receive information to help them decide if they want to move in or not. The home’s system of assessing those referred for possible admission needs to be improved so that the home has relevant information to ensure that it only admits those people whose needs it can meet. EVIDENCE: Residents described how they looked around the home before moving in. This involves the prospective resident spending time at the home and joining the other residents for a meal. The manager confirmed that prospective residents can visit as many times as they wish. The manager explained how she assesses people who are referred to the home for possible admission. It was reported that referring social services departments do not always provide copies of their assessments and care plans Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 11 and that the home does not always receive a copy of multi agency planning meeting minutes. For one person recently admitted to the home, there was a copy of a care manager’s risk assessment and minutes from a multi agency Care Programme Approach meeting. For a second person there were no copies of social services’ care manager’s assessments and care plans nor was there a copy of any multi agency planning meeting. A care plan had been recorded 6 days after the person’s admission to the home, which includes details of the person’s needs. The home had not carried out and recorded a pre admission assessment. The inspector suggested the use of a pre admission assessment pro forma covering those needs listed in the National Minimum Standards, which should be assessed before the home agrees to accommodate the person. The home has a Service Users’ Guide and a Statement of Purpose. These give details of the service, including the complaints procedure. The manager stated that these are supplied to prospective residents. One resident stated that he/she did not receive a copy of these documents until after he/she moved in and another resident stated that he/she has not had any literature about the home and does not know what to do if he/she has a complaint. Each of the surveys completed by a resident states that they received enough information about the home before moving in and that received a contract for their stay at the home. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 12 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, 8 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans need to be expanded to show how personal and health care needs as well as social and recreational needs and that the personal goals of each person are reflected in their individual plan. Lack of risk assessments has the potential that staff do not have clear guidance to follow in situations involving risk. EVIDENCE: Assessments and care plans were looked at for 4 residents. Each has a care plan, structured in the following way: Care/Nursing needs, Problems and Likely Causes; Aims of Care Plan and Expected Outcomes; Care/Nursing Instructions and Reports. These refer to care and health needs. Reference to social needs is Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 13 brief with little or no information about the social, educational, occupational, leisure and relationship needs. This was discussed with the manager who agreed that the care plans could be expanded to include these details. Staff surveys confirm that they are given up to date information about the needs of the residents. It was noted that the care plans do not record whether or not residents have been involved in their preparation, although the manager stated this is the case wherever possible. For one person there are comprehensive details from the West Sussex Mental Health Services, including guidance on how to deal with health needs. For another person there are also details from the referring mental health services. Risk assessments have not been completed for these 4 residents. For one person there was information from a health agency on how to deal with a situation but this was not reflected in the care plan or in any risk assessment. An entry in the care records and discussion with the manager showed the home was not following this guidance. This was discussed with the manager who acknowledged the need to carry out a risk assessment in conjunction with the referring agencies. A date has already been set for this to take place. The manager referred to the home being involved in the review of residents’ needs at meetings and at joint health and social services’ Care Programme Approach meetings. Daily running records are collectively recorded for all residents in a diary. A summary of this information is recorded each month in the individual care plans. A discussion took place with the manager regarding contemporaneous recording for individual resident’s daily events. Records should be confidential to the person concerned should they wish to view their records. It was explained that by recording individual daily occurrences that this is a more effective way of monitoring needs and patterns of events and behaviours. From discussion with residents and observation, it is clear that residents have opportunities to involve themselves in daily life at the home. One person helps in the kitchen, which he/she said is enjoyable. Residents are consulted about their views of the service by annual surveys. There is choice at mealtime and in how the people who live at the home spend their time. Residents are able to choose the colour scheme when their bedroom is redecorated. There is scope to develop the involvement of the people who live at the home in other decision-making processes. This was discussed with the manager. