Inspection on 10/11/05 for Albany Nursing Home

This inspection was carried out on 10th November 2005.

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.

Other inspections for this house

Albany Nursing Home 08/05/07

Albany Nursing Home 19/06/06

Albany Nursing Home 05/05/05

Albany Nursing Home 09/11/04

Albany Nursing Home 05/05/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Albany Nursing Home 11-12 Albany Road Leyton London E10 7EL Lead Inspector Harun Rashid Unannounced Inspection 10th November 2005 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 Nursing Home DS0000025945.V264597.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 Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Albany Nursing Home Address 11-12 Albany Road Leyton London E10 7EL 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) 0208 556 7242 0208 556 0550 Topcare Limited Ronna Doreen Gummer Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (17) of places Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 2 Beds may be used for day care and respite provision 1 Bed may be used for a named non-nursing resident Date of last inspection 5th May 2005 Brief Description of the Service: Albany Nursing Home is situated in a residential area of Leyton in the London Borough of Waltham Forest. The registered provider is Top Care Limited. The home can accommodate a total of 55 service users and provides nursing care for older persons and younger adults with physical disabilities. There is one double bed room and the remainder are single, and all rooms are en-suite. Planning permission is currently being sought for an extension to the existing building to accommodate an additional seven residents. The Statement of Purpose states that Albany Nursing Home will develop care facilities by delivering a range of professional health services, ensuring that client needs are identified and holistically addressed on individual basis. The management shall continue to develop their expertise in providing both general and specialist services to meet continuing care demands whilst demonstrating a level of flexibility to meet changing market needs. The professional staff team will continue to focus on developing standards of excellence in their home, whilst they will remain committed to their personnel, supporting their professional development training and career progression. The staff team consists of 39 care staff, 15 registered nurses, 18 ancillary staff, one activity co-ordinator and 1 handy man in addition to the manager and deputy manager. Some of the care workers are working as part time employees. There are always 3 registered nurses and 11 care workers and 1 ancillary staff on duty on each shift. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted on a weekday morning on 10/11/05. The inspector spoke to nine service users and interviewed two registered nurses and three-care assistants. They all expressed their satisfaction with the standard of care provided. A tour of the premises took place during the inspection. What the service does well: What has improved since the last inspection? 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 Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 6 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 Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 7 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): 2,3,4 and 6 All service users are provided contracts, which included statement of terms and conditions. The admission procedure ensures that service users assessment of needs is carried out prior to the admission. EVIDENCE: The home provided all service users contracts known as ‘Terms of Residents Admissions’. This included details for example, the room to be occupied by service users; the services covered by the fees; the arrangements for paying the fee; any services over and above those included in the fees, the rights and obligation of the service users and the provider, and the terms and conditions of occupancy, including any period of notice. The registered manager and the deputy manager are both RGN’s and have experience and skills to carry out assessment of needs, they carry out preadmission assessments prior to any admission to the home. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 8 For individuals referred through care management arrangements, the manager obtains a summary of the care management of the health and social services assessment and a copy of the care plan. From discussions with service users, staff and examining documentations it was clear that staff work in partnership with service users families, health professionals and with voluntary organisations to meet service users holistic needs. Staff were provided training to meet service users assessed needs and they seek professional help and support from district nurse, tissue viability nurse and other specialist services. Staff have understanding and are able to meet service users socio-cultural and religious needs. A part-time activity coordinator assists service users indoor and outdoor activities. Standard six is not applicable to this service, as they do not provide intermediate care. Albany Nursing Home DS0000025945.V264597.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): 7,8,9 and 10 The service demonstrates that service users health and personal care needs are met. Care plans are reviewed on a monthly basis. Staff seek specialist advice and support to meet service users assessed needs. EVIDENCE: It was evident from examining service users files and discussion with staff and the registered manager that care plans were generated from comprehensive assessments of care managers/health professionals. For service users who are self funded care plans were developed from comprehensive assessments carried out by the manager/deputy manager. Staff interviewed and daily records showed how care plans were implemented. The named nurses review care plans on a monthly basis. Service users were referred appropriately to health and social care professionals. Nurses carry out nutritional assessments for service users. Staff were provided training for the better management of pressure sores and ulcer care. The management also consult with Tissue Viability Nurse specialist and take advice for the better management of pressure sores. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 10 The management provides appropriate pressure relieving equipment for service users who are suffering from pressure area problems. The home has employed a physiotherapist who works twice a week to assess and support service users who have mobility problems. Following the recommendation of the previous inspection report it was evident that the home works in partnership with service users families in order to meet their socio-cultural and religious needs. These were recorded in service user’s care plans. From discussion with qualified nurses and examining documentation, for example, Medication Administration Record (MAR) sheets it was evident that registered nurses administer all medications and keep records on MAR sheets. The nurses keep appropriate records of all medications received and leaving the home. The medications are disposed of by an appropriate organisation to ensure that there is no mishandling. Nurses also keep records of temperature of the clinical room and this was found to be below 25 degree centigrade. Registered nurses also administer controlled drugs as prescribed by G.P. At the time of the inspection no service user was prescribed a controlled drug. From the inspector’s observation during the tour of the premises and discussion with staff and service users it was evident that staff respect service users privacy and dignity at all times. Bedroom doors, toilets and bathroom doors were closed during the delivery of personal care. Service users have access to telephones for private use and receive their mail unopened. Staff addresses service users by their preferred names. Albany Nursing Home DS0000025945.V264597.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 14 and 15 The home encourages service users families and friends in to the home. The home arranges individual and group activities for service users. A varied and balanced diet is provided. EVIDENCE: The home employs a part-time activity co-ordinator who works in the afternoon from Monday to Friday. The co-ordinator arranges group and individual activities for service users. She also escorts service users to hair dresser/ shopping trips. A leisure profile of each service user has been compiled. Staff encourage service users to join dial-a-ride and trips outside of the home are prompted as part of their social and leisure profiles. The home employs a gardener to run a gardening club in summer. Service users of Albany Nursing home are able to receive visitors in private in bedrooms, and are able to choose whom they see and do not see. In addition to this, they can meet their visitors on the first floor multi-sensory room while this is not in use. The home does not have any separate visitors’ room. The proprietor is addressing the matter of the provision of a visitors’ room. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 12 Staff encourage service users to handle their own finances and they are able to keep personal allowances in cash tins, which are kept in a safe. Staff also help service users who are able to maintain an individual expenditure book. Information regarding service users access to advocacy services was displayed on the notice boards. Service users have access to Age Concern and Care Aware advocacy services. From examination of the weekly menu and inspector’s observation it was evident that service users receive a varied, appealing, wholesome and nutritious diet which is suited to individual, assessed and recorded requirements. Religious and cultural dietary needs are catered for as agreed at admission and recorded in care plan. The chef was interviewed by the inspector who informed that they are able to meet all dietary needs. The kitchen was found to be very clean and tidy at the time of the inspection. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 13 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): 16,17 and 18 The home has a complaint procedure and this is made available for all relevant parties. The home has an adult protection procedure, which contains guidance for staff to protect service users from abuse. EVIDENCE: The nursing home has a clear and accessible complaint policy and procedure available for relevant parties. A record of all complaints was kept by writing in a complaint book including details of investigation and any action taken. The complaint policy contains the contact details of the Commission for Social Care Inspection. The manager advised that service users were able to exercise their civic rights by voting in this general election. The family members acted as service users advocates to preserve their interests. In addition to this service users and family members were provided information how to get access to advocacy services like Age Concern and Care Aware. The home has an adult protection policy and procedure, which ensures that service users are safeguarded from physical, financial and sexual abuse. The Adult Protection Policy and procedure (including Whistle Blowing) and DOH Guidance ‘No Secrets’. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 14 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 and 26 The home is suitable for its stated purpose. The management is making provision for a visitors’ room and two extra bedrooms. The provider is required to apply for a major variation to the CSCI for this purpose. EVIDENCE: The location and layout of Albany nursing home is suitable for the service users currently living in the home. However, the current facilities are not fully suitable for young adults with complex disabilities. The manager must ensure that the home has appropriate facilities to meet the needs of service users as identified by the admission and continuing assessment process. As stated before, there is no separate visitors’ room and this will be addressed during the building extension. The registered manager informed the inspector that the proprietor has applied for planning permission for the extension of the building. This plan includes provisions for two extra bedrooms for service users, storage and a visitors’ room. The inspector advised that the Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 15 management must apply for a major variation should they wish to increase bed numbers for service users. Service users are able to smoke in a designated area and a risk assessment is in place for each service user who smokes. At the time of the inspection the premises were clean, hygienic and free from offensive odour throughout. The policies and procedures for control of infection include the safe handling and dispose of clinical waste; dealing with spillages; provision of protective clothing and hand washing. Washing machines have specified programming ability to meet disinfection standards. The nursing home has a sluicing facility and sluicing disinfector. Albany Nursing Home DS0000025945.V264597.