Inspection on 20/09/07 for Albemarle Care Home

This inspection was carried out on 20th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Albemarle Care Home 11/04/07

Albemarle Care Home 11/04/06

Albemarle Care Home 25/10/05

Albemarle Care Home 22/06/05

Albemarle Care Home 27/01/05

Albemarle Care Home 04/08/04

Albemarle Care Home 06/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Albemarle Care Home 4 Albemarle Road Woodthorpe Nottingham NG5 4FE Lead Inspector Karmon Hawley Key Unannounced Inspection 20th September 2007 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 Albemarle Care Home DS0000026406.V348559.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. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albemarle Care Home Address 4 Albemarle Road Woodthorpe Nottingham NG5 4FE 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) 0115 960 7339 0115 962 1841 Mr Abdul Rashid Vacant Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th April 2007 Brief Description of the Service: Albemarle Care Home provides nursing and personal care for up to 20 older people. Mr Abdul Rashid is the registered provider the manager’s position is currently vacant. The Home is located in Woodthorpe an inner city area of Nottingham, it is close to a local bus route into the city, which is well supported by road and rail networks. It is also close to shops, general practitioners surgery, pubs and other amenities. Albemarle is an extended residential house, which consists of two floors; there are two lounges and a dining room on the ground floor. The home has eight single rooms and six double rooms. There are three bathrooms, two of which are fitted with bathing hoists and one with shower facilities. There is a passenger lift to the upper floor and the house is wheelchair accessible. The grounds are well maintained and offer a relaxing environment. The current fees for the home are as follows: residential fees start at £334 rising to £336 depending on service users needs. There is also an additional charge of £16 for a double room and £32 for a single room. Nursing fees start at £360 and rise to £579 again depending on service users needs. An additional fee is also charged with the exception to high band nursing of £16 for a double room and £32 for a single room. The provider ensures service users and relatives are made aware of these fees on enquiry, it is also during this time that any required information such as the statement of purpose, brochure, terms and conditions and the latest inspection report are made available. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken by an inspector reviewing all the previous inspection records available, looking at information provided by the manager about Albemarle Care Home and by undertaking a visit to the service with the inspector using a method called “case tracking.” “Case tracking” involves identifying individual service users who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. The inspector also checked that information provided by the staff matched individual experiences of the service user living at the home by talking with them and observing the care received. General records maintained by the home were looked at to ensure these were maintained and provided positive outcomes for service users. What the service does well: What has improved since the last inspection? To ensure service users are fully protected risk assessments are now reviewed on a regular basis and staff have received an update in the safe administration of medication. Recruitment policies and procedures have been improved to ensure that service users are fully protected. The acting manager has submitted her application to the Commission for Social Care Inspection to become the registered manager thus demonstrating that that the home is run by a person who is fit to be in charge. The practice of wedging open fire doors has ceased thus ensuring service users are further protected from the risk of fire. Accurate records of service users finances were available demonstrating that service users finances are safeguarded. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 6 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. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assured that their needs will be assessed before admission and that the service can meet these if they decide to move in. The service does not offer intermediate care. EVIDENCE: Prior to admission, to ensure that the service is able to meet individual needs registered nurses visit prospective service users in the community to carry out a preadmission assessment. To enable service users to get the feel of the home they and/or their family may also visit and spend time at the home prior to making a decision to move in. One service user spoken with discussed the preadmission procedure they had undertaken prior to moving in to the home, confirming that they felt reassured that the home could meet their needs. The service does not offer intermediate care. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users health and personal needs are met, however further development with regards plans of care for those service users with dementia care needs would be beneficial to ensure that their current strengths are fully recognised and nurtured and challenging behaviour management strategies are fully documented. Service users are protected by the homes medication policies and procedures. EVIDENCE: Service users undergo various assessments such as the activities of daily living, manual handling and nutritional needs, information gained forms the plan of care. Plans of care in place were personalised and reflected service users individual needs. In regard to service users with dementia care needs, plans were in place, however these did not fully identify the service users strengths and capabilities or how challenging behaviour would be managed. Daily records showed that there had been incidents of challenging behaviour occurring, however staff had managed these incidents appropriately. Appropriate risk assessments for identified