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 14 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): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to spend their time as they wish but their social, educational, and occupational and leisure needs are not fully assessed and planned for. The home provides a nutritious and balanced diet. EVIDENCE: Discussions took place with the manager about the daily lives of the people who live at the home and the opportunities for personal development by accessing activities and facilities. Five residents attend a local day centre, Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 15 which provides various activities such as a gardening club, dog walking, cooking and an art club. Residents described their daily lives. One person said how he/she goes out and about to shops and cafes. Another person stated that there is always someone to talk to in the home and that this has a beneficial effect on his/her mental health. Residents were observed using the home’s facilities including the lounges and dining areas. A resident stated how much he/she likes sitting at the tables on the garden terrace. One person said how much he/she feels valued at being able to help with some of the kitchen duties. The manager acknowledged that the care plans could be improved to include greater detail of resident’s social needs. There is no assessment of the resident’s individual needs regarding occupation, education, leisure and how the person spends his or her day, although some of these needs are mentioned in the care plan. Only one of the residents has been on a recent holiday and the manager referred to a lack of funding for holidays. Outings occasionally take place, although the manager described practical difficulties in organising these. For instance, residents deciding they don’t want to go out when transport has been arranged. One person said that there are no outings. Two residents said that staff accompany him/her to the local shops, the hairdressers and to shopping centres. Surveys from 3 staff and one professional comment that the provision of activities for residents could be improved. Five residents’ surveys state that activities are ‘sometimes,’ (rather than ‘always,’ ‘usually’ or ‘never’) provided and one person says he or she would like to do more activities. The professional expressed the view that the service could be improved by “a member of staff that facilitates social activity, accessing local resources and outreach.” Both professionals state that the service supports individuals to live the life they choose. The home plans to involve residents in redeveloping the garden and in growing plants. Discussion took place with the manager about social services assessing the social needs of residents so that these needs can be addressed. In the past residents have taken part in supportive employment. Residents said that the food is very good and that there is a choice. One person said, ‘The food is fantastic,’ and another person said, ‘The chips are good.’ Records of meals provided to residents are maintained. These show traditional meals, which the manager said the residents prefer. Changes have been made to the menu following feedback from the residents’ surveys. Records and receipts show that the home provides fresh vegetables and fresh meat from a local butcher. On the day of the visit the midday meal was toad in Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 16 the hole with fresh carrots, peas and new potatoes. One person had a salad as an alternative and another person, sausages and another shepherd’s pie. Dessert was meringue with fresh strawberries. Four of the eight residents’ surveys returned state they ‘always’ like the food and four that they ‘usually’ like the food. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 17 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported with their medication, health and personal care needs, although clearer guidance is needed in care plans so that staff know how to meet mental health needs. The home works with local mental health services to ensure that residents receive specialist care and medication. EVIDENCE: A resident has guidelines to help him/her with mental health symptoms. A resident said that he/she finds the staff very helpful and that he/she has an agreement to ask for assistance for dealing with mental health needs. The majority of the residents are independent in dealing with their personal care needs. Care plans include details of any assistance that a resident may Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 18 need with personal care. Surveys from residents state that they ‘always’ receive the care and support they need. Six surveys state that they ‘always’ receive the medical support they need and two state this is ‘usually’ provided. Staff surveys state that the home is good at meeting the care needs of the residents. One staff member adds, “The service cares for the users well and at a high standard.” A resident described how the home’s management make arrangements for appointments and health checks. An optician makes routine visits to the service so that residents can have an eyesight check. The manager confirmed that each resident is supported to ensure that a six monthly health check is carried out at the person’s general practitioner surgery. The home works with local mental health services who have provided support to the staff team by arranging a one day course entitled, ‘Mental Health Awareness.’ The two health care professionals confirm that the home ‘always’ or ‘usually’ seeks advice about health care needs and accesses the 24-hour community services. The home’s medication procedures were looked at. Medication administration recording sheets and containers of medication show that residents receive medication as prescribed. Appropriate records are kept for medication that is stored as a controlled drug. It was noted that this medication is supplied to the home in the blister packs with the other medication. This means the home cannot store it in a controlled drug cupboard. This was raised with the manager who contacted the supplying pharmacist who responded by confirming that a controlled drug cupboard would be supplied in the next few days and that future stocks would be supplied in separate containers. Surveys from health care professionals state that the home either ‘always’ or ‘usually’ supports residents with management of their medication. One professional states the home has a “good awareness of medication issues.” Staff receive training in the handling and administration of medication. The home liaises with the local mental health services regarding arrangements for more specialist medication. