Inspection on 06/07/05 for Allambie Court

This inspection was carried out on 6th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Allambie Court 29/01/09

Allambie Court 10/10/08

Allambie Court 07/01/08

Allambie Court 21/09/07

Allambie Court 29/11/06

Allambie Court 19/04/06

Allambie Court 22/11/05

Allambie Court 15/02/05

Allambie Court 23/04/04

Similar services:

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

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

CARE HOMES FOR OLDER PEOPLE Allambie Court 55 Hinckley Road Nuneaton Warwickshire CV11 6LG Lead Inspector Suzette Farrelly Unannounced 06 July 2005 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 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. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Allambie Court Address 55 Hinckley Road Nuneaton Warwickshire CV11 6LG 02476 383501 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) ADL Plc Mr Peter Jones Care home with nursing 30 Category(ies) of Mental Disorder (30) registration, with number Dementia - over 65 (30) of places Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 15 February 2005 Brief Description of the Service: Allambie Court Nursing Home is situated in Nuneaton approximately 1 mile from the town centre. The local public bus stops near by. The home is an Edwardian building converted into a nursing home, set in its own grounds. There is a large garden to the rear with ample space for service users to do some gardening or to just sit in the open, weather permitting. The home provides nursing care to persons with dementia and mental health problems. The accommodation is in single and shared rooms. Services offered include full personal and nursing care for persons with dementia. Qualified nurses and carers deliver the care twenty-four hours a day. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two consecutive days. On the first day the manager and administrator were not available and some records could not be seen. The nurse in charge on the first day accompanied the inspector on a tour of the home and discussed issues related to care provision and the environment. Discussion took place with five residents, two staff, the activity organiser, the cook and one relative. There was mixed views about the home and although all agreed that the care was good, there were many issues related to the environment. The inspector arrived at 14:00 and remained at the home until 18:00 during this time residents were seen sitting in the two lounges, there was little activity seen. Staff were present in both lounges and dealt with immediate issues and concerns of the residents. The activity organiser was in the garden mowing the lawn to ensure that the garden area was tidy for the ‘Garden Fete ‘ on Saturday. One resident was seen wandering around the garden alone. The rear of the garden was very untidy, the grass is long and there was old furniture stacked in an overgrown flowerbed. The home environment had an unpleasant smell and the carpet in the upstairs dining area was very badly stained. The re-decoration of a number of bedrooms is of poor quality and the decorator has painted over the fire strips on the doors making them ineffective. Other rooms require decorating and much of the bedroom furniture is in poor repair and very tired looking. Only one bedroom door has a lock and residents do not have the choice to lock their doors. There are two new bathrooms and two shower rooms. The shower rooms are only appropriate for residents who are relatively mobile. Both new bathrooms are incomplete and one bath has a crack in the plastic and the shower attachment is damaged. It was difficult to see how the hoist could be used in either of these rooms to assist residents to get in and out of the bath as the space is very small. What the service does well: It was difficult to see what the home does well in the face of so many areas that are not achieved. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 6 The staff appear to have a reasonable relationship with the residents and visitors and one visitor was pleased with the care given to their relative. The activity organiser has brought a number of good ideas to the home and there is evidence that she carries out small group work and works individually with the residents if needed. What has improved since the last inspection? What they could do better: The home has received a letter of serious concern regarding the management of the home. Below is a summary of areas that need to be addressed by the manager and provider of this service. • • • • The Statement of Purpose and the Resident’s Guide need up dating so that the information available is correct. The Contract of Residency needs assessing to ensure that the information is correct for the service. The provider and manager must consider how the home can meet the psychological needs of the residents in line with recent changes and developments in the care of people with dementia. The care plans are poor and a number have not been up dated for more than three years. They are not evaluated monthly to ensure that the care given is meeting the outcomes and dealing with the complex care required. The risk assessments for pressure damage, nutrition, and falls are not completed regularly and residents are not weighed, this may result in harm to the residents. The medication administration records are not properly completed this could result in medication being given incorrectly. The general hygiene and cleanliness of the residents is poor and a number of residents were seen unshaven with dirty hair. The manager and activity organiser must develop a programme of activity that meets the needs and interests of the residents. The home must ensure that all residents receive a healthy well balanced diet at all times and are given sufficient to eat. The manager must ensure that the cleaning of the kitchen is completed and that there is sufficient equipment available to ensure that all types of dietary needs can be met. The provider and manager must ensure that the dining areas are redecorated and re-furbished to an acceptable standard. The provider must remove the Perspex window in the first floor dining room and replace with glass to ensure that the residents have a clear view of the outside world. E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 7 • • • • • • • • Allambie Court • • • • • • • • • • • • • The provider and manager must ensure that the policies and procedures related to the prevention and reporting of abuse must be up dated and reflect the national and regional guidelines. The provider and manager must check the Criminal records