Inspection on 12/12/08 for Albury House

This inspection was carried out on 12th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Albury House 25/11/09

Albury House 06/02/07

Albury House 09/11/05

Albury House 08/09/04

Albury House 16/06/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Albury House 17-19 Tweed Street Berwick Upon Tweed Northumberland TD15 1NG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anne UrwinBrown     Date: 1 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Albury House 17-19 Tweed Street Berwick Upon Tweed Northumberland TD15 1NG 01289-302768 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs M L Burn,Mr A E Burn care home 12 Number of places (if applicable): Under 65 Over 65 1 11 dementia old age, not falling within any other category Additional conditions: 0 0 The home is able to provide one place for a named resident under the age of 65. Should this person leave the home, the CSCI must be notified. Date of last inspection Brief description of the care home Albury House provides accommodation for up to twelve older people in a two-storey town house near the centre of Berwick upon Tweed. The house is in a quiet residential area and has been converted from a family home to suit its present use. Bus and train services are available within a short walk. The home has accommodation on two floors and there is no lift fitted residents occupying the first floor bedrooms have to use the stairs. There is an emphasis on retaining the feel of a family home. Furnishings and the decor have been chosen with this in mind. Fees are 419.08 pounds per week. The Statement of Purpose has been reviewed since the last inspection and is available at the home. Information for prospective residents is also available. Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirment is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit: We looked at: Information we have received since the last visit. How the service dealt with any complaints & Care Homes for Older People Page 5 of 26 concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on date 12th December 2008 and lasted seven and a quarter hours. During the visit we: Talked with people who use the service, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the owners what we found. What the care home does well: What has improved since the last inspection? What they could do better: Hand written entries in the medication records must be signed by two members of staff to ensure that they are correct. The central heating system needs repair to ensure that appropriate temperatures can be maintained throughout the building. The bathrooms need upgrading to ensure that they provide appropriate facilities that meet the needs of the people living in the home. The kitchen needs refurbishing to provide appropriate facilities for the preparation of Care Homes for Older People Page 7 of 26 food. The quality assurance system needs further development. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed prior to their coming to live at the home to ensure that their needs can effectively be met. Evidence: The Statement of Purpose has not been updated since November 2006. There is an information leaflet available for people thinking about coming to live in the home that tells them what it is like to live at Albury House. Two people said that they had plenty of information about the home and that they had been able to visit before making their mind up to come to stay. They said that the manager had been very helpful. Each person has a written contract detailing the terms and conditions of residence. There are written assessments completed prior to someone coming to live at the home. Good information was available for the most recently admitted residents. Staff Care Homes for Older People Page 10 of 26 Evidence: said that they have enough information about peoples needs to ensure that they can provide the support that they need. One resident said that staff knew what she needed help with when she came to live at the home. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are identified and met as part of a regular care planning process. Evidence: Since the last inspection a new care planning system has been introduced and staff are working to complete every plan in the new format. Plans that have already been completed generally contained good information about peoples needs and how these are met. 4 people were case tracked including one person recently admitted. Regular reviews of care are carried out and recorded, although sometimes the information is limited. There was evidence of changes being made to care plans following change of needs. Two people living in the home were able to confirm their satisfaction with the quality of care provided. One said the staff are very kind, they know what I like and make sure that I have everything I need to hand. I see the owner regularly and I know all of the staff well and they treat me very well. Most health care needs were clearly recorded and examples were available to show good multi-disciplinary working. Interactions with health care professionals were Care Homes for Older People Page 12 of 26 Evidence: recorded and on most occasions this information is transferred to care plans. There was not sufficient information about some peoples specific health care needs within their plans, although staff were able to describe how they would address these. Copies of initial falls, nutrition, moving and handling were were available, but these are not regularly updated and there was not evidence that information from these was always used in preparing and reviewing care plans. Generally good systems were in place for administration of medicines. Records are kept of ordering and disposal of medicines and these were clear so that it was possible to confirm stocks held. Some hand written entries in medicine records had not been double signed. Staff have had training in administering medicines. There was evidence that care is provided in a way that takes account of equality and diversity principles and person centred planning. People living in the home said that they felt satisfied that staff respect their dignity and privacy. Staff were observed knocking on doors and speaking respectfully towards the residents. There is an emphasis on providing individualised support that takes account of peoples wishes and this was evident from talking to staff. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lifestyle in the home suits the preferences and expectations of the people living there. Evidence: People are encouraged to make personal choices about their individual routines and lifestyle. Three people said that they could decide on how they spend their time, rising and retiring times and the way in which staff support them. Information was available in care plans about peoples routines and interests. There are not many organised social activities at Albury House, however this is the choice of the people living there. Staff said that they spend time with people on an individual basis and people living at the home confirmed this. There are newspapers, books, tapes, DVDs available. There was evidence from individual records that staff support people to go out in the community and to maintain links with their friends and families. Visitors are welcomed to the home and the visitors book shows there are frequent visitors to the home. People are encouraged to retain control of their finances and to be as independent as possible. The staff at Albury House actively promotes people to make choices about Care Homes for Older People Page 14 of 26 Evidence: their lifestyle. The principles of fairness, equality, dignity, respect and autonomy underpin the practice of staff working at the home. People living in the home are very satisfied with the quality and quantity of food provided. They said that they get a varied diet and their likes and dislikes are well known to staff. The menus showed that people have a nutritious, well balanced diet and individual needs are known to staff so special diets are well catered for. The kitchen is small and space is very limited. The kitchen units are worn and some drawers and unit doors are damaged. The manager said that new units are ready to be fitted and this work will be completed shortly. The cook has completed food hygiene training. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes arrangements for dealing with complaints and allegations. Evidence: The home has a clear complaints procedure that is supplied to everyone living in the home and is on display. People living in the home are aware of how to make a complaint and four people said that they felt able to speak to staff or the owners if they are not happy about anything. One person said We see the owner regularly and I feel able to tell her if there is anything I am concerned about and I know that she would take it seriously. There is in place a system for recording complaints, the investigation and outcome. There have been no complaints since the last inspection. Staff were able to describe how they would help someone to make a complaint. No safeguarding referrals have been made at Albury House in the past year as there have been no incidents. The home understands the procedures for safeguarding adults and the need to provide appropriate information about any concerns. Staff have received appropriate safeguarding training. Staff could describe the action to be taken in the event of an allegation of abuse being made and this followed the homes procedures. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe well maintained environment that suits their individual needs. Evidence: Albury House has accommodation on two floors and the living environment is clean, very homely and comfortable. There is a garden to the rear of the building with a patio and lawn area directly outside the rear door. New paving has been laid since the last inspection that makes this area very accessible. Since the last inspection further work on the garden has created an area on a lower level that is reached by a stair lift. Work on this was still progress at the time of this inspection and when it is finished it will make a very attractive area with good views of the river for residents to spend time in. Since the last inspection stair lifts have been installed to the first floor to ensure that all areas of the home are accessible for people with mobility problems. The providers installed stair lifts because there is not sufficient space to install a shaft lift. Maintenance records were available to show that work is carried out promptly and that regular servicing of equipment is undertaken. The sitting, dining and other public areas of the home are well furnished and decorated providing suitable accommodation for the people living in the home. People living in the home said that they found the accommodation comfortable and suited to their needs. Care Homes for Older People Page 17 of 26 Evidence: There are six bedrooms with en-suite accommodation. There are sufficient toilets available and two bathrooms. Some work is needed in both bathrooms to upgrade the facilities. The bathroom upstairs is used by all the people living in the home and at the time of this inspection the downstairs bathroom was being used as a storeroom/drying area for laundry. The flooring in the upstairs bathroom is carpet that is marked and worn and does not provide an impermeable surface to minimise risks of cross infection. The ground floor bathroom is not readily accessible for people with mobility problems and the decor in this room and the upstairs bathroom is not of the good standard evident in other areas of the home. Some en-suites would also benefit from updating the decor. Bedrooms are well furnished and show good evidence of peoples interests and preferences. Most people have brought in items from their previous homes. Lockable storage is provided and keys to the rooms are also provided unless a risk assessment has deemed it unsafe to provide someone with a key. Two people living in the home said that they are very satisfied with their rooms, which they said were comfortable and suited them. One person said I am really pleased with my room, it is spacious and has wonderful views, I couldnt have better. On the day of the inspection the central heating was not working properly and some rooms were cold. This was reported to the plumber for attention during the inspection. Lighting levels were appropriate and thermostatic controls are fitted to hot water outlets. The laundry is sited in a shed at the rear of the building. Washing machines have appropriate wash cycles for soiled linen. Written guidance is in place for infection control and staff training is provided. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are adequate to meet the needs of the people living in the home. People are protected by the staffing arrangements at Albury House. Evidence: There are always two staff on duty during the day, with one waking member of staff on duty at night and one person sleeping in on the premises. This level of staffing is adequate to meet the needs of the current residents and can be adjusted to suit peoples changing needs. People living in the home said that there were enough staff available to meet their needs. Two people said staff come quickly when they call for them and that the staff are good at their jobs. One person said they always know what help I need and are there when I want them. Staff said that there were enough people to cover the rota. The rota showed that staff work additional shifts to cover absences due to annual leave and sickness. Good opportunities are provided for training and seventy-five per cent of staff have completed national qualifications in care. Training is targeted and focused on improving outcomes for people living in the home. Two staff said that they get good opportunities for training and are well supported by the management of the home. A training programme has been drawn up to ensure that mandatory training is provided at appropriate intervals. All new staff complete comprehensive induction training that Care Homes for Older People Page 19 of 26 Evidence: is service specific and they are supported by existing staff when they start work. Staff said that new staff receive appropriate training and support to equip them to do a good job. Staff records showed that good recruitment practices are followed and that appropriate reference, Criminal Records Bureau and other checks are carried out before any new staff start work. There is some evidence to demonstrate that attention is being given to improving policies and procedures taking account of equality and diversity principles. People using the service report that they know the staff well and that their needs are consistently met. There is a settled staff team who work well together providing consistent support for people living in the home. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is well managed and takes account of their views in planning changes to the service. Evidence: The manager has the experience to run the home, but lacks a recognised qualification. She is supported by a Deputy Manager who has appropriate management and care qualifications and who is involved in developing the new care planning system and updating policies and procedures together with the manager. This is a small family run business and the manager is aware of the need to keep up to date with practice. She does not intend to complete the Registered Managers award and has not yet identified a clear plan for the future management of the home. The manager has good people skills and understands the importance of providing good outcomes for people living in the home. The Quality Assurance system is based on the use of questionnaires for people living in Care Homes for Older People Page 21 of 26 Evidence: the home, their families/friends and professionals. The information supplied before the inspection clearly identifies work going on to improve practice and systems and where they still need to make improvements. It shows how they plan to do this. The service is person centred focused on promoting an increased quality of life for individuals that takes account of equality and diversity principles. People are supported to manage their own money and the home does not hold any money on behalf of anyone living there. There are clear health and safety policies in place. All staff are made aware of these and have appropriate training opportunities. Good records are kept of accidents. Mandatory training is provided. Records showed that regular checks are made of equipment and action is taken to address any issues identified. Records of fire alarm tests, servicing and equipment tests are kept in good order. Records show that staff have received fire training at appropriate intervals. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 The statement of purpose/service user guide must be updated. This will ensure that people have enough information about the service to make an informed choice. 31/01/2009 2 9 13 Any hand written entries on medication records must be double signed. This will ensure that there are appropriate checks to ensure safe recording of medicines. 31/01/2009 3 21 23 The bathroom facilities must 31/01/2009 be upgraded to meet the needs of the people living in the home. This means that the facilities are appropriate for the people living in the home. 4 25 23 The central heating system must be repaired and steps taken to ensure that it is kept in good working order. 31/01/2009 Care Homes for Older People Page 24 of 26 This means that people living in the home are kept warm. 5 33 24 The quality assurance systems need to be improved to include regular audits of systems, policies and practice. This will ensure that the service provided is regularly reviewed to make sure that it meets the needs of the people living in the home. 28/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 All care plans need to be completed using the new format so that staff have clear information about how peoples needs are met. Regular assessments for falls, nutrition, moving and handling, tissue viability and dependency should be carried to ensure that individuals needs are regularly reviewed. The kitchen requires refurbishment and decoration to provide a more suitable environment for the preparation of food. Paper towels and liquid soap should be made available in each toilet and bathroom to minimise risks of cross infection. 2 8 3 15 4 21 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!