Inspection on 20/03/06 for Albemarle

This inspection was carried out on 20th March 2006.

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

Albemarle 15/11/07

Albemarle 19/07/06

Albemarle 29/09/05

Albemarle 02/11/04

Albemarle 25/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Albemarle 50 Kenilworth Road Leamington Spa Warwickshire CV32 6JW Lead Inspector Deirdre Nash Unannounced Inspection 20th March 2006 11:00 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 Albemarle DS0000004202.V287208.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. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Albemarle Address 50 Kenilworth Road Leamington Spa Warwickshire CV32 6JW 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) 01926 425629 01926 315627 The Albemarle Rest Home Limited Ms Sonia Penelope Meade Care Home 24 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (24) of places Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2005 Brief Description of the Service: Albemarle is a care home providing personal care and accommodation for 24 older people aged 65 years and over. The home is located in Leamington, close to shops, pubs, the post office and other amenities. The home provides 24 single rooms, 20 of these are en-suite. Nine bedrooms are on the ground floor; seven of these have en-suite facilities. There are six bedrooms on the first floor, all have en-suite facilities and there are a further eight bedrooms on the mezzanine floor, six of these have en-suite facilities. All floors are accessible by use of a chairlift and stairs. The home has a large garden to the rear of the property, which is well maintained and easily accessible. There is ample parking at the front of the house. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector called without any notice. She looked around the home and spoke to five residents and five staff including the Deputy Manager. She also looked at the care file for one resident and at other general documents. What the service does well: What has improved since the last inspection? What they could do better: Although there is no indication that residents are in any thing other than safe hands, the procedures used for hiring staff still need to be tighter to fit what the law requires to protect vulnerable people. The home has been told about this twice before and we are considering taking enforcement action to improve this. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 6 The interior of the home is well decorated but patterns in floor and wall coverings are powerful. More thought needs to be given to the effect that décor can have on the ability of people with dementia to find their way through a house confidently. There is information about this in the professional journals. The registered person failed, by the time that this report went to the publishers, to provide us with an action plan for putting these improvements in place 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. Albemarle DS0000004202.V287208.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 Albemarle DS0000004202.V287208.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): 0 EVIDENCE: Albemarle DS0000004202.V287208.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 Service user plans are up to date with residents changing conditions and needs and contain specific healthcare information plans for addressing psychological needs and leisure needs. Residents experience a consistent and professional approach to their care. The home is in regular contact with community healthcare workers, specialists and social workers. Residents receive the same healthcare services as the rest of the community. EVIDENCE: The care plan of one resident was looked at. It was chosen because this person is currently room bound. It clearly set out what this residents care should be like. There was sufficient detail supported by a range of information collected daily about the well being of this resident. This included fluid and diet intake and skin viability information. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 10 Staff were seen making records and when questioned were clear about how this resident is to be looked after and why. It could be seen that with the help of community health care specialists the home has turned around the physical and mental health of this resident in just a few months and opened up her life again. The home is commended for its systematic, optimistic and compassionate approach to caring for resident’s health at the same time as addressing their social care needs. The resident told the inspector that she is well looked after. Care plans are reviewed monthly by the manager or a deputy using a range of records made over the previous month about the individuals well being. Record sheets are collated in monthly bundles to facilitate this process. This is a systematic and efficient approach to using information. Albemarle DS0000004202.V287208.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, 15 The home provides some daily activities and occupation for residents and staff speak to them. Resident’s psychological health is supported. EVIDENCE: The manager is establishing a system for collecting information about individual’s interests and hobbies and staff were seen involving residents in the lounge in some physical activity. One member of staff at least has considerable crafts knowledge and flower arrangements were around the small lounge. A number of residents were reading newspapers and magazines. Staff could be heard talking to residents in bathrooms and speaking to residents as they helped them to eat a meal or to take a drink. Although the atmosphere in the home was calm there was a constant low-level buzz of chat and movement. The Inspector had lunch with four residents; they each agreed that the food is good. The main meal is served at lunchtime and there were three courses. No one was rushed through his or her meal and staff spoke to residents while they helped them to eat. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 12 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 The home responds to complaints and takes them seriously. Residents are encouraged to speak out. EVIDENCE: The home keeps a log to record any complaints and the action taken to respond to them. The last entry however had not been completed properly with the outcome written in although the manager was able to describe what action had been taken. Complaint records must be complete. The Commission for Social Care Inspection has received no complaints about the home since the last inspection. A recommendation was made at the last inspection for the home to update and improve it written policy and procedure for responding to any allegation or suspicion of abuse of a resident. At this visit there was no policy or procedure available at all. The manager was able to describe the appropriate response and reported that she has been going through most policy documents systematically since she arrived in post. This is positive but written policy and procedure must be produced for this important area and include the multi agency agreement on protection. Then staff must be made aware of it. There was evidence that staff have undertaken some DVD based training on recognising abuse, completed multiple choice questionnaires were seen in staff files. This is also positive and now must be supported by a policy commitment and education in appropriate procedures for action. