Inspection on 20/06/06 for Albany Park Nursing Home

This inspection was carried out on 20th June 2006.

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 Park Nursing Home 19/05/09

Albany Park Nursing Home 24/05/07

Albany Park Nursing Home 07/11/05

Albany Park Nursing Home 05/04/05

Albany Park Nursing Home 30/09/04

Albany Park Nursing Home 04/05/04

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

CARE HOMES FOR OLDER PEOPLE Albany Park Nursing Home 43 St. Stephens Road Enfield Middlesex EN3 5UJ Lead Inspector Tony Brennan Key Unannounced Inspection 20th 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 Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 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 Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Albany Park Nursing Home Address 43 St. Stephens Road Enfield Middlesex EN3 5UJ 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) 020 8804 1144 020 8804 7733 GSG Nursing Homes Limited Ms Milda Williams Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Room 12, ground floor, is unsuitable for wheelchair dependent service users. 7th November 2005 Date of last inspection Brief Description of the Service: Albany Park Nursing Home is a purpose built care home registered to provide nursing care for a maximum of forty-three service users. Albany Park is to provide nursing care for older people. It is owned by GSG Nursing Homes Ltd. The home is a detached four-storey building. All bedrooms have en-suite facilities. The home is situated in a residential area. It is close to shops, restaurants and public transport links. Fees are linked to the assessed level of nursing care that servcie users need. These range from £525 to £560 a week. Privately funded service users pay £635 a week. This report is available through the internet. Copies may also be obtained from the provider of this service. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken as part of the annual inspection programme. The inspector also sought to confirm that the home has continued to improve since the last inspection. The inspection took place over one day. The registered manager, Millie Williams, assisted the inspector with part of the inspection. The inspector spoke with six people who live at Albany Park and five staff. The inspector observed care practice and interaction between service users and staff. The inspector toured the building and examined a number of records relating to the care, health and safety and management of the home. The inspector would like to thank the registered manager and staff who assisted him by answering questions about the running of the home. The inspector would also like to thank those people who live at the home who discussed their views of the service they receive. What the service does well: What has improved since the last inspection? What they could do better: A service user said “some staff do understand my needs and others don’t”. The inspector found that care plans did not provide guidance on how the needs of people should be met. The preference and choices of those who live at the home had not been included in their care plan. People living at Albany Park had not been involved in the development of plans to meet their needs. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 6 There had been a recent complaint involving one of the people who live at the home. The registered persons need to ensure the safety of this person in light of the investigation. Training needs to be provided on the provision of activities, adult protection, dementia and person centred care. This will ensure that the needs of those who live at the home are met sensitively. 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 Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 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 Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 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 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users needs are assessed prior to admission to the home to ensure they receive the care and support they require. EVIDENCE: A service user said, “staff are understanding and kind. The inspector found that service users files contained assessments carried out by the home and from care management. The registered manager explained That she or senior nursing staff carry out assessments. Staff spoken to understood the needs of individual service users. Training records showed that staff had received training on areas relevant to meeting the needs of service users. Care plans did not highlight all the needs identified in initial assessments. Staff were observed interacting with service users. The inspector found that staff had difficulties in communicating with service users effectively. These issues are addressed further in the relevant outcome areas in this report. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 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 10 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users personal, social and medical care needs are not planned for and met. Service users are fully protected by safe procedures for handling medication. Service users right to privacy is supported. EVIDENCE: A service user said “some staff do understand my needs and others don’t”. The inspector examined the care plans for a number of service users recently admitted to the home. One of these was discussed with staff who explained that the servcie user refused support with personal care. The service users care plan did not contain information on how this should be handled. Service user care plans did not outline service users preferences and choices as to how they wished to be supported. There was no evidence that service users or their representatives had been consulted about the content of their care plans. There are falls, nutrition and manual handling assessments in place that outlined service users needs. Service users had been assessed for susceptibility to developing pressure sores. The tissue viability nurse had been consulted about appropriate treatment where this was necessary. Service users records also showed that they had access to medical support they needed. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 10 Records for medication received, administered and returned were all complete. The medication policy covered all the areas necessary to ensure detailed guidance on the handling of medication was provided to staff. The inspector spoke with staff and examined training records that showed that staff training had been received on this system. Staff were observed administering medication and saw that this was done safely. The inspector observed staff assist service users and this was done sensitively, with time taken to explain what was happening. Staff were observed to knock on service users bedroom doors before entering. The inspector observed interaction between service users and staff and found that staff treated service users with respect. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 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 15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are provided with sufficient and varied activities to meet their needs. Service users are supported to maintain contact with relatives and other representatives of their choice. Service users are able to make choices about how they live in the home. Service users are provided with varied and balanced meals. EVIDENCE: The inspector observed service users taking part in activities on the day of the inspection. Bingo and listening to music were provided and staff were observed encouraging and supporting service users to take part. Service users enjoyed both these activities. The inspector saw that there was an activities plan. The registered manager explained that the activities organiser had recently resigned. Staff are providing activities on a daily basis. The inspector spoke with staff and looked at training records. These showed that staff had not received training in the provision of activities. This was discussed with the registered manager who agreed to ensure staff are trained to deliver activities. A service user spoken to explained that they go to church regularly and staff provide support to do this. Service users and relatives spoken to confirmed that there was no restriction on times of visits. A service user said, “people come and go as they like”. The Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 12 chef explained that service users were asked what they would like to eat each day. A service user said that staff “ask me what I like to eat”. The menu showed that a range of meals was offered. A service user commented that the food was “very good”. Another service user said, “the food is excellent”. The registered manager explained that service users are consulted about the menu. The inspector saw that meals were well presented and they were provided in a relaxed environment. Sufficient staff were available and when necessary service users were observed being assisted to eat. