Inspection on 24/04/06 for Aldington House

This inspection was carried out on 24th April 2006.

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

Aldington House 06/04/08

Aldington House 21/11/05

Aldington House 06/12/04

Aldington House 01/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Aldington House 107a Blackheath Park Blackheath London SE3 OEX Lead Inspector Ms Pauline Lambe Key Unannounced Inspection 24th April 2006 09:15 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 Aldington House DS0000006853.V292627.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. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Aldington House Address 107a Blackheath Park Blackheath London SE3 OEX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8463 0641 020 8297 8985 New Century Care Limited ** Post Vacant *** Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st November 2005 Brief Description of the Service: Aldington House is a care home registered to provide accommodation and personal care for thirty -one older people. The home is part of a group of Nursing and Care homes managed by New Century Limited. The home is situated in a quiet residential road on a private estate in Blackheath. It is approximately 15 minutes walk to the shops, local facilities and public transport connections in Blackheath Village. Accommodation in the home is provided on three floors. The home has twenty -nine single and one shared bedroom. There are pleasant and well-maintained gardens to the front and a small patio area accessible from the lounge on the lower ground floor. There are no parking facilities at the property but you may be able to park in the road. The current fees in the home at the time of this inspection ranged from £395.35 - £650 per week. Residents paid privately for newspapers, personal telephone calls, hairdressing, outings and medical services not provided by the NHS. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection included a site visit over two days for 9 hours. The service was last inspected on 21st November 2005. At the time of this inspection the manager was in charge. The manager of the service was in the process of changing and the new manager was spending his first day in the home. Thirty residents were in the home. The inspection process included speaking to residents, relatives, staff and management. Reviewing records and information provided to the Commission since the last inspection. Records required by regulation were inspected and a tour of the premises was undertaken. Compliance with requirements and recommendations made at the last inspection were reviewed. One requirement in relation to staff recruitment had not been met. Feedback was obtained from the district nurse, a visiting GP, the home care team and commissioning staff at Greenwich social services, 7 relatives and 10 residents completed comment cards with 4 others providing feedback on the day of the site visit. Some relatives were contacted by phone following the inspection. Feedback from residents and others was generally positive. One relative raised some concerns about the care their resident received with the inspector and with the relative’s agreement these were brought to the manager’s attention. What the service does well: What has improved since the last inspection? Care plans were much better and showed how care needs were to be met. The medicine storage area had a portable air conditioning unit provided to ensure medicines were stored at the correct temperature. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 6 A system to provide individual supervision for staff had been introduced and records seen showed this was being happening. Regulation 26 reports were being sent to the Commission on a regular basis. 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. Aldington House DS0000006853.V292627.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 Aldington House DS0000006853.V292627.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): 2 and 3. Standard 6 did no apply to the service Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Three of the four resident files seen included a contract for service and all the files seen showed that preadmission assessments had been completed. Residents and relatives had access to relevant information about the service. EVIDENCE: Four resident files were inspected. Three of these contained contracts for service. These residents said they were not aware of the contract as they left this for their relatives to deal with. Relatives contacted said they were given adequate information about the service when they visited the home. Copies of the statement of purpose and service user guide were seen in resident’s bedrooms. All four files contained pre-admission assessments and other information to enable the home to make a decision about the suitability of the service to meet the resident’s needs. Aldington House DS0000006853.V292627.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 to 10 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Care plans had improved since the last inspection and showed how resident needs were being met in respect of health and welfare. Medicines were safely managed and residents and relatives said staff treated them with respect. EVIDENCE: The care plans for four residents were inspected. These were well written, included risk assessments and care plans showing how assessed needs were to be met. Risk assessments had been completed to identify residents at risk of developing pressure sores. Staff worked closely with the district nurse and GP to ensure resident health needs were met. The district nurse seen at the time of the inspection gave positive feedback about the care provided and the appropriate referrals made by staff to her service. Care plans seen were reviewed monthly and indicated that where possible residents or relatives were informed about care plans. All care plans seen included a social history. None of the residents in the home had pressure sores. Staff supported residents to access medical services as needed. A GP visited the home weekly and staff arranged for residents to have routine dental, Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 10 optical and chiropody care. Residents were supported to keep hospital and other medical appointments. The home had policies and procedures on medication management, which reflected the current practice in the home. Medicines were safely stored and a portable air-conditioning unit had been provided for the medicine room to ensure the temperature was kept within safe limits. Internal and external medicines were stored separately and eye drops were dated when opened. The district nurse had assessed named staff as competent to assist a resident with administering insulin. Medication records were well completed and up to date. All the senior staff were currently completing training on ‘the safe management of medicines’. Medicine records for four residents were checked and found to be correct. Accident records since the last inspection were viewed and were generally well written. However two residents sustained minor injuries when they were being transferred and two unknown injuries to residents were recorded. A system must be in place to follow up such injuries to try and establish how they had occurred and if any action could be taken to prevent a recurrence. Residents and relatives seen and relatives contacted said staff treated them with respect. Relatives said staff kept them informed of any issues or concerns in relation to their resident. Feedback obtained from social services commissioning team and home finding team was positive about the quality of service provided in the home. Requirement 1. Aldington House DS0000006853.V292627.