Inspection on 08/05/07 for Albany Nursing Home

This inspection was carried out on 8th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Albany Nursing Home 19/06/06

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 Ms Gwen Lording Unannounced Inspection 8th May 2007 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 Nursing Home DS0000025945.V337733.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.V337733.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.V337733.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 19th June 2006 Brief Description of the Service: Albany Nursing Home is a purpose built care home owned and operated by Topcare Limited. The home is situated in a residential area of Leyton in the London Borough of Waltham Forest and is close to shops and public transport. The home can accommodate up to 55 people and is registered to provide nursing care to older people; and younger adults with physical disabilities. There is one double room and the remainder are single rooms with ensuite facilities. Accommodation is over three floors and each floor has a lounge and separate dining room. On the day of this inspection the range of fees for the home was between £565.00 and £1600.00 per week. A copy of the Statement of Purpose and Service User Guide to the home and a copy of the most recent inspection report is located in the reception area or made available on request. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection undertaken by the lead inspector Gwen Lording. It started at 09.30am and took place over seven hours. The registered manager was available throughout the visit to aid the inspection process. Discussion took place with the manager, several members of nursing and care staff; kitchen and laundry staff; the home’s physiotherapist and the administrator. The inspector spoke to a number of residents and relatives; and where possible residents were asked to give their views on the service and their experience of living in the home. Nursing and care staff were asked about the care that residents receive, and were also observed carrying out their duties. A tour of the premises, including the laundry and main kitchen, was undertaken and all areas were clean and tidy with no offensive odours. The files of eleven residents were case tracked, together with the examination of other staff and home records. This included medication administration, activity programmes, staff rotas and training records; maintenance records; complaints and staff recruitment procedures and files. Information was also taken from a pre-inspection questionnaire, which was completed and returned to the Commission. As part of the inspection process the views of several community health care professionals who provide a service to the home were sought and are commented on in this report. The people living in the home and the manager were asked how they wished to be referred to during the inspection and in the report. They expressed a preference to be referred to as ‘residents’. At the end of the visit the inspector was able to provide feedback to the manager. The inspector would like to thank the residents and staff for their input during the inspection. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The manager has further developed care plans to make them more ‘person centred’. From discussions with residents, staff and from viewing care plans it was evident that this is generally being positively achieved. More development is needed around areas such as skin and hair care and issues related to individual’s sexuality. However, this was discussed with the manager who would ensure that this is included in care plans. The arrangements for staff supervision have improved and now includes observational and peer supervision. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 8 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.V337733.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 3, 4 & 5 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Comprehensive pre-admission assessments are being undertaken for all residents prior to them moving into the home. Care plans are drawn up from the information in this assessment, ensuring that the needs of the residents are identified, understood and met. The Statement of Purpose and service user guide provide residents and their relatives/ representatives with information about the home. However, consideration must be given to providing the service user guide in alternative formats that are more accessible and easily understood by all current and prospective residents. The home does not offer intermediate care. EVIDENCE: Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 10 Individual records are kept for each resident and a number of files were examined across all units of the home. All records inspected had assessment information recorded and the information had been used to continue assessment following admission to the home, and develop written care plans. The inspector was satisfied that a full assessment of need is undertaken prior to residents moving into the home, and that the manager would not admit a new resident unless she was sure that the assessed needs of the individual could be met. The records showed that residents and their relatives/ representatives are involved in the process. Where appropriate, information provided by the placing authority was also included. Prospective residents and their relatives/ representatives are provided with information about the home and there is always the opportunity to visit the home prior to making any decision to move in. The Statement of Purpose and Service User Guide are both comprehensive documents, which are regularly updated to reflect any changes in the service. However, it is strongly recommended that consideration be given to providing the Service User Guide in alternative formats that are more easily understood and accessible to those residents with specialist needs such as sensory disabilities or people who have special communication needs. All resident receive a contract/ statement of terms and conditions which clearly sets out the fees and includes information about any individual nursing or resident contributions The manager was provided with a copy of the Commission’s ‘Policy and Guidance on Provision of Fees Information by Care Homes’. This sets out what information care home providers need to include in the Service User Guide regarding fees and terms and conditions, and is in a format that is easy to understand. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 & 11 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The health, personal and social care needs of residents are set out in individual care plans and provided staff with the information they need to satisfactorily identify and meet resident’s needs. All residents could be assured that at the time of their death, staff would treat them and their family with care, sensitivity and respect. There are clear medication policies and procedures to follow, so as to ensure that residents are safeguarded with regard to medication. Medication audits are undertaken on a regular basis. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 12 EVIDENCE: Since the last inspection the manager has further developed care plans to make them more ‘person centred’. From discussions with residents, staff and from viewing care plans it was evident that this is generally being achieved. Individual care plans were available for each resident and a total of eleven residents were case tracked across the three floors, and their care plans and related documentation inspected. All residents had comprehensive care plans, which covered health, personal and social care needs. Care plans were specific with regard to cultural and religious needs and how these needs impacted on the type of care provided and the anticipated outcomes for the individual. For example the care plan of one resident specified the individua’ls religious observances and the involvement of his family members. This could be further developed to include reference to needs such as skin and hair care and issues related to an individual’s sexuality. This was discussed with the manager who would ensure that these were included in the care plans. There was evidence that care plans were being reviewed at least monthly and updated to reflect changing needs. As far as possible, residents’ and/ or their relatives are involved in the drawing up of their care plan. The documentation/ health records relating to wound management; management of a resident with complex physical care needs; catheter care; management of insulin dependant diabetes; and a recently admitted resident were examined. The records for these residents were found to be detailed and being adequately maintained. Risk assessments are routinely undertaken on admission for all residents around nutrition, manual handling, continence, falls and pressure sore prevention; and reviewed on a regular basis. In addition the home employs the service of a physiotherapist and she assesses each new resident on admission and is also able to respond in a timely way to any individual’s changing care needs. She undertakes workshops with staff around the importance of appropriate seating and posture for residents. Records are maintained of nutrition, including weight gain or loss with appropriate action being taken where necessary. Records indicated that residents are seen by other health professionals such as tissue viability nurse and diabetic nurse specialists; speech and language therapist; optical, dental and chiropody services. Care plans contained some information on ‘End of Life’ wishes and the importance of developing these was discussed with the manager, during the inspection. However, from discussions with the manager and staff, it was apparent that staff dealt with a person’s dying and death in a sensitive and Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 13 understanding manner, both for the individual and relatives. The registered manager has expressed an interest in implementing the Liverpool Care Pathway (LCP) for the Dying Patient. This transfers the hospice model of care into other settings and has been used effectively in care homes. Residents were being weighed on admission and then generally on a monthly basis and records are maintained of nutrition including weight loss or gain with appropriate action being taken where necessary. However, staff should record such observations in one source only, so as to ensure consistency and provide a more accurate picture of any fluctuations in weight. A number of monitoring charts were examined including blood sugar monitoring, turning charts and fluid intake/ output monitoring charts. The majority of these were found to be in good order. However, a small number of fluid charts were being completed retrospectively by care staff. For example, at 12.00 hours on the day of the inspection the last recorded entry on some charts was 08.00 hours. It is essential that all monitoring charts are maintained accurately and up to date. Staff talked about and were observed to treat residents in a respectful and sensitive manner. They were seen to be very gentle when undertaking moving and handling tasks and offered explanation and reassurance throughout the activity. Several residents were asked about the care they receive in the home. Comments included:”I looked at a couple of homes, but liked this home best. I enjoy my own company and staff respect this”. Another said: “I have lived here for one year, I am very happy, staff are kind and friendly and they understand what I need”. An audit was undertaken for the handling and recording of medicines within the home and a random sample of Medication Administration Record (MAR) charts were examined on each floor. Discussions with staff and the review of medication records show that staff are following policies and procedures, so as to ensure that residents are safeguarded with regard to medication. Medication audits are undertaken on a regular basis. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The lifestyle within the home matches the expectations and preferences of residents and meets individual’s social, cultural, religious and recreational interests and needs. The attitude and practice of staff promote opportunities for residents to remain independent, exercise choice and express their wishes and needs. The nutritional needs of residents are well considered so that food and mealtimes are seen as being important. EVIDENCE: The home employs an activity co-ordinator who works four hours a day, five days a week. On the day of the visit she was on leave. However, planned activities were being carried out by the care staff. There is a programme of planned activities including a variety of large and small group activities such as Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 15 card games, quizzes, carpet bowls and bingo, but there is also an emphasis on meeting individuals preferences and interests. On the day of the visit one resident was being supported and accompanied by a member of staff to attend a Tai Chi session, which he enjoys and regularly attends. The member of staff had been rostered specifically for this purpose. Another resident who prefers to stay in her room is very keen on wildlife. She shares this interest with a member of care staff and they enjoy watching wildlife programmes together on the television in her room or discussing this shared interest. Other recent planned activities have included pub lunches and trips to a local farm. One of the Aims and Objectives in the home’s Statement of Purpose is: Each service users’ needs and values are respected in matters of religion, culture, race, ethnic origin or sexuality. The manager and staff are very aware of promoting issues of equality and diversity and the respect of individuals’ beliefs and cultures. This was evidenced on care plans by the recording of any specific religious observances and how this can be enabled for residents. For example, one resident is afforded a quiet and private environment for religious observance with his family. Other residents are enabled and supported to go to their preferred place of worship. Diets specific to individuals culture and religion are clearly recorded on care plans and provided accordingly, for example Halal diet. Throughout the visit the inspector observed staff allowing time for residents to express their wishes and supporting individuals to make choices in their everyday lives, for example choosing a drink, music they wished to listen to, or where they wished to sit or eat their meal. Menus were inspected and found to be balanced and a choice is offered each day. The inspector was able to observe the lunchtime meal being served to residents on the first floor. Meals are served in the dining room; lounge or residents may choose to eat in their rooms. Meals were served to residents on trays with individual condiments and drinks and dining tables were nicely laid with tablecloths, napkins, cutlery and condiments. There is a small selection of laminated picture menus to assist residents with choices. Staff were on hand to assist individuals when necessary and staff offered such assistance in an appropriate manner and residents were not rushed. Staff discussed the meal and engaged with individuals to make the mealtime an enjoyable experience. A visit was made to the main kitchen and the inspector was able to discuss the storage and preparation of food with the cook and a member of kitchen staff. They were fully aware of those residents requiring special therapeutic diets such as diabetic and low sodium; and those residents with cultural and religious dietary needs, such as Halal diet. They demonstrated a good knowledge and understanding of the importance of a well balanced and well presented meals. Fresh fruit is provided daily and is available on request. One resident likes to have a banana each day with his breakfast. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 16 Relatives/ friends are encouraged to visit the home and there are no restrictions on when people can visit. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The manager and staff make every effort to sort out any problems or concerns. Residents and their relatives/ representatives can be confident that their complaints and concerns will be listened to and acted upon. All nursing and care staff working in the home have received training in safeguarding adults. However, this training must be extended to include all staff working in the home, to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a written complaints policy/ procedure and the complaints log inspected indicated the number of complaints and issues of concern received, and included details of investigation, action taken to resolve them and the outcome for the complainant. All complaints are responded to in writing within the timescales as stated in the policy. Information on making a complaint is on display in the home. The address and telephone number of the local Commission office must be amended as the office changed location last September 2006. Residents and relatives are also able to record any concerns in a book that is kept in the reception area and this is viewed on a regular Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 18 basis by the manager. This means that she can address issues of concerns quickly and take action to resolve such concerns to the satisfaction of the complainant. Those residents and relatives spoken to were aware of how to complain and to whom. Residents said that any concerns are dealt with immediately by the manager and staff so that issues do not escalate and become major concerns or complaints. No complaints have been received by the Commission since the last inspection. There is an in house training programme for staff in safeguarding adults and recognising and reporting abuse. All nursing and care staff working in the home have received this training and this is included in induction training for all new staff. The manager must ensure that this training is extended to include all staff working in the home, for example administrative and ancillary staff. Staff spoken to during the inspection were aware of the action to be taken if they had concerns about the safety and welfare of residents. The manager was clear when such incidents and concerns needed to be referred to the local authority as part of local safeguarding adult procedures. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 22, 24 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The environment is well maintained and the décor and furnishings are of a good standard. This provides residents with a clean, safe and comfortable place in which to live. EVIDENCE: The building was toured by the inspector, accompanied by the manager, at the start of the visit, and all areas were visited later during the day. Some bedrooms were seen either by invitation of the residents, whilst others were seen because the doors were open or being cleaned. Residents are encouraged to personalise their bedrooms and all of the bedrooms seen were very personalised and representative of the occupant’s interests, culture and religion. There is a call alarm system fitted to each bedroom, and is located within easy reach of each resident’s bed. It was noted that some bedrooms Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 20 were being used to store boxes of enteral feeds, catheter drainage bags and nutritional supplements. Whilst it is acknowledged that these are for the use of the occupant’s of the rooms, it is not acceptable to store surplus stocks in residents rooms, as it impinges on their individual, space, comfort and privacy. There were no offensive odours and the home was clean and tidy. The standard of décor, furnishings and fittings are being maintained to a good standard. There is an ongoing programme of refurbishment and re-decoration. The home employs a maintenance person and there is an effective system in place for the staff to report items requiring attention or repair. There is a small area of carpet in the reception area, which is worn, however, the manager stated that this is being addressed. There are a small number of residents in the home that smoke. At the current time there is a small room on the ground floor and on the first floor that are designated as smoking areas. Both these rooms have no natural ventilation or extraction. The manager has received information and is fully aware of the recent legislation regarding smoking in care homes, which comes into effect on the 1st July 2007. The registered providers must ensure that the smoking environment complies fully with the Health Act 2006, Smoke-free (Premises & Enforcement) Regulations 2006; this is to ensure the health of residents. The manager may also wish to make reference to the Royal College of Nursing (RCN) recent best practice guidance for staff and managers on Protecting Community staff from exposure to second-hand smoke. This will ensure that there are adequate systems in place for the protection of staff working in the home. The laundry area was visited and this was found to be clean, with soiled articles, clothing and foul linen being appropriately stored, pending washing. Laundry staff were aware of health and safety regulations with regard to handling and storage of chemicals. Personal Protective Equipment (PPE) such as clothing, gloves, mask and goggles were available and in use. Hand washing facilities are prominently sited and staff were observed to be practising an adequate standard of hand hygiene. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. Residents benefit from a committed staff team who have the skills and training to meet their needs. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: Staff rotas were inspected and the staffing levels and skill mix of qualified nurses and care staff was sufficient to meet the assessed nursing and personal care needs of residents. Care workers were being effectively deployed to ensure that residents’ choosing, or needing to remain in their bedrooms were being cared for appropriately. Albany Nursing Home has a relatively stable workforce and there is no use of agency staff. This is clearly to the benefit of residents since it provides consistency of care, which is important to all residents. Effective team working was observed and evidenced throughout the inspection. Staff interacted well, both with each other and the residents. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 22 Topcare Limited; as an organisation, employs a workforce from diverse cultures and backgrounds. It was apparent at the time of the inspection that the ethnicity of the staff team was generally reflective of the people living in the home. In discussion with the manager and staff they were able to demonstrate an awareness of the importance of understanding and appropriately meeting the needs of all residents, wherever possible around equality and diversity issues. A random sample of the files of the three most recently appointed staff were examined. These were found to be in good order with necessary references, Criminal Record Bureau (CRB) disclosures, and application forms duly completed. It was evident that the recruitment procedures are robust and in accordance with the Care Homes Regulations. From talking to staff and inspecting training records it was evident that nurses and care staff have undertaken a wide variety of training, and that such training is then put into practice within the home to the benefit of residents. Records showed that staff had undertaken training in essential areas such as fire safety, manual handling, protection of vulnerable adults, infection control and first aid. Other staff have undertaken training in understanding dementia, diabetes management and managing challenging behaviour. The planned training schedule identified future training for key staff in vene-puncture and urinary catheterisation. From reviewing staff records and talking to staff, it was evident that the arrangements for staff to receive regular supervision has improved and includes observational and peer supervision. The home has an agreement with Thames University to take student nurses on 8-week placements. Key nursing staff have undertaking the required mentoring courses. In discussion with a student nurse on current placement she commented that it had been a very positive learning experience. The pre-inspection questionnaire completed by the manager states that 50 of care staff are qualified to National Vocational Qualification (NVQ) level 2 or above. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 People using the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The manager of the home is a well qualified and experienced person and residents benefit as the home is run in their best interests. Monitoring visits are undertaken regularly by the responsible individual to monitor and report on the quality of the service being provided in the home. Staff are appropriately supervised and the health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 24 The registered manager has been in post for approximately one year. She is well qualified and experienced to manage the home and meet its stated aims and objectives. She does not hold a registered nursing qualification however, she is ably supported in clinical issues by the deputy manager, who is an experienced and suitably qualified nurse who manages/ advices on the nursing elements of the service. All staff spoken to throughout the visit, both care and departmental staff, spoke positively about how well supported they felt by the manager. Staff receive regular 1:1 supervision, direct observation of care practices and staff group meetings. The responsible individual undertakes Regulation 26 monitoring visits on a monthly basis to monitor and report on the quality of the service being provided in the home. A copy of the report is sent to the Commission. The organisation undertakes annual customer satisfaction surveys and an annual quality assurance report is published. A copy of the 2006/2007 survey of questionnaires sent to relatives was given to the inspector following the visit. One of the main aims of the home is to provide good quality nursing care which is person centred. The results/ responses in the survey positively reflect that this is being achieved. Currently the manager does not act as an appointed agent for any resident. Residents’ financial affairs are managed by their relatives/ representatives. The home has responsibility for the personal allowance of several residents. Through discussion with the administrator and records inspected, there was evidence to show that residents’ financial interests are safeguarded. Secure facilities are provided for the safekeeping of money and valuables held on behalf of residents. A discussion took place with the manager around the recently introduced Mental Capacity Act 2005, which became effective for those people who do not have family or friends from April 2007, and for everybody from October 2007. It is important that this is discussed with people living in the home, staff and relatives, and that the organisation ensures that staff undertake adequate and appropriate training in this important area. A wide range of records were looked at including, fire safety, emergency lighting, water temperatures checks, portable appliance testing (PAT) accident/ incident records, and lift/ hoist maintenance. These records were found to be detailed, up to date and accurate. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 25 Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X 3 X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO 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 OP7 OP11 Regulation 12 & 15 Requirement Timescale for action 30/06/07 2. OP8 12 3. OP16 22 4 OP18 12 & 18 The registered providers must ensure that care plans are more specific with regard to the recording of the care of skin and hair and how these are to be met, and include End of Life choices and decisions. The registered providers must 08/05/07 ensure that where a record of food/ fluid is indicated, that these recordings must be accurately maintained and up to date. The registered providers must 30/06/07 amend the contact details for the local Commission office on the complaints policy. This will ensure that anyone in the home wishing to make contact with us has the correct information. The registered providers must 31/08/07 ensure that training in safeguarding adults is extended to include all staff working in the home, including administrative and ancillary staff. This will ensure that there is a proper response to any suspicion or allegation of abuse. DS0000025945.V337733.R01.S.doc Version 5.2 Albany Nursing Home Page 28 5 OP19 23 6 OP24 23 (2) (l) The registered providers must ensure that the smoking environment complies with the Health Act 2006, Smoke-free (Premises & Enforcement) Regulations 2006. This is to ensure the health of residents. The registered providers must ensure that more suitable arrangements are made for the storage of surplus stock such as nutritional supplements. This will ensure that the storage of such items does not impinge on the individuals space, comfort and privacy. 30/06/07 08/05/07 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 OP1 Good Practice Recommendations Consideration must be given to providing the service user guide in alternative formats that are more easily understood and accessible to those residents with specialist needs such as sensory disabilities or who have special communication needs. Albany Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Nursing Home DS0000025945.V337733.R01.S.doc Version 5.2 Page 30 - 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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