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 19 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home listens and acts on the views of the residents. Steps are taken to protect residents from possible harm. EVIDENCE: The home’s complaints procedure is contained in both the Service Users’ Guide and the Statement of Purpose. These are supplied to each resident, although one person said he/she has not received either of the documents. One person stated that he/she does not know what to do if he/she is not happy and wants to make a complaint. Surveys show that each person knows what to do if he or she wishes to make a complaint. Residents state that their views are listened to and that the staff are approachable. Residents’ views are sought by surveys and the manager explained how changes have been made to the menu as a result of the feedback in the surveys. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 20 Both professionals who completed a survey state that the service responds appropriately if any concerns are raised, with one person commenting, “I have great faith in the manager’s ability to deal with any issues.” The home has a logbook to record any complaints. There have been no complaints made to the home. The home has a copy of the local authority procedure for dealing with suspected abuse. Staff are given information about the principles of safeguarding vulnerable adults via a training video entitled, ‘No Secrets.’ Staff surveys state that staff know what to do if a resident or relative has concerns about the home. The home has its own written procedure for dealing with any possible violence from residents. This emphasises calming techniques of de-escalation. The home supports residents in managing their money. Records are kept of any amounts being held as well as any amounts deposited or withdrawn along with a signature of the staff member involved. Receipts are kept where purchases are made. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 21 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, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made to the home’s environment to the benefit of the people who live there. Residents are able to express themselves in their rooms. Residents’ safety and privacy are promoted although there is scope to improve this. EVIDENCE: The home has a system of maintenance and repair planning. A number of improvements have been made to the home since the last visit. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 22 A number of residents’ bedrooms were seen as well as the communal areas. Bedrooms contain numerous items belonging to residents including televisions, music listening equipment, books, ornaments, pictures and drink making facilities. A resident described how much he/she likes his/her room. One person said how he/she is encouraged to be independent to keep his/her room clean and tidy and that staff provide support with this. Residents’ bedrooms are decorated in a variety of different colours. The manager explained that when a bedroom is redecorated the room’s occupant can choose the colour scheme. Bedrooms contain a lockable cupboard for residents to store valuables. Each bedroom door has a lock, which residents can use for privacy and security. These also allow staff to override the lock in an emergency. Residents were seen using the bedroom door locks and one person spoke of using the lock. It was noted that there is a door between two bedrooms, which cannot be locked for reasons of fire evacuation. This means the two residents do not have privacy and security. The home should look at the specialist locking mechanisms that can overcome this, which also meet fire safety standards. There are 3 bathrooms each with a toilet and there are five separate toilets. There is a specialist bath in one bathroom for those with difficulty getting in and out of a bath. It was noted that there was no privacy blind on one bathroom window. The manager stated that this is already on the home’s list of action. The home was found to be clean. A resident said, ‘The home is clean.’ Surveys from 7 residents state the home is ‘always’ fresh and clean and one resident said this is ‘usually’ the case. Bars of soap and cotton hand towels are provided in the bathrooms and toilets. The home should consider liquid soap dispensers and papers towels for hygiene reasons. The home has an infection control procedure. Staff are due to have training in infection control. Toilet and bathroom doors have a lock for privacy but these cannot be opened in an emergency by staff as they consist of a bolt inside the door. Locks with an override device should be installed. The manager agreed to implement this. This will be followed up at the next visit. The home has a dining room, a lounge for smoking and a non-smoking lounge. Repairs are being made to the ceiling in one of the lounges following a leak and damage to plasterwork. Residents were observed using the lounges and the dining room. A professional commented that the service has a “comfortable ‘home’ environment.” The smoking lounge opens onto the garden, which has a lawn, shrubs, flowers and trees. The manager has plans to develop the garden and this will involve Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 23 the residents. A resident said how much he/she enjoys sitting in the garden at the tables. Issues regarding residents being able to access the kitchen were discussed with the manager. She agreed to consider a risk assessment regarding the reasons for this. The home has arranged for a private company to assess the home’s environmental risks and hazards and to devise an action plan where necessary. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 24 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): 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a staff team supplied in sufficient numbers to meet their needs. Improved recruitment checks would ensure better protection for residents. EVIDENCE: The manager explained that the staffing levels can be adjusted to meet the changing needs of the residents. There is a set staff rota, which showed that at least 2 staff are on duty at any given time. At busy periods the number of staff on duty can be up to five care staff. The inspector explained that if staffing levels change from that as recorded on the rota that a record of this must be made as required by the regulations in the form of a duty roster. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 25 Each of the care staff surveys states that there are ‘always’ enough staff to meet the needs of the residents. A resident described the staff as helpful and that there is always someone to speak to. Another resident said that the staff are kind and helpful. One person commented in a survey, “The staff are very supportive to me.” Staff have access to a variety of training courses, including National Vocational Qualification (NVQ) in Care level 2 and 3. At the time of the visit none of the 8 care staff have completed the NVQ level 2 in care. This is due to staff that have NVQ training leaving the home. Three staff are studying NVQ level 2 in care and one staff member NVQ level 3 in care. Staff have recently attended a training course provided by the local mental health services entitled, ‘Mental Health Awareness.’ A staff member states that this was “very good.” Training is also provided in first aid, moving and handling and food hygiene. The manager was advised to check that the moving and handling training by video instruction meets the relevant regulations for moving and handling training. Records show that newly appointed staff have an induction to their work, that regular supervision takes place and that staff complete an appraisal. Staff confirmed that they receive an induction. Staff also confirm that they receive relevant training and that they ‘always’ have the right support, experience and knowledge to meet the different needs of the residents. Professionals state that the care staff are experienced and ‘always’ have the right skills and experience to support the residents. Recruitment procedures were looked at for 3 recently appointed staff. Each person completed an application form. Criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks are completed before the person starts work. It was noted that one reference had been obtained for each person when a minimum of two should be obtained. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 26 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, and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is open to ways in which the service can be improved. The home seeks the views of those who live there. The number of matters requiring attention as found at this visit shows that the home’s management needs to be more thorough in checking that the service meets the Care Homes Regulations 2001 and that it promotes the health, welfare, privacy and safety of residents. EVIDENCE: Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 27 The home’s manager has completed the City and Guilds 3250/03 Advanced Management for Care qualification as well as the NVQ Level 4 Registered Manager’s Award level 4. The manager discussed the home’s operation and procedures and was open to any suggestions regarding improving the service. The home asks residents, mental health professionals (including consultant psychiatrists and community psychiatric nurse) and residents’ relatives about the service provided by the home. The results of this are summarised and improvements made where appropriate. The home uses a maintenance book to record any repairs that are needed, which is then used to plan for works to be carried out. Hot water temperatures are controlled by thermostatic devices to prevent any possible scalding to residents. The home has two systems for heating: gas central heating in one half and electric storage heaters in the other. Radiators in the area heated by gas are covered to prevent possible burns to residents. There are no covers on the night storage heaters. The manager said that the temperature of the night storage heaters is controlled. There was supplementary heating of a portable electric convector heater in one bedroom. The last report raised the best practice suggestion that risk assessments should be completed for the use of additional heaters. This has not been done. This was discussed with the manager. The risk assessments must also include the storage heaters. The home’s appliances and equipment are serviced and tested by suitably qualified persons. Staff receive training in first aid, food hygiene, moving and handling and fire safety. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 28 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 3 2 2 3 X 4 3 5 3 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 2 25 3 26 3 27 2 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 1 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 1 X LIFESTYLES Standard No Score 11 2 12 2 13 3 14 2 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 1 X Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 29 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA2 Regulation 14 Requirement The home must carry out assessments of need for those referred to the home for possible admission. Where the person is referred from social services this must include a copy of the care management assessment and care plan, or, the Care Programme Approach minutes and plan. Care plans must include an assessment and plan for individual resident’s social, educational, occupational, relationship and leisure needs. This must include the involvement of the resident where possible, which must be recorded. 3 YA9 13 Assessments of risk must be 20/10/08 carried out where appropriate for each resident. Plans must be formalised for procedures and guidance to minimise risk. Where appropriate this must include agreed strategies with community mental health DS0000014348.V368980.R02.S.doc Version 5.2 Page 30 Timescale for action 20/11/08 2 YA6 15 20/12/08 Albany House services. 4 YA26 13 The home must look into ways that the door, which opens between the two residents’ rooms can be locked for privacy and security. This must also meet fire safety standards for evacuation purposes. The home must consult the fire service regarding any locking arrangements. Staff must only be employed in the home after 2 written references have been obtained. Risk assessments must be carried out and recorded for unguarded storage heaters and electric convector heaters. An action plan must be implemented to address and minimise risks of burns. 20/12/08 5 YA34 19 30/10/08 6 YA42 13 30/10/08 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 YA30 Good Practice Recommendations Advice should be sought and action taken to minimise the spread of infection by the use of liquid soap and paper towels. Albany House DS0000014348.V368980.R02.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 © 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 DS0000014348.V368980.R02.S.doc Version 5.2 Page 32 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!