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Inspection on 06/01/06 for Albany House Nursing Home

Also see our care home review for Albany House Nursing Home for more information

This inspection was carried out on 6th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is comfortable and clean with a welcoming atmosphere. The staff are very friendly and one relative spoken with said that `nothing was a problem` and `they were all lovely.` Staff chatted to residents and listened to their views. Staff responded to what the residents wanted and there was plenty of friendly banter between staff and residents throughout the day which the residents enjoyed. Since the last inspection an activities organiser has been appointed who has developed a busy programme tailored so that every resident is involved and has things to do that suit them. There has been a recent fund raising event that has been successful. The decoration programme upstairs continues and the area is very bright and colourful which helps residents find their way about.

What has improved since the last inspection?

Residents now have things to do five days a week because an experienced activities co-ordinator has been recruited. Residents and staff all were very positive about the range of activities that were available. Refurbishment throughout the home is continuing, including sensory areas for the dementia unit. The unit is clean, welcoming and bright and has been developed by the staff and the residents. They are proud of the unit and what they have achieved is reflected in the friendly, up beat atmosphere.

What the care home could do better:

Although some of the communal corridors have been newly carpeted the carpet chosen although it looks hardwearing, is very rough and harsh to touch, and a dark grey colour. This looks very institutional and is very rough and abrasive if residents should fall. There is new laminate flooring in the downstairs dining room though practical, is noisy and gives the room a hollow sound in the absence of soft furnishings. Staffing levels have not changed since the last inspection so concerns about staff being able to give care in a safe and dignified manner. The levels set by the company staffing grid do not take into account the layout of the building or the dependency levels of the residents. Staffing levels especially during the night give cause for concern. The food provided is of a high standard and plentiful but lunch was hurried and noisy in the downstairs dining room.