needs were in place. There was evidence that service users or their relatives had been involved in the plan of Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 10 care. Reviews were taking place on a regular basis, which identified any changes in service users needs or conditions. Staff spoken with were able to discuss service users needs and how support is offered to enable service users to meet their needs. All service users spoken with expressed that they were happy with the care received and felt that their needs were met. One service user said, “the staff are very kind, they help me when I need it.” There was evidence within service users files to show that the doctor, district nurses, tissue viability nurses, dentist, optician and specialist services are accessed as required to ensure that service users needs are met. During the tour of the home specialist cushions and mattresses were seen. Two service users spoken with said that they may see the doctor at any time. All registered nurses have attended an update on medication training, one registered nurse spoken with stated that she had found this beneficial. Medication records checked with the prescription corresponded, there was evidence of medication being signed into the building correctly. There were no gaps in administration and any medication that had been omitted was documented. One service user spoken with confirmed that the registered nurses give them their medication and they were happy with this arrangement as it ensured that they got their medication on time. Staff spoken with discussed how they ensure service users privacy and dignity is maintained. Staff were seen to treat service users with respect when attending to their needs. Service users spoken with said, “staff are always nice and treat me respectfully,” and “staff knock on my door before they come in, they are very polite.” Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users find the lifestyle experienced in the home matches their expectations and preferences, however it may not fully satisfy their needs due to limited activities. Service users receive a wholesome and appealing diet. EVIDENCE: Despite numerous attempts to secure an activities coordinator these have been so far unsuccessful. Therefore the acting manager continues to advertise for this position. In the meantime staff offer activities as time allows, this may include sing a longs, dominoes or games. Staff spoken with felt that there was not always enough to occupy service users at present and they look forward to this role being filled. Service users spoken with had varying views; one service user said,” there is not that much to do, but I am happy just sitting here and watching the television,” whereas another discussed playing dominos and enjoying the football. Several service users stated that although they get the opportunity to go out on occasions it would be nice if they got more opportunities especially when the weather was nice. Both the staff and service users spoken with said that the home was flexible in its routine and service users may choose how they spend the day. A local vicar Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 12 visits the home and offers Holy Communion on a regular basis, there was evidence of this occurring in service users plans of care. There are no restrictions imposed on visitors and visitors may be received in private should they wish. Visitors were seen to visit freely during the day. All service users spoken with said that visitors were made welcome at all times, one service user said, “my family often come to see me, I enjoy this, I can spend time with them”. Staff spoken with also confirmed that visitors are always made welcome. Within service users case files there was evidence of service users past life experiences, personal needs and preferences. On speaking with staff they were able to discuss service users individual needs and personalities and how service users were supported in meeting their needs. Issues regarding the rights and choices of individuals were also discussed; staff had a clear understanding of this and discussed how they enabled service users to make their own choices as able. Service users spoken with said that staff listened to them and they felt that they were treated as individuals and respected. A wholesome and appealing diet is on offer and choices are available. Service users spoken with said, “the food here is very good, I get plenty to eat,” and “the food is very good and there are choices available at each meal”. Staff were observed to assist service users as needed and special diets such as diabetic and soft meals were on offer. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that staff will listen to their concerns if raised and that these will be resolved. Service users are protected from abuse; however additional training in this area would prove beneficial to ensure all staff have a thorough understanding of the protection of vulnerable adults. EVIDENCE: To ensure that complaints are dealt with effectively, appropriate policies and procedures are in place for dealing with complaints received. There have been no complaints received since the previous inspection. Staff spoken with were able to discuss how they would deal with a compliant should it be received. Service users spoken with expressed that they were satisfied with the staff and care received and did not voice any concerns. Two service users stated that they felt confident talking with staff if they had any concerns. The recruitment procedures have been improved to ensure that all staff have satisfactory checks such as POVA 1st (a check to ensure that an individual has not been placed on a register for abusing service users in the past) and criminal record bureau checks (a police check which shows if an individual has any convictions or cautions) in place before they commence employment. Staff spoken with stated they had not received training in the protection of vulnerable adults, however they were able to discuss relevant issues and how they would respond should they suspect that abuse is occurring. Other members of staff have received training through the national vocational Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 14 qualification (a nationally recognised work and theory based qualification) in the past. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a well-maintained environment, which is clean and tidy, homely and comfortable. EVIDENCE: Routine maintenance continues, and the home is well maintained. The practice of wedging fire doors has now stopped; no fire doors were seen wedged open during the visit and there was evidence that this had been discussed with staff in the minutes of staff meeting and all wedges discarded. All areas of the home were clean and tidy and relevant equipment such as hand washing facilities were in place. Staff spoken with were able to discuss infection control arrangement and care of service users clothes and linen. Staff have received training in infection control. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel that staff are available to meet their needs at all times. Although staff training continues to develop it would be beneficial to discuss further training needs with staff and prepare a training matrix so a clear idea of all training undertaken and due is available. EVIDENCE: The staff duty rotas seen demonstrated that sufficient staff are on duty to meet service users needs. Staff spoken with said “there are enough staff available to meet service users needs and standards of care are very good,” and “although more time to do my job would be beneficial there are enough staff on duty to meet service users needs.” Service users spoken with said, “staff are always available when I need them to help me,” and “staff are very good, they always help me when I ask.” Five members of staff have attained the NVQ level 2 and four are working towards this qualification. The induction consists of a workbook on health and safety, a tour and discussion about the home and a training course with an outside agency. Evidence of these taking place were available within staff personnel files. Three staff personnel files were seen. Procedures with regards to recruitment have made improvement to ensure service users are fully protected. All Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 17 required documentation such as an application form, proof of identity and references were in place. Staff training continues to develop; however as the acting manager was not at the home on the day of the visit, it was difficult to get a full up to date picture of staff training. Certificate of training were seen within the staff training files observed. During discussions with staff it was express that they had undertaken little training this year, one member of staff felt that they had received all the training they needed whereas another member of staff felt that further training such as training in dementia awareness would prove beneficial and enable them to fully understand individual needs. One service user spoken with said, “staff are very good, I think they know all they need to know to look after me”. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal finances are safeguarded. Systems of working ensure that service users health, safety and welfare are supported and protected. EVIDENCE: The acting manager has applied to the Commission for Social Care Inspection to become the registered manager. She is currently undertaking the National Vocational Qualification level 3 (a nationally recognised work and theory based qualification) and has completed a course in leadership and management. Staff spoken with said that the acting manager was supportive and approachable. Service users spoken with also spoke highly of the manager. There have been no further changes in the quality assurance since the previous inspection, questionnaire are not yet due to be sent out again. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 19 Four service users personal finances were checked. These corresponded with the accounts. Receipts were available for transactions and items purchased. Staff had signed for all transactions. Staff spoken with said that service users had access to their money when needed. One service user spoken with said that they could access their money when they needed. The proprietor stated that all maintenance checks had been carried out as needed, evidence of this will be forwarded to the Commission for Social Care Inspection in the services annual quality assurance information. The home was well maintained and no hazards were observed on the day of the visit. There was evidence available to show that staff had received training in health and safety and staff were able to discuss relevant issues. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 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 X X 3 Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 21 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 OP12 Regulation 12(1,a) Requirement Provide adequate activities and stimulation for service users to ensure their social and recreational needs are fully met. Arrange further training in adult protection to ensure all staff have an in depth knowledge in this area thus ensuring service users are fully protected. Following discussions with staff arrange dementia care training to ensure service users dementia care needs are fully met. Timescale for action 05/12/07 2 OP18 13(6) 05/12/07 3 OP30 18(1,c,i) 05/12/07 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 OP7 Good Practice Recommendations Further develop plans of care for those service users who have dementia care needs to ensure that their needs are fully considered and met. To prepare a staff training matrix to offer a clear up to DS0000026406.V348559.R01.S.doc Version 5.2 Page 22 2 OP30 Albemarle Care Home date picture of staff training thus demonstrating that staff are fully trained and competent to carry out their job role. Albemarle Care Home DS0000026406.V348559.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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