Inspection on 02/02/06 for Albert House

This inspection was carried out on 2nd February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Albert House 12/07/06

Albert House 15/11/04

Albert House 21/05/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Albert House 19 Albert Road Weston Super Mare North Somerset BS23 1ES Lead Inspector Carolle Wise Scanlan Unannounced Inspection 2nd February 2006 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 Albert House DS0000020267.V276138.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. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Albert House Address 19 Albert Road Weston Super Mare North Somerset BS23 1ES 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) 01934 622869 01934 613807 Yeoman Care Limited Mrs Catherine Blanche Barron Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate 20 persons aged 50 years and over who require nursing care of whom up to 3 residents may be 65 years and over in need of personal care only. Staffing Notice dated 06/10/1999 applies Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 2nd August 2005 Brief Description of the Service: Albert House is run by Yeoman Care Ltd. The Responsible Individual for the company is Mr W. Esland, and the registered manager is Mrs C Barron. The home provides nursing care to up to 20 patients over the age of 50 whose needs include sickness, injury and infirmity. The home may provide personal care for up to 3 people over the age of 65. The total number of people who may be in residence at any one time is 20.The home is set near the seafront in a quiet residential area. Shops and other community facilities are nearby and the main town centre is a short journey away. The premises are comfortably furnished and designed to create a relaxing home atmosphere. There is a sheltered and private back garden. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over seven hours. The two inspectors met with eight residents, some staff on duty and visitors to the home. The inspectors sampled and reviewed documentation maintenance records. They also looked at and reviewed a number of records that need to be kept in the home. What the service does well: What has improved since the last inspection? What they could do better: Residents’ care plans must be reviewed at least once a month. The registered manager must ensure that the premises are kept in a good state of repair externally and internally. Equipment provided at the home should be maintained in good working order, and appropriate records kept. Sluice areas of the home needed significant cleaning. A sluicing disinfector should be provided to promote infection control. Staff need infection control training. Recruitment checks are required prior to employment to include Criminal Record Bureau and POVA checks. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 6 All records as specified under the standards must be kept securely at the home such as personnel records and residents finance records. Cleaning products must be labelled and be stored securely when not in use. . Improvements in décor and deep cleaning to the ground floor shower room. To ensure residents privacy and dignity, safety locks must be provided to all bathrooms and toilets. 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. Albert House DS0000020267.V276138.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 Albert House DS0000020267.V276138.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): 1, 3, 4 & 5 Residents receive sufficient information and have the opportunity to visit Albert House before admission. Residents are appropriately assessed to ensure that the home can safely meet their needs. EVIDENCE: Residents and relatives felt they were offered sufficient information and opportunities to visit the home prior to making a decision to live here. The care records demonstrated good practice with residents needs assessed prior to moving in. Visitors met during the course of the inspection recalled meeting and having discussions with the Matron with regard to how their loved one would be cared for at the home. Visitors who were residents’ relatives recalled having a ‘trial period’. They felt this gave their loved one the opportunity to ensure that this was the ‘right’ home for them to move into permanently. Albert House DS0000020267.V276138.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 Care plans are clear and person centred however they must be reviewed at least monthly. The home’s medication administration has clear auditable records and staff complete regular training updates. Further improvement is needed in the recording of resident’s medication when handwritten onto the Medication Administration Record sheet. EVIDENCE: Care plans reviewed were person centred and written to specifically meet the individual resident needs. Good practice was demonstrated with care plans setting out specific details for example on wound care, nutrition and communication. These had not however, of late, been reviewed on a monthly basis, which was readily acknowledged by the matron. Some care plans reviewed had not been reviewed for three months. Residents have access to dentists, chiropody, opticians and GP and their care records noted any visits from health and social care professionals, which is good practice. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 10 In general, medication administration practice and audit was clear and good practice was noted. In one instance a residents’ medication had been handwritten onto the Medication Administration Record (MAR) this had not been signed or dated. Staff were observed during the inspection giving one to one support to residents and assisting them with mobility. This was carried out in a respectful and considerate manner with account made of the resident’s needs and that of others. The majority of the current residents are not self-reliant with regard to their day-to-day personal routines. Albert House DS0000020267.V276138.