CARE HOMES FOR OLDER PEOPLE Albany House Nursing Home Albany Washington Tyne & Wear NE37 1BJ Lead Inspector Sheila Head Unannounced Inspection 6th January 2006 09:30 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 Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 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 Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Albany House Nursing Home Address Albany Washington Tyne & Wear NE37 1BJ 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) 0191 415 3481 0191 417 3433 Cotswold Spa Retirement Hotels Limited (wholly owned subsidiary of Four Seasons Healthcare Ltd) Mrs. Enid Hansford Care Home 38 Category(ies) of Dementia - over 65 years of age (17), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (20) Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The MD(E) service user category relates to the current service user only. 10th August 2005 Date of last inspection Brief Description of the Service: Albany House offers permanent accommodation with nursing and personal care for up to thirty-eight older people. The home accommodates persons with general nursing care needs on the ground floor and persons with dementia care needs on the first floor of the building. The home does not provide nursing care for people with dementia. The property is situated in a residential area of Washington and is within walking distance of a range of local amenities, including a large shopping complex with a post office, banks and a pub. Churches of three denominations are also nearby. The area is well served by public transport. Accommodation is provided over two floors, each with self-contained facilities including lounges, dining areas and bathrooms. Externally generous car parking is available, along with a pleasant, secure courtyard area, which service users can enjoy in good weather. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over seven hours as part of the annual inspection programme. The Registered Manager was on duty and present throughout the inspection. The inspector looked around the building, reviewed a number of records including three residents care plans, training records, medication records, maintenance records and the complaints system. During the inspection, five relatives, seven members of staff and six residents were spoken with. Lunch was shared with the residents in the ground floor dining room. What the service does well: What has improved since the last inspection? Residents now have things to do five days a week because an experienced activities co-ordinator has been recruited. Residents and staff all were very positive about the range of activities that were available. Refurbishment throughout the home is continuing, including sensory areas for the dementia unit. The unit is clean, welcoming and bright and has been Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 6 developed by the staff and the residents. They are proud of the unit and what they have achieved is reflected in the friendly, up beat atmosphere. 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 Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 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 Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 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): Nil EVIDENCE: None of these standards were inspected on this visit Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 Individual care plans are in place that show the health, social and personal care needs of each resident. There is a clear care planning system in place that gives staff adequate information to effectively meet residents needs. Sample care plans were inspected, two from each of the units of the home. Medication practices ensure that the needs of residents are met. Clear systems are in place. EVIDENCE: The staff in the dementia unit have worked hard to improve the care plans in the unit and the manager has given care plan training to all the staff. The care plans relating to residents in the dementia unit were clear, up to date and had been developed with the involvement of residents and relatives. The care plans gave a true picture of the health, personal and social needs of each resident. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 10 Care plans in the nursing unit are individual to each resident outlining their care. New style reporting sheets are being introduced into some of the care plans. Although the manager has given training to the staff there are still gaps on social admission assessments and some reviews have not been completed. Report writing by staff that are employed through the ‘Bank’ system for the company is sparse and is uninformed. Assessments are in place for pressure damage prevention, moving and handling, nutrition and weight monitoring and dependency levels. Pressure relieving mattresses are provided along with other aids to assist in the residents care. Residents spoken to all said they were happy with their care, one said ‘ I don’t lack anything, the staff think of everything’. Visitors were also satisfied. Comments included ‘Nothings been forgotten or been too much trouble, even though Mums been so ill’. The home has a safe policy for the administration of medicines. In the dementia unit the senior care staff have all been trained in the safe handling of medicines that reflects in the good practice shown. The recording and storage of medicines in the unit is complete and safe, however a sample signature record was not available so there is no way of telling which signatures belong to which member of staff. The audit trail was correct with no discrepancies. The nursing unit downstairs follows the same policy with qualified nurses giving out medicines. When antibiotics are prescribed, the medicine must be given as directed by the doctor. If doses are missed then reasons must be recorded using the code system on the Medication Recording Sheet. The fridge was dirty so must be routinely cleaned to control infection and this must be recorded. It was open where it should be kept locked to ensure safe storage methods. There were amounts of controlled drugs that were no longer needed locked away safely in the cupboard. However these need to be destroyed now the Home has obtained Chemical Destruction Packs. Recording is clear and the audit trail found to be correct. The manager routinely audits the procedure to make sure that staff continue to work correctly. New members of staff are trained by the manager in the policy. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 15 There is a varied choice of activities provided by the home. Residents are offered the opportunity to take part in a wide range of varied leisure and social activities. They are encouraged to keep their links with family, friends and maintain the interests they had before coming to live in the Home. Residents are offered varied, nutritious, plentiful meals, plus home baked biscuits and cakes throughout the day. EVIDENCE: Residents are offered the opportunity to take part in a wide range of leisure and social activities. They are encouraged to keep their links with family and friends. They are encouraged to maintain their interests and hobbies that they had before coming to live in the home by visiting places they used to go or still doing things with their friends. The Home has recruited a full time experienced activities organiser who has also had training in dementia needs. An organised programme is delivered to both units. One resident said ‘there is always something going on if you want it’, another ‘never a dull moment’ Visitors spoken to said ‘the activities person really tries Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 12 to do something for everyone’ Another visitor said ‘even though Mum cant do much the ‘activities’ doesn’t forget her’ On the day of the inspection some residents were having a competition throwing beanbags into a bucket, some listening to music from their youth, some doing gentle musical movement. There was a game of bingo before lunch that some relatives joined in. After lunch, quieter pastimes were encouraged, some residents discussed the days newspaper bulletins plus individual short reading time was given to those residents who aren’t able to join in. Activities are recorded for each resident as part of their care plan. The likes and dislikes of each resident are taken into consideration. One resident said ‘I don’t join in but like to watch and no one minds if I do just that’ ‘This is your life’ plans are being developed with the help of each resident and their relatives, so that activities can reflect their past interests. There is a small special sitting room for residents to reminisce that is set out, as it would have been when the residents were younger with items to bring back memories and stimulate conversation. Fund raising events, regular contact with local churches and schools, shopping trips are all organised to suit the residents which gives them contact with other people. Visitors are welcome in the Home at any time and they are able to see residents in their own room or in the lounges. They can use the small kitchens to make drinks at any time. One visitor said ‘ It’s a pleasure to come, the staff always offer a cuppa and are always cheerful.’ Meals at lunchtime reflected the menu and there was a choice of two main meals and two puddings. If a resident wanted something different they could have it. The cook said ‘I cook whatever the residents want, whatever they want to eat.’ Lunch was well cooked, well presented and everyone had plenty to eat. A visitor said ‘the food is excellent and just what the people who live here like’ However in the downstairs dining room where some residents need assistance, the atmosphere was noisy and hurried. Two residents ate alone, one at either side of the dining room on tables that had four places, whilst the remaining residents were around a communal table with four staff giving assistance. The meal time could have been made more discreet and encouraging for those residents requiring help if more use was made of the other tables and staff did not all sit around the same table. Puddings were served before residents had finished their main courses and as a result were cold. Salt and pepper were not offered so the residents ate the meal as it was served. The tables lacked homely touches such as tablecloths although these were put on the tables after lunch for decoration. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 13 There was a buffet tea offered on the day of inspection. One resident said ’its always sandwiches for tea, but they are very nice,’ another said ‘ Tea is always nice but I would like a change.’ Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 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 Residents and relatives can be confident that their concerns will be listened to and dealt with efficiently EVIDENCE: The complaints procedure is available to residents and their visitors telling them how to make a complaint and who to. The procedure is displayed in the entrance hall and is given to residents and their families as part of the welcome pack when they come to live in the Home. No complaints have been recorded since the last inspection. However one visitor said ‘I have spoken to staff about this problem and I was told it would be sorted but as yet I don’t know when, I didn’t want to complain as the staff are so good. I know I can write a letter’. Staff must be able to recognise and record verbal complaints so they can be dealt with to the satisfaction of visitors and residents. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 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): 26 The home offers a pleasant, clean place to live. EVIDENCE: The home was very clean and there were no smells on the day of inspection. The domestic staff are appreciated and liked by the residents and relatives. ‘The cleaners work really hard nothing is too much bother even though my mums room is full of her bits’. Staff were observed using wet floor signs and worked around the residents safely. Staff work safely and have had COSHH and Health and Safety training. Staff spoken to knew about the cleaning products, their dangers and how to store them safely. The well-equipped laundry was clean and tidy though the door had been left unlocked. A keypad is in place so staff must make sure they use it to lock the door when there is not a member of staff inside. The residents looked neat and tidy and were wearing their own clothes which were laundered to a high standard. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 16 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): 30 Staff are encouraged to attend relevant training to enable them to fulfil their roles. Residents and relatives are be confident that their needs will be met and that staff know how to look after them. EVIDENCE: There is a training plan for all staff within the home that is developed by the manager after discussion with each member of staff. Staff said that they were pleased with the training they had been given. One person said ‘We do fire drills all the time so we will know what to do’ Another member of staff said ‘I have done my level 2 in care and its made me much more aware of how I have to be to do a good job.’ Training attended is documented by topic and would perhaps be clearer if documented in individual portfolio form. The manager has been formulating a matrix type of recording. Certificates are kept in individual files. Staff are up to date with health and safety training, fire training, food hygiene and moving and handling. An induction training programme is available for every new starter which is coordinated by the manager. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 17 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,and 38 The Registered Manager is suitably experienced and qualified to manage the home in the best interests of the residents that live there. The best interests of the residents are assured through monitoring systems that are in place. Satisfactory measures are in place to protect the health and welfare of residents through implementation of checks. EVIDENCE: The manager is suitably qualified and has many years experience in management within the care setting. She has almost completed the Registered Managers Award qualification and constantly updates her knowledge. The manager has an open door policy for residents, relatives and staff. She walks around the Home everyday and everyone spoken with knew her and where to find her. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 18 The manager is investigating beginning a newsletter for residents and relatives but this is still in the discussion stage. Residents and relatives have not been invited to a residents meeting for over a year as the manager said there was little response. However there is a system for asking relatives and residents for their views about life in the home. Questionnaires are available from the entrance hall. These can be completed anonymously if desired and either handed in to the office or sent directly to the company head office. These same questionnaires are sent to relatives and residents once every year asking for their views. Response is usually high in numbers but the feedback to the home is poor from head office. Requirements are outstanding from the last inspection and the last Regulation 26 monitoring form was received in July 2005. Accidents are reported and documented. The accident book is very small with little space to describe events. An up to date maintenance file is kept in the home that has all the relevant servicing of equipment certificates. All necessary checks are recorded clearly and are up to date. Any repairs needed are written in a book that the Maintenance person checks every day. Once a repair is made it is documented. Requirements made by the Tyne and Wear Fire and Rescue Service from their annual inspection have been implemented immediately. Smoke seals are on order. Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 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 x x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x x x 3 Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 20 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 OP27 Regulation 18 Requirement Staffing levels must meet the needs of the residents that live in the home to ensure safe and dignified practice is carried out at all times The fridge for storage of drugs must be cleaned regularly and this must be recorded. It must be kept locked at all times. Timescale for action 30/04/06 2 OP9 13 06/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 2 Refer to Standard OP15 Good Practice Recommendations Mealtime arrangements in the nursing unit need to reviewed Albany House Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Nursing Home DS0000018186.V268193.R01.S.doc Version 5.0 Page 22 - 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. 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