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 13 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): 20, 25, 26 The house is clean, tidy and warm. Residents enjoy a comfortable home. Decorative patterns in carpets and wallpapers are strong. Residents with some confusion may experience difficulty recognising different floor levels, staircases and rooms. EVIDENCE: The Inspector called unannounced and the home was clean and tidy and smelled clean. It was a cold day but the house, including the bedrooms were warm. The wallpaper and carpets in the communal areas and stairs, corridors and landing have powerful floral and stripped patterns. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 14 The home is registered for three people with dementia but other residents have some degree of cognitive impairment. The décor of an interior can have a big effect on the perception of space and depth for people with cognitive impairment and can further confuse them. This can lead to a reduction in confidence to move about independently. It is recommended that the manager takes the opportunity when an area is to be redecorated to make sure that an ‘enabling’ style is chosen. There is advice and guidance in the professional journals. Albemarle DS0000004202.V287208.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, 29 The home is well staffed but managers are still not being careful enough about the procedures followed to take on new staff. Residents may be at risk from people who are not suitable to work with them. EVIDENCE: There were five care staff on the morning shift and four care staff plus a deputy on the afternoon shift until 9pm. This is sufficient staff for the number and the needs of current residents. One resident was out of necessity confined to her room. Staff were seen calling on her half hourly. The home has two staff at night neither of which sleep. One staff file was looked at, the most recent recruit to the team. No Criminal Records Bureau Enhanced Disclosure application had been made for this worker. The manager thought that the owner had done it and vice versa. No POVA First check had been made either. The manager said she did not know how to do it. The Inspector referred her to the CRB website and gave her a copy of the Department of Health Guidelines to photocopy. The manager said that this worker is has not been permitted to work alone. This safeguard must continue until the checks have been made. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 16 There was no evidence in this staff file that the manager had accounted for a gap of nearly two years in the employment history. Even had a POVA First check been carried out, this recruitment system is not rigorous enough to qualify for the exemption of starting a worker in advance of a CRB Disclosure arriving. The home has been told to improve its recruitment practices in these areas before. The previous two inspections, 29th September 2005 and 2nd November 2004, made requirements under regulation 19 about recruitment practices. An immediate requirement was made at the inspection of 2nd November 2004 about information and proofs and an immediate requirement has been made again this time. The registered person has been reminded before about responsibilities for this important safeguard and the Commission is considering taking enforcement action. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36 Management and leadership of the home has improved considerably since the last inspection. The home is run professionally and in the best interests of its residents. EVIDENCE: The home has a registered manager who has the professional Award at level 4. Noted above care planning and monitoring has improved greatly since last year. There are two deputy managers and also a system whereby a’ responsible body in charge of the shift’ is rotated through the staff group to share the development of leadership skills and accountability. The owner is in the home daily. Supervision records for December 2005 were seen for staff and also an appraisal record. This is very positive progress but regular dates have not been diarised for a rolling programme of one to one meetings. This must now be done. Albemarle DS0000004202.V287208.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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 x 3 x x x x 3 x STAFFING Standard No Score 27 3 28 x 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x 2 3 x Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 19 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 OP1 Regulation Requirement Timescale for action 30/11/05 4,5Schedu The registered person must le 1 review and update the Statement of Purpose and Service User Guide to ensure compliance with the regulations and standards. (the previous timescale of 28/02/05 was not met) Not inspected this time 13(2) The registered person must ensure that all medication is disposed of safely and correctly and that a record is kept of their disposal. (Not inspected this time) 2. OP9 30/11/05 3. OP29 7,9, 19Sch 2 The responsible individual and 22/03/06 manager must ensure that all staff files contain the information required in Schedule 2 of the Care Home Regulations 2001, including proof of permission to work in the UK.[made at 29/09/05 inspection :compliance date 31/12/05] Immediate requirement to comply with this regulation made again at this inspection-apply for CRB Disclosure and POVA First check on named worker DS0000004202.V287208.R01.S.doc Version 5.1 Page 20 Albemarle 4 OP22 22 5 OP18 13 6 OP36 18 The registered person must 15/04/06 ensure that records of complaints are fully completed to include action taken and outcome The registered person must 01/05/06 ensure that a written policy and procedure is produced to respond to suspicions or allegations of abuse of residents and that staff are made familiar with it. The registered person must 01/05/06 ensure that staff have at least six individual professional supervision sessions each year with their manager. Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 21 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. 2. Refer to Standard OP4 OP9 Good Practice Recommendations Accidents/incidents should be audited monthly and action taken as appropriate to reduce risks identified. The manager should consider changing the use of 14 week Medication Administration Record Sheets to 28 day Medication Administration Record Sheets. The manager should consider the use of Medication Administration Record Sheets for recording the receipt of medication. The manager should take opportunities to make the interior décor in the home less likely to disable residents with confusion and other cognitive impairment. 3. OP9 4. OP20 Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Albemarle DS0000004202.V287208.R01.S.doc Version 5.1 Page 23 - 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. 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