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 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 18 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: The complaints policy explained how to make a complaint and how it would be dealt with. This was displayed around the home. The complaints record showed actions taken to resolve complaints. There were two complaints since the last inspection. There was a clear record of complaints and how they had been responded to. One of the complaints that had been investigated by the home involved the use by a member of staff of inappropriate language towards a service user. The service user involved spoke with the inspector and raised concerns about the way the complaint had been resolved. The inspector discussed this with the registered manager who explained that the member of staff involved would be returning to work at the home. The registered persons need to inform the Commission how they are going to safeguard the service user involved in this complaint. A service user said, “ you can say what you like”. Service users said that they felt safe and could approach staff if they had any concerns regarding how they are treated. There were comprehensive policies on handling abuse and protection. Discussion with staff and the training records showed that staff need to be trained in adult protection. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 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 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in a safe and comfortable environment. The home is a clean and hygienic environment for service users to live in. EVIDENCE: The inspector toured the building and fixtures and furniture were all in working order. The home was appropriately decorated. The registered manager explained that there was an on-going maintenance programme for the home. Bedrooms were personalised with service users effects. A service user said, “my bedroom is how I want it”. The inspector found that the home was clean and hygienic. Guidance and procedures were in place to prevent cross infection. Protective clothing and hand washing facilities are available to staff throughout the home. The sluice rooms were tidy and in working order. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 15 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 30 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Sufficient staff are available at all times to meet service users needs. Staff do not have the skills to meet all the assessed needs of service users. Service users are protected by the home’s recruitment practices. EVIDENCE: The rota showed that a consistent level of staffing is maintained. Service users and staff spoken to felt that there were sufficient staff available. A service user spoken to said, “staff are well informed and I am sure they know what they are doing”. Staff spoken to and training records confirmed that staff had achieved National Vocational Qualification at level 2 in care. A number of staff have commenced the National Vocational Qualification at level 3. Training records also showed that staff did have all the statutory required training. However, training is required in the area of adult protection. Nursing staff spoken to confirmed that they had training on tissue viability, PEG feeding and taking blood. The inspector observed care practice and found that staff needed guidance and training on how to care in a person centred way. The inspector observed staff dealing with a service user who had a degree of confusion and found that they had difficulty in finding appropriate methods of communication with the service user. Training needs to be provided in dementia care. The inspector examined staff records, which contained all the required information. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 16 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 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The registered manager does have all the necessary qualifications to manage the home effectively and in the best interests of service users. Service users are consulted about the quality of the service provided and encouraged to make suggestions for improvement. Service users financial interests are protected by the home’s procedures. Staff are supervised to ensure they are supported to meet the needs of service users. Service users and staff are not protected by the home’s health and safety procedures. EVIDENCE: The inspector spoke with the registered manager who explained that she has completed the Registered Manager’s Award and has a number of years experience in management. The registered manager explained that she is planning to do further training on areas of nursing practice relevant to her work. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 17 Servcie users have been consulted about the quality of the service that the home provides. The inspector found there was a system to ensure this was done regularly. The home has no outstanding complaints. Minutes of service user meetings showed that servcie user views are sought on a regular basis. Their relatives or social service departments manage service users finances. Records are kept of any small amounts of money held by the home for three service users. These showed that monies spent had been signed for and receipts were obtained. Staff supervision records were complete. Staff had received supervision every two months. Staff spoken to confirmed that they had been supervised. Staff are being supported to care for service users. Records showed that fire equipment was tested regularly and maintained. Drills were taking place. The inspector questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. Records showed that staff had received training on health and safety topics. The inspector found that the first aid boxes did contain all the necessary items required to ensure that basic treatment could be offered in the event of an accident to service users or staff. The inspector discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for recording accidents. There was a record of food prepared each day, the record of food temperature did specify what had been prepared. Fridge and freezer temperature were within safe limits. Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 18 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 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 3 X 3 3 X 3 Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) Requirement The registered persons must ensure that care plans give detailed action to meet the needs of service users. The registered persons must ensure that care plans contain information regarding the personal choices and preferences of service users. The registered persons must ensure that service users and their representatives are consulted regarding the content of their care plans. The registered persons must ensure that staff receive training in the provision of activities for service users. The registered persons must ensure that they provide the Commission with written details of how they will protect the service user involved in a recent complaint. The registered persons must ensure that staff have training on adult protection. The registered persons must ensure that training is provided DS0000027799.V289904.R01.S.doc Timescale for action 01/10/06 2 OP7 15(1) 01/10/06 3 OP7 15(1) 01/10/06 4 OP12 18(1) 01/10/06 5 OP16 13(6) 30/09/06 6 7 OP18 OP30 13(6) 18(1) 18(1) 01/10/06 01/11/06 Albany Park Nursing Home Version 5.1 Page 20 on dementia care and person centred approaches to care. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Albany Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Park Nursing Home DS0000027799.V289904.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!