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): 27,29 and 30 Current staffing level is sufficient for meeting service users current assessed needs. The home operates a recruitment policy based on equal opportunities. The management is required to provide staff training on dementia awareness. EVIDENCE: From the examination of staff rota and discussion with the manager it was evident that the management has reviewed staffing levels. Currently 15 registered nurses and 39 (part time/full time) care staff and 18 ancillary staff (part time/fulltime) are employed by the home in addition to the registered manager and deputy manager. During the day 3 registered nurses and 11 care workers are on duty in each shift. At night 3 registered nurses and 3 care workers are on duty. At the time of the inspection the home employed three adaptation nurses. The registered manager informed that the present staffing ratio is 1:10. The home’s written policies and procedures relating to the recruitment and selection process were robust. The management operate a thorough recruitment procedure based on equal opportunities. The management receive two references for each staff member prior to employment. The management ensures that all staff have current CRB disclosures. The management had introduced an induction programme for all staff, which complies with TOPSS standards. Two newly appointed care assistants informed Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 17 that they were properly inducted and have opportunities to attend various training. The home is arranging infection control training. A care assistant also informed the Inspector that she has completed her NVQ level three training recently and was going to attend medication administration training though she doesn’t administer medication. However, it was evident that staff work across the floors and some of the service users accommodated on the ground floor had been diagnosed with dementia. Therefore, the management must provide staff with dementia awareness training. The registered manager informed that she would arrange such training for all staff. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 18 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): 31,33,35,36 and 38 There is a system in place to monitor the quality of the service. The newly appointed manager to apply for her registration to the CSCI. The manager to ensure that all staff receive one to one supervision at least six times a year. EVIDENCE: The registered manager is a qualified RGN and experienced to run a nursing home. She is able to demonstrate leadership through her communication with members of staff to deliver an effective service for the service users accommodated in the home. However, the registered manager informed that a new manager would be appointed to the registered post, and current post holder would be promoted within the organisation. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 19 The inspector advised that the newly appointed manager must apply for her registration to the CSCI including the CRB disclosure through the Commission. The management ensures that there is an effective quality monitoring system in place to measure success in meeting the stated aims, objectives of the home. The nursing home carries out service users’ and relative’s satisfaction survey questionnaires on a periodic basis. The results of service users surveys were published and was made available to current, prospective service users and for other relevant parties. Service users financial interests were safeguarded and there were procedures in place. The majority of the service users’ finances are looked after either by the Court of Protection or by family members. The registered manager ensures that the employment policies, procedures induction and training arrangements are put in place. The registered manager and clinical nurses have supervisory responsibilities to supervise care assistants. However, it was evident from the examination of documentation and discussion with staff that not all are receiving regular one to one supervision as part of the formal support from the management. The inspector fedback to the registered manager and stated that the management must ensure that all staff receive a minimum of six one-to-one supervisions in a year. The manager ensures staff and service users health, safety and welfare. Staff were provided training with manual handling, fire safety, first aid, food hygiene and infection control. Regular checks are carried out on gas and electric appliances. Staff carry out fire alarm tests on a weekly basis. The home has a valid insurance cover against loss or damage to the assets of the property. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 20 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 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 2 x 3 Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 21 Yes 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 OP 19 Regulation 39 Requirement Timescale for action 31/03/06 2 3 OP 30 OP 31 18 9 4 Op 36 18 The registered provider is required to apply for a major variation to the Commission should they wish to increase bedrooms for service users. The registered provider to 31/03/06 ensure that all staff receive dementia awareness training. The newly appointed manager to 30/11/05 apply for her registration to the CSCI and CRB disclosure through the Commission. The registered manager must 31/12/05 ensure that all staff receive a minimum of six, one to one supervisions in a year. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 22 No. 1 Refer to Standard OP13 Good Practice Recommendations It is recommended that the manager to submit an action plan to the CSCI addressing the matter of the provision of a visitors’ room. Albany Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Nursing Home DS0000025945.V264597.R01.S.doc Version 5.0 Page 24 - 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!