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 The home s routines allow for the residents own preferred lifestyles with visitors made welcome at the home. The home has a new kitchen with resident’s dietary needs and preferences made account of. EVIDENCE: Activities at the home are ‘low-key’ activities such as reading, armchair music exercises, church visits and staff chatting with residents or playing cards or games. These events are recorded in the ‘visitor book’ in the reception hallway noting the residents name and the activity undertaken. An improvement would be for this record to be audited regularly to ensure that all residents have regular social activity to meet their expressed preferences. Matron felt that at times staff forget to complete the book following activities. There is open visiting and visitors were welcomed into the home during the course of the inspection. The kitchen has a new stainless steel modern kitchen. The chef remarked that this is easy to wipe down and keep clean. Resident’s found the menu choices and food to their taste with consideration made of their dietary needs and preferences. The lunch menu is that of a hot meal with an alternative choice Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 12 available on request. The evening meal choices are lighter, such as a variety of sandwiches. The home has a separate dining room on the ground floor, which has a ‘homely’ feel and the majority of resident’s take their meals in the dining room. The freezers are stored separately to the kitchen area. One of these was in need of defrosting and had a broken handle. Albert House DS0000020267.V276138.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): 18 Staff receive training in Adult Abuse Awareness and this is regularly updated to safeguard the residents. EVIDENCE: Staff attend abuse awareness training and the staff notice board had notes regarding training updates. The Matron said that should the residents feel that they have any concerns they have the opportunity to discus things with her or the homes proprietor, Mr W Esland. Residents and the visitors met found they could access the Matron to discus any issues they may have. All felt that any matters brought to her attention would be taken seriously. Albert House DS0000020267.V276138.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): There is need for improvement and maintenance to several areas of the home to ensure residents comfort and safety. Assessments of risk are completed but significant improvement is needed to ensure that these are ‘person’ and ‘room’ specific. EVIDENCE: The residents feel comfortable and at home at Albert House. The home has a relaxed and welcoming ambience. The accommodation is arranged over two floors with stairs and a passenger lift enabling access to both floors. It has a pleasant garden to the rear of the property having a large lawn area with bordering shrub/flower beds. The ground floor has two separate lounges and a dining room in good decorative order. On the first floor, there is a combined lounge/dining room. Bathrooms have been adapted to meet the needs of the current residents. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 15 The majority of communal toilet and bathrooms are not fitted with locks. The shower room on the ground floor needs to be redecorated and the showerhead and wall fixing replaced. There is some under stairs storage for equipment such as wheelchairs. The home has a ‘call bell’ system in place. Resident’s private rooms are arranged over both floors. Residents can bring in their own personal items and several had decorated their rooms with their own pictures and photographs. The private rooms of the residents do not have locks unless specifically requested. Residents however do have the option of a bedroom door lock with their preference noted in the care records. Risk assessments were in place for the use of ‘bed sides’. One of the bedrooms was fitted with a ‘stable door’. The use of this could be interpreted as a form of restraint. There was no evidence of a risk assessment regarding its use, and discussion with staff suggested that it was not necessary for the current resident. One height adjustable bed was in need of maintenance. In another case, ‘bed sides’ were in place but had been poorly fitted. The inspectors were able to slide them up and down the bed. The top of a chest of drawers was noted to be chipped. This may pose a risk such as a skin tear or infection control and should be risk assessed and remedial repairs made. None of the radiators are covered with low temperature guards. One radiator was felt to pose a significant scald risk to the service user. This was discussed with Mrs Barron and Mr Esland during the inspection. New washing machines have been fitted in the laundry. The floor in this room is unfinished and is not impermeable. As such it poses a potential infection risk. Since the last inspection new boilers have been installed. In some of the bedrooms it took a significant amount of time before the water ran hot. This was discussed at length with Mr Esland. He reassured the inspectors that staff always ensured that water was sufficiently hot before bathing a resident. Housekeeping at the home needs to be improved. The ground floor sluice was particularly dirty. Dining room chairs were found to have old food deposits and dust to the back of the chairs. Housekeeping products were left unattended and must be stored in accordance with COSHH. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 Staffing levels meet the needs of the current residents. . In order to protect the residents at Albert House, CRB and PoVA First checks must be carried out before staff start work in the home. EVIDENCE: Mr Esland currently keeps staff personnel files in his own home. These must be securely stored at Albert House. Two of the four staff files reviewed did not contain evidence of a CRB or PoVA First check before employment started. In each case two written references had been obtained. The files contained copies of staff qualification certificates and recent training. Residents said the nurse call bells were answered in good time and felt that staffing levels were appropriate. The staff duty rota confirmed a balanced mix of experienced and less experienced staff on each shift. Staff said that they felt supported in their practice. One staff member remarked that it was useful working through and learning the ‘protocols’ at the home. Staff enjoy working at the home and find that there is ‘always some form of training that is relevant to the work going on’. Albert House DS0000020267.V276138.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, 35, 37, 38 The residents and visitors benefit from the homes clear management and staffing structure. A more proactive approach is needed by the homes management to ensure that health and safety maintenance checks are regularly undertaken to protect staff and residents. EVIDENCE: The inspection took place with the Registered Manager Mrs C Barron who is an experienced Registered General Nurse. She has completed the NVQ level 4 Registered Managers Award. In her role as Matron at Albert House she demonstrates a strong leadership style and is well respected by the residents, staff and visitors alike. The residents find matron approachable willing to help and an easy person to discuss ‘things’ with. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 18 The majority of residents manage their own financial affairs with their families or representatives according to the proprietor. Records regarding residents financial affairs must be kept securely at the home and be available for audit purposes. Records such as maintenance and some service contracts were randomly audited and found incomplete. There were several records including servicing and electrical checks, which were not available during the inspection. The registered manager must ensure that the premises are kept in a good state of repair externally and internally and that equipment provided at the home is maintained in good working order. Portable appliances seen throughout the home during the inspection were without testing date labels. An example of which was a high wall heater in the dining room this needed dusting and had no PAT test. Fire doors in zoned areas were wedged open and must comply with Avon fire officers guidance letter. Products used for cleaning must be labelled appropriately and stored securely when not in use under COSHH (1998). Maintenance of some hospital beds was needed. Risk assessments to be completed in relation to hot water radiators and action taken to address identified risks. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 19 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 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 3 2 2 3 2 2 1 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 2 X 2 1 Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 23(2)(d) Requirement Shower room to be updated and fit a replacement shower fitting and shower head. Safety locks are required on all bathroom and toilet doors. Bed sides must be fitted in accordance with the manufacturer. Height adjustable beds must be kept in a good state of repair. Hot radiator to have a risk assessment completed and action taken to address the identified risks. Staff to receive further training in Infection control Sluicing disinfector to be installed to make suitable arrangements for the prevention of the spread of infection. Laundry floor to have remedial action taken to ensure it is impermeable Staff personnel records to be kept securely at the home. CRB code of practice and the National minimum standards DS0000020267.V276138.R01.S.doc Timescale for action 30/04/06 2 3 4 5 OP21 OP22 OP24 OP25 12 (4) 13(4)(c) 13(4)(a) (c) 13(4)(a) (b) (c) 18(1)(c) 13(3) 30/04/06 30/04/06 30/04/06 30/04/06 6 7 OP26 OP26 30/04/06 30/06/06 8 9 10 OP26 OP29 OP29 16(2)(j) 17.2 Schd 4 19 30/04/06 30/04/06 30/04/06 Albert House Version 5.1 Page 21 11 OP35 Sch 4 (9) 12 OP37 23(2)(c) 13 14 OP38 OP38 16(2)(k) 23(4) 15 OP38 13(4)(a) records of CRB are to be maintained. Records regarding resident’s monies as identified in the schedule to be kept at the home must be complied with. Portable appliance records of checks undertaken must be available to audit. Checks of all portable appliances must be undertaken periodically. COSHH training for all staff Doors must not be wedged open in those ‘zoned’ areas as specified by Avon Fire Brigade Guidance to the home. Products used for cleaning must be clearly labelled and stored securely when not in use. 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 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 3 Refer to Standard OP7 OP9 OP38 Good Practice Recommendations Care plans to be reviewed at least monthly according to the residents changing needs. Medication when handwritten onto the MAR sheets must be signed and dated with a clear audit trail as to the prescriber. Freezer under window of ‘staff room’ to be defrosted and remedial repair to the handle. Albert House DS0000020267.V276138.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Albert House DS0000020267.V276138.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. 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!