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 to 15. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. This judgement has been made using available evidence including a visit to the service. From the evidence provided and comments made by residents and relatives they were satisfied with their lifestyle, the meals provided and the way their care was provided. EVIDENCE: Comment cards were completed by or on behalf of 10 residents. These indicated satisfaction with the service. Verbal feedback from other residents supported this. One resident said, “this is the best place you will find, the staff are lovely and we have enough activities”. During the inspection a number of residents were seen enjoying gentle chair exercises to music. The home had an activity organiser for 22 hours a week. A weekly activity programme was prepared and additional entertainment was bought in for resident enjoyment. A number of residents said they did not like socialising or joining in with activities and said staff respected their wishes about this. The home had an open visiting policy. Relatives seen and contacted said they were made to feel welcome by staff and some relatives were observed enjoying time with their resident in their bedroom or the lounge and having a cup of tea. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 12 Staff were observed interacting appropriately with residents. Several residents said staff helped them to choose their daily outfits, choose their meals and decide where and how to spend their day. Some residents choose to spend their time in their bedrooms and others liked to sit in the lounge. Relatives and visiting professionals said staff were helpful and welcoming and supported residents to have visits in private if they wished. The menus seen showed residents were given a varied and nutritious diet. Three cooked meals a day were provided and residents were offered a choice for each meal. Residents could eat in the dining room or in their bedroom if they preferred. During lunch staff were observed serving meals and offering assistance appropriately. Residents spoken with during lunch said they enjoyed their meals and one resident said they did not get enough green vegetables. The menus seen did include a variety of vegetables. The registered person planned to refurbish the kitchen in the near future. Quotes had been obtained for this work but no dates were available to show when the work would start. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. This judgement has been made using available evidence including a visit to the service. The home had a complaints procedure and residents and relatives said they knew how to make a complaint. Compliant records needed some improvement. Staff displayed an understanding of adult protection but the procedure to manage allegations needed some amendments. EVIDENCE: A system to record complaints made about the service was provided. This showed that one complaint had been made since the last inspection. However there were no records available to show how this had been managed or what the outcome was for the complainant. Some residents said if they had a concern they would talk to the manager or one of the staff while others said they would talk to a relative and get them to sort the problem out. Most of the residents and relatives seen and contacted on this occasion said they had not needed to make a complaint. However one relative contacted raised concerns they had about the service with the inspector and said they had formally complained to management about some issues. As some issues remained unresolved, with the relative’s permission, these were brought to the attention of the home manager for him to address. The home had a policy and procedure in relation to adult protection. Since the last inspection a number of staff had received training on this topic from discussion with some staff it was evident they had a good understanding of adult protection. The procedure relating to adult protection did not clearly Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 14 reflect that all allegations or suspicions of abuse must be referred to social services for investigation. One allegation of abuse had been investigated by social services since the last inspection and there was no evidence found to support that abuse had occurred. Management co-operated fully with the investigation. Requirement 2 and recommendation 1. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23 and 26. Quality in this outcome area was excellent. This judgement has been made using available evidence including a visit to the service. The environment was maintained to a high standard and residents and relatives were satisfied with this. There was evidence to show that attention was given to ensuring the premises were kept clean and safe. EVIDENCE: Completed resident comment cards and comments received from relatives indicated that in their view the home was kept clean and free of unpleasant odours. This was found to be the situation during the inspection. Some relatives commented on the lounge. They felt this was not a particularly pleasant area. Little could be done structurally to change this room and the home was registered prior to the introduction of the national minimum standards and therefore complies with current environmental standards. The home was decorated, fitted and furnished to a high standard. Bathing and toilet facilities were suited to meeting the needs of the residents. Assisted baths and hoisting equipment was regularly serviced as was other Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 16 equipment provided. One relative said that there was never any hot water in the bedroom occupied by their resident. With the agreement of the relative this was brought to the attention of the manager who said he would look into the matter. The residents who spoke to the inspector said they were satisfied with their bedrooms and a number of them said they choose to spend their time there rather than in the communal lounge. Bedrooms seen had personal items such as ornaments, photographs, pictures, T.V and some had small furniture items. Personal clothing was neatly stored and residents were well presented with the ladies wearing jewellery and makeup and men being clean-shaven. Since the last inspection a number of staff had received training on infection control and they had access to a policy and procedure on this topic. Hand washing facilities were provided where waste was handled and staff said they had access to adequate supplies of protective clothing. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 17 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 to 30. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. Adequate staffing levels were maintained and the staff team presented as having the skills needed to meet the resident’s needs. Recruitment procedures did not comply fully with regulation and this could pose a risk to residents. EVIDENCE: The home benefited from having a stable staff team. The staff team comprised of a full time manager, deputy manager, team leaders, care assistants, domestic and ancillary staff. A new manager took up post in April 2006. From observation staff interacted in a friendly yet professional manner with residents. Residents seemed relaxed and comfortable in their surroundings. From the staff rotas seen for a four-week period, including the week of the inspection, it was evident that adequate staffing levels were maintained. Relatives contacted said that in their view the home had adequate numbers of staff on duty. Four staff files were inspected. It was disappointing to note that none of these complied fully with regulation and that a requirement made at the last inspection in respect of this standard had not been met. Therefore an immediate requirement was left for the registered person to address this as a Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 18 matter of urgency. The Commission will monitor compliance with this requirement. Staff said they had adequate support and training to fulfil their roles. Since the last inspection staff had access to training such as adult protection, infection control, health & safety and moving & handling. Fire safety training sessions were planned for May and October 2006. NVQ training for care staff continued and senior staff were in the process of completing training on the safe management of medicine. Requirement 3. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. A new manager had taken up post on the day of the inspection. The provider had a quality audit system in place and resident money was safely managed. Staff were provided with formal supervision and records seen showed attention was given to ensuring a safe environment was provided. EVIDENCE: As mentioned a new manager was in post and will need to apply for registration with the Commission. From talking to him he presented as having the skills, experience and qualifications needed to manage the service. The manager will need to apply for registration with the Commission. To help him settle into his new role had had one-week handover from the departing manager and support fro the regional manager. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 20 A number of residents said they would know how and who to talk to if they had a concern. The inspector was told that efforts had been made to hold resident and relative meetings but these were poorly attended and not found to be useful. The provider completed an annual satisfaction survey of the service and a copy of the last one was sent to the Commission. This indicate a high level of satisfaction with the service overall. A copy of the survey was left in the home for residents and relatives to see. A policy and procedure in relation to management of resident’s finances was provided. Where possible residents were encouraged to manage their own finances. Where this was not possible arrangements were in place to hold small amounts of personal allowance for residents. Relatives provided the money, which was held as cash and not in a bank account. Receipts were kept for money received and spent and a personal record kept for each resident. Records for four residents were checked and found to be correct. From the records seen and from talking to staff it was evident they received regular supervision. Staff said they benefited from this both in their work with residents and personal development. A selection of safety records were inspected. These included fire safety, lift, hoists, gas, electricity and hot water checks. The records seen were up to date and showed systems and equipment were being routinely maintained. Fire drills were held but there was no evidence that these were done at times to include the night staff. Requirement 4 and recommendation 2. Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 21 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 3 X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 4 X 4 X 4 X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 2 Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 22 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 OP8 Regulation 13 Requirement Timescale for action 30/06/06 2. OP16 17 3. OP29 19 Schedule 2 4. OP38 23 The registered person must ensure risks to residents are identified and as far as possible eliminated. Injuries to residents such as unexplained injuries and injuries sustained during transfer must be followed up by management to try and establish why and how the injury occurred and to identify if action could be taken to prevent a recurrence. The registered person must 30/05/06 ensure records were kept of all complaints made about the service and the action taken in respect of any such complaint. 30/06/06 The Registered Person must ensure compliance with this regulation and obtain the information required for all staff employed. (Timescale of 30/12/05 had not been met) An immediate requirement was left with the manager to audit all staff files and send a copy of the findings to the Commission. The registered person must 30/06/06 ensure fire drills are held at DS0000006853.V292627.R01.S.doc Version 5.1 Aldington House Page 23 times to include all staff including night staff. 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 OP18 Good Practice Recommendations The registered person should ensure the procedure in relation to adult protection clearly states that all allegations or suspicions of abuse are referred to the host social services authority for investigation. The registered person should ensure the new manager submits an application to register with the Commission as soon as practicable. 2 OP31 Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Aldington House DS0000006853.V292627.R01.S.doc Version 5.1 Page 25 - 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!