Inspection on 19/06/06 for Albany Nursing Home

This inspection was carried out on 19th June 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.

Other inspections for this house

Albany Nursing Home 08/05/07

Albany Nursing Home 10/11/05

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 Key Unannounced Inspection 19th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 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 Mrs Janis Albinia Lin Warawi 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.V300169.R01.S.doc Version 5.2 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 10th November 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 of the nursing home is Top Care Limited. The home can accommodate a total of 55 service users and provides nursing care for older peoples and younger adults with physical disabilities. There is one double bed room and the remainder are single and all rooms are en-suite. The staff team consists of 38 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 3 registered nurses and 12 care workers and 1 ancillary staff on duty on each shift. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 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 19/06/06. The inspector spoke to fifteen service users and interviewed the newly appointed registered manager, the deputy manager, two registered nurses, the activity co-ordinator and three care assistants. The inspector also spoke to a speech and language therapist who was visiting service users in the home. A tour of the premises was conducted during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered manager to ensure that all staff receive dementia awareness training. The registered manager and the deputy manager to continue with staff supervision and ensure that all staff receive one to one supervision at least six times a year. The management must ensure that all staff receive annual appraisals. The registered provider to apply for a major variation should they wish to increase service users numbers. The registered manager to ensure that the results of service user surveys are published and made available to all relevant parties. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 6 The registered provider to apply for a major variation for service users who are out of categories and how their needs would be met. 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.V300169.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 The quality in this outcome area is adequate. This judgement had been made using available evidence including a visit to this service. The admission procedure of Albany Nursing Home ensures that service users assessment of needs is carried out prior to the admission. However, the registered provider to apply for variations for service users who are out of categories and how their needs would be met. EVIDENCE: Three newly admitted service users files were examined during the inspection process which confirmed that the home has carried out pre-admission assessment of the prospective service users prior to the admissions to the home. The management has informed the inspector that six of the service users are self-funded. 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. The registered manager who has completed her Registered Manager’s Award (RMA) and the deputy manager is a Registered General Nurse (RGN) and have experience and skills to carry out assessment of needs, carried out preAlbany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 9 admission assessments of the prospective service users prior to the admissions to the home. However, it was evident that some of the service users had been diagnosed with dementia as secondary needs in addition to their primary care needs (nursing care needs). The registered manager is required to apply for a major variation for service users who are out of categories and how their needs would be met. Standard six is not applicable to this service, as Albany Nursing Home does not provide intermediate care. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 The quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. The home can demonstrates that service users health care needs are met. Staff seek specialist advice and support in order to meet service users complex needs. EVIDENCE: Service users care plans were generated from comprehensive assessments of health professionals and home’s own assessments of needs. Staff of the home carry out comprehensive health care needs assessments for newly admitted service users within 24 to 48 hours of their admissions. Then staff begin the process of developing care plans within three to four days. Staff interviewed and daily records showed how care plans were implemented on a daily basis. The name nurses who act as key workers for individual service users review care plans at least once a month. Care files examined indicated that service users were refereed appropriately to health and social care professionals. Registered nurses carry out nutritional assessments for each service user. Staff were provided training for better management of pressure sores, catheter care and ulcer care. The management consult with Tissue Viability Nurse specialist and take advice for the better Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 11 management of pressure sores. Staff provided appropriate pressure relieving equipment for a service user who is suffering from pressure sore area problem. The inspector observed at the time of the inspection that a speech and language therapist and occupational therapist were supporting service users who were recovering from stroke onsets. Registered nurses of the home administer all medications to service users and keep records of medication administration on Medication Administration Record Sheets. Nurses keep records of all medications received from the chemist and medications disposed of by an appropriate organisation to ensure that there is no mishandling. Medication administration records were checked and found to be satisfactory. 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 shut 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.V300169.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. 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 four and a half hours in each afternoon from Monday to Friday. The co-ordinator arranges group and individual activities for service users. The activity co-ordinator informed the inspector that last week she escorted six of the service users to London Eye and escorted other service users to London Zoo recently. 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 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. Information regarding service users Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 13 access to advocacy services was displayed on the notice boards. Service users have access to Age Concern and Care Aware advocacy services. It was evident from the examination of weekly manus 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. A newly admitted service user informed the inspector that she likes the foods provided and other service users spoken to had similar views. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. 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 to all relevant parties. The complaint procedure of the home was displayed on the hallway for visitors and service users attention. A record of all complaints was kept by writing in a complaint folder including details of investigation and any action taken. 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’ were available for inspection. The registered manager informed that the next elder abuse training will take place in July 2006. The registered manager is aware of her responsibility to refer member of staff to POVA register who has harmed service user in their care. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The quality in this outcome area is adequate. This judgement had been made using available evidence including a visit to this service. 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 the management at Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 16 the last inspection that the home must apply for a major variation should they wish to increase bed numbers for service users. The newly registered manager informed the inspector that they intend to apply for a major variation in the near future. Service users are able to smoke in a designated area and a risk assessment is in place for each service user who smokes. A tour of the premises was carried out during the inspection. It was found that 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.V300169.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 The quality in this outcome area is adequate. This judgement had been made using available evidence including a visit to this service. Current staffing level is sufficient for meeting service users current assessed needs. The home operates a recruitment policy based on equal opportunities. However, the management is required to provide staff training on dementia awareness. EVIDENCE: The management had reviewed staffing levels. Currently 15 registered nurses and 38 (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 12 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 two adaptation nurses. Staff interviewed informed that regular staff meetings take place and they have opportunities to discuss issues if they wish to. The registered manager informed that they have facilitated staff meetings for the night staff as well. The registered manager and the deputy manager have attended night staff meetings. The management and staff advised the inspector that 16 of their care staff have completed their NVQ level 2/3 in care and other four staff are currently attending NVQ level 2 training in care. In addition to this currently two qualified nurses are working as adaptation nurse and three other qualified Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 18 nurses are working as care assistants. Therefore, the home met this standard in full. 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 inspector examined newly appointed member of staff’s files and found to be satisfactory. The management had introduced an induction programme for all newly appointed staff, which complies with TOPSS standards. Newly appointed care assistants informed that they were properly inducted and have opportunities to attend various training. All registered nurses of Albany Nursing Home attend a minimum of two clinical training in a year at Whips Cross hospital. Registered nurses interviewed confirmed that both of them recently attended care planning and management of leg ulcer training at Whips Cross. The inspector examined the ‘Clinical Skills Service, A3’ training programme for 2006. The deputy manager and registered manager informed the inspector that registered nurses are encouraged to attend clinical training in order to update their knowledge in the clinical areas. 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 as a secondary needs in addition to their nursing care needs. Therefore, the management must provide staff with dementia awareness training. The registered manager informed that she has now received all training materials and would arrange such training for all staff in July 2006. This standard will be assessed at the next inspection. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 The quality in this outcome area is adequate. This judgement had been made using available evidence including a visit to this service. The management must ensure that all staff receive at least six supervision in a year and annual appraisals. The management must publish the results of the service users satisfaction questionnaires. EVIDENCE: The new manager of Albany nursing Home was appointed in December 2005. She is a non-nurse manager. However, she has successfully completed her registration with the CSCI and received the registration certificate in May 2006. She had several years of management experience in domiciliary care services with the London Borough of Waltham Forest prior to her appointment. The job description of the registered manager enables her to take responsibility for fulfilling her duties. She has completed her Registered Managers Award (RMA) in May and now waiting for the certificate. The registered manager to send a copy of her certificate to the CSCI when this is obtained. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 20 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. However, the results of service users surveys to be published and made available to current, prospective service users and for other relevant parties. The registered manager showed the evidence of some completed questionnaires and assured the inspector that once majority of those are collected she will publish the results of the surveys. Service users financial interests were safeguarded and there were procedures in place. The majority of the service users’ finances are looked by family members. The management advised the inspector that 51 of the current service users finances are managed by their family members. Two of the service users finance is managed by the Court of Protection/Receivership. In addition to this service users can keep their personal allowances to a safe for looking after. As the registered manager is a non-nurse manager, the deputy manager has supervisory responsibility to supervise all clinical nurses and the manager supervise all care assistants and ancillary staff. The registered manager showed evidence that she has started one to one supervision process since January 2006 and minutes of supervision notes were available for inspection. The deputy manager has started one to one supervision with all clinical nurses since May this year. She has shown the evidence of this. The inspector advised the management that they must continue the individual supervision with all staff and make sure all staff receive at least six supervision in a year and they all receive annual staff appraisals. 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. A fire risk assessment of the premises is completed. The home has a valid insurance cover against loss or damage to the assets of the property. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x 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 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 2 x 3 Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 39 Requirement The registered provider is required to apply for a major variation to the CSCI should they wish to increase bedrooms for service users. The registered provider to ensure that all staff receive dementia awareness training. The registered provider to ensure that the results of service users surveys are published and made available to all relevant parties. The registered provider to ensure that all staff receive a minimum of six, one to one supervision in a year and they all receive annual appraisals. The registered provider to apply for a major variation for service users who are out of categories and how their needs would be met. Timescale for action 30/04/07 2. 3. OP30 OP33 18 35 30/04/07 30/04/07 4. OP36 18 30/04/07 5. OP3 14 & 15 30/04/07 Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP13 Good Practice Recommendations It is recommended that the management to submit an action plan to the CSCI addressing the matter of the provision of a visitors’ room. Albany Nursing Home DS0000025945.V300169.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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. 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