and Protection of Vulnerable Adults List before offering employment at the home to ensure that the employee is safe to work with vulnerable adults. The home needs redecoration in a number of areas such as the dining rooms, bedrooms, bathrooms, toilets and corridors. The carpets in a number of bedrooms require replacement and some flooring also requires attention. Furniture in the bedrooms is old looking and in places damaged, this needs replacing. The vanity units around the sinks are in poor condition with obvious water damage, these need replacement. The decorating that has been carried out is of poor quality and needs to be addressed. The chairs in the lounge areas have non-matching seat cushions and these areas generally looked untidy. The home was found to be dusty with cobwebs in various areas and there was an unpleasant smell in the dining rooms, lounges and a number of bedrooms. It was noted that lampshades were missing from some ceiling lights. The carpet in the first floor dining room was very stained and dirty this needs replacement. The bathrooms have recently been changed, the flooring in these areas needs replacing as a matter of urgency and the rooms need to be suitable for use. The garden area requires attention, old furniture needs to be removed and the grass cut. The sluice rooms were found to be unlocked; the manager must ensure that staff lock these areas, as they are potentially dangerous. 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. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 9 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 standard(s) 1, 2, 4, 5 The information for prospective residents requires up dating, as this may currently cause some confusion when deciding if the home can meet their needs. Each resident has a written contract, this has information that is not appropriate for residents with dementia and could be misleading and cause confusion. The residents and their representatives may be mislead that the home can meet their needs as information and care planning is inadequate, this may lead to disappointment and concerns for well being. All residents and their families are invited to visit prior to admission and there is a period of settling in allowing the right decision to be made. EVIDENCE: The Statement of Purpose and the Residents’ Guide to the home were seen and examined. Information concerning the number of qualified staff available at the home was incorrect and this is misleading. The Residents’ Guide is suitable, however, it was noted that a copy is not given to prospective Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 10 residents and their families and other information such as the last inspection report and the results from surveys are not readily available. The contracts given to residents and their representatives give false information about handling of residents’ personal monies and do not refer to the fact that the home invoices the residents’ representatives monthly for extra expenditure. There was no evidence that specialist serviced are offered to meet the psychological needs of the residents. On the day of the inspection it was seen that the staff communicate appropriately with the residents and meet their basic physical needs. No activities or therapeutic inputs were seen. The home invites the representatives and the resident to the home prior to admission, it was noted that the residents rarely visit and their representatives make the decision for admission. There is a four-week settling in period and this is not extended. Social services carry out a review six weeks after admission. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 11 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 standard(s) 7, 8, 9, 10 The residents’ health, personal and social care needs are not fully met and this may result in harm and deterioration of well-being and health. The homes’ administration of medication does not follow the correct procedure and this may result in medication errors and harm to residents. Some areas of the residents life is not respected, their right to privacy is also at times not up held this could result in depersonalisation and loss of self worth. EVIDENCE: Four resident profiles were examined, the information was poor and records of the residents needs are not maintained. One resident had not had their care evaluated since 2002 and the plans of care were written in 2000. In another profile there were three separate care plans that discussed the risk of pressure damage, this is confusing and could result in an oversight of care. The care plans are not clear and do not contain up to date information and care practices. There was no evidence that the care plans are used to direct practice. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 12 The health care of the residents was difficult to assess. Risk assessment forms are available, however, these are not consistently completed and where there is an identifiable risk there are no corresponding care plans. In one profile it is recorded that there is weight loss, the resident has not been weighed since December 2003, there is no nutritional assessments and the care plan is inappropriate. This could result in complications of malnutrition and discomfort for the resident. In another resident’s profile it was noted that there is a risk to pressure damage, no preventative care plans were seen. It was noted that tissue damaged occurred, no suitable care plans were seen to direct to staff in how to promote healing. There is no evidence that psychological assessments are carried out and the home cannot demonstrate that the mental health needs of the residents are met. The homes’ handling of medication was examined. It was noted that there are gaps on the medication administration records and one medication was checked and it was noted that the wrong code had been used. This lack of care when recording could result in mistakes being made during administration. The home has a basic policy and procedure for non-prescribed medication this is out dated and could result in medications being given that interact and reduce the desired effects. All medication is administered by the qualified nurse on duty and assisted by the care staff when required. A number of residents hair looked dirty and unkempt. It was stated that the hairdresser visits weekly and cuts, sets and maintains the residents hairstyles. There is no designated hairdressing area, and the residents have their hair washed in one of the shower rooms. This involves covering the resident in a full plastic mack and using the showerhead to wash their hair. This could be degrading and does not reflect normal life. The hairdresser has used a shared room in the past, and now uses the dining room. The residents clothing was seen to be in varied states of repair, however, all clothes were clean. It was noted that facial hair is not removed from female residents and some of the male residents had a few days growth. One resident required grooming and the staff had failed to ensure that his personal hygiene needs were met appropriately. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 12, 13, 14, 15 The home could not demonstrate that it can meet the expectations and satisfy the social, cultural, religious and recreational interest and needs of the residents this may result in reduced mental well being and changes in behaviour due to boredom. The residents are assisted to maintain contact with relatives and friends. There is limited contact with the community and this may result in a reduced sense of self worth for the residents. The residents are assisted to exercise choice and control over their lives and this will increase and maintain their self worth. The residents do not receive a wholesome, appealing and well balanced diet in pleasing surroundings and this could result in weight loss, reduced experience of quality of life and poor self-esteem. EVIDENCE: The home has a part time activity organiser who also fundraises monies to pay for the activities. It was noted that there is no designated budget for activities. On the day of the inspection the activity organiser was in the garden mowing the lawn, no residents were seen with her. There was to be a fete on Saturday and the activity organiser was tiding the garden for this reason. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 14 The home does not have a formalised plan for activities and the activity organiser stated that she usually carries out one to one activities and smaller groups. Sometimes she takes individual residents out to town, the countryside, garden centres and to the local pubs and restaurants for lunch. There is no record that this takes place. Scrapbooks containing themed pictures were seen; these are used to encourage residents to discuss different subjects. For the duration of the inspection the residents were seen sitting in the two lounges or wandering around the home or garden alone. There were no organised interaction or activities occurring. The home has open visiting and encourages family to spend time with the residents. One relative was spoken to who stated that her relative had settled well at the home and she was happy with the care. The home is aware that community contacts need further development. Residents’ rooms were seen during the tour and many are drab and bare; residents are allowed to bring personal items to the home however, where there are no relatives the home has not encouraged the resident to personalise their own room. The staff are not fully aware of the rights of residents and their representatives is relation to access to records. Tea was served at approximately 4:45 in the afternoon; it was seen that residents were given one slice of bread with filling and a small piece of cake followed by a cup of tea. Residents also ate in the lounge; the inspector noted that residents were not asked if they would like more food. It was discovered that only a small number of residents remain up late and the night staff will give sandwiches if the residents ask for them. There is grave concern that the diet is inadequate and could result in gradual weight loss and possible malnutrition. The kitchen area was viewed and it was noted that there are no electrical liquidisers or mixers to enable the cook to provide food in a suitable manner for residents. The cleaning schedules were not completed and it was found that the cook cleans only half the kitchen; the domestic staff or carers clean the remaining areas. The fridge and freezer temperatures are checked as required. It was seen that some food in the freezers had come out of their packaging and spilled into the freezer. This could result in out of date food being used, cross contamination and demonstrates a lack of concern, care or training placing residents at risk. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 15 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 standard(s) 18 The home was unable to demonstrate that it had suitable systems in place to protect residents from abuse. EVIDENCE: The home has policies and procedures concerning the management of residents who may exhibit verbal and/or physical aggression, this described clearly how staff should respond. This policy also includes the use of bed rails and other forms of restraint. Policies and procedures concerning the recognition and reporting of abuse were unavailable. The home faxed a copy two days after the inspection, these were examined and it was noted that this document does not meet with the local and national guidance and could result in poor management of abusive practices. There was no recognition of the Protection of Vulnerable Adults lists and the role of the management in ensuring that any worker who is involved in abuse is referred to the list so that they would be unable to care for vulnerable adults in the future. There is evidence in the training records that the staff have received training in abuse, its recognition and action to be taken. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 16 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26 The residents’ do not life in a safe, well-maintained home, which may result in low self-esteem and poor quality of life. There are sufficient toilets and bathing facilities however these are poorly organised which may reduce the quality of life of the residents. The home is not clean and in some areas there are unpleasant smells resulting in a reduced quality of life. EVIDENCE: The inspector toured the home and gardens during the inspection. It was seen that some bedrooms had been decorated, it was noted that the walls had been painted, but holes had not been filled in, the boarder had been painted over and in one room these were pealing away from the walls. The doors were badly finished, and the original colour could be seen, the fire strips around the doors had also been painted over, reducing their efficiency and placing residents at particular risk in the case of a fire. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 17 In places the paint on the radiators was pealing revealing the original colour. Other bedrooms required decorating. The plan for refurbishment was seen, the management have allocated £100 per room to re-decorate and purchase new curtains and bed linen. It was also seen that the furniture in a number of bedrooms was old and in need of replacement. The units surrounding the hand basins had water damage and the veneer was lifting away from the surface of the unit. The rooms were drab and uninviting and there was minimal evidence of personalisation to the rooms. There was no evidence that the home encourage residents without immediate family to make their rooms personal. The home have made some changes in relation to bathing. Two bathrooms have been modified and two new shower rooms created. The bathrooms are not complete and require decorating and new flooring. In one bathroom it was difficult to see how a hoist could be used to assist residents with bathing as the bath is on a slant and the hoist would not fit with ease. The shower rooms are small and there are no grab rails to assist residents. One shower room leads directly onto a communal corridor near the ground floor lounge. From discussion it was determined that residents are taken from the shower to their room to get dressed as the shower room is too small, this could compromise their privacy and dignity. The two lounges have been re-carpeted and the décor is acceptable, the furniture in the lounge areas require attention, the seat cushions do not match and there was no evidence of books, magazines or newspapers. The dining areas are in need of re-decoration, new floor covering and replacement of some furnishings. The upstairs dining room was not inviting and one window pain was made of Perspex and cloudy not allowing a view to outside. The home was found to be dusty with cobwebs in various places and the lighting in the corridors was poor. There was an unpleasant smell in various areas throughout the home such as the lounges, dining areas and bedrooms. The garden area was well maintained immediately outside the rear of the home, however further back it was noted that old furniture was stacked in an overgrown flowerbed and the grass was long and untended. The manager stated that this land is to be sold for development. The home has a call bell system in all bedrooms and communal areas. There are grab rails throughout the corridors, however there are no grab rails in bathrooms, toilets or shower rooms. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 18 The first floor can be reached using the shaft lift, which was not very clean. There is minimal storage space for wheel chairs and hoists. The home has two sluice rooms, these were both unlocked, which could be potentially harmful to residents as chemicals are stored in these areas. The laundry is appropriately situated and has two washing machines that are able to disinfect and sluice. One tumble drier is out of order and this is insufficient for the quantity of washing required. There is a hand washbasin in the laundry, it was noted that there are no hand towels; this would suggest that staff do not wash their hands and this may result in spread of infection. There are a number of baskets with odd socks and items of clothing, these are either not labelled or have not been returned to the resident. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 19 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 The residents’ needs are not completely met by the numbers and skill mix of staff and are not protected by the homes recruitment policies and practices. EVIDENCE: Through discussion and examination of records it was seen that there are four care staff on duty during the morning with a qualified nurse and a further carer who works a shorter shift to assist with care. This is reduced to three care staff in the afternoon and two at night. There is a qualified nurse on all shifts. Incidents during the day suggest that training is required in areas such as nutrition, activities, challenging behaviours and overall care needs of residents with dementia and the complex needs that can arise. There is also a cook who works until 15:00 hours and the care staff are responsible for completing the evening meal and tidying the kitchen. There are two staff employed to clean the home. It was noted that only two of twenty-one care staff who are qualified, this is 9.5 of the work force and the home has no firm commitment to training, which will increase this to 50 as required. Other training takes place and a schedule was seen, other paper work was absent. The Induction Programme is very limited and does not ensure that all the areas of care practices and management are addressed. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 20 There is grave concern about the employment practices, it was seen that the home is not carrying out Protection of Vulnerable Adult checks on new staff employed since July 2004 as required by law. It was also noted that staff are employed without the proper Criminal Record Checks. This practice could result in abusive harm occurring. The Codes of Practice from the General Social Care Council are incomplete and after discussion the administrator stated that full copies will be ordered. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 21 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 36 The home is poorly managed and not run in the best interests of the residents which could result in poor outcomes and reduced quality of life. Staff are not appropriately supervised possibly resulting in poor outcomes and reduced quality of life for the residents and staff. EVIDENCE: The manager has been in post for eighteen months and works as a qualified nurse in the home. This leaves no time for management and from this inspection it was clear that areas of management responsibility are not being addressed. The manager is unable to carry out audits of care practices, meetings, quality assurance monitoring or formal supervision of staff. It was seen in the records that the residents’ families had been surveyed and the results of this was seen from 2004. This is not included in the Residents’ Guide. It was stated that the surveys for 2005 have been sent to the families; however, no replies have been returned at the time of the inspection. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 22 There is no formal supervision of the care staff; the manager informed that during the working day he informally supervises and discusses issues with care staff, this is not recorded. The home has suitable insurance cover. A record of all financial transactions made in the home are maintained, these were examined and found to be up to date. Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 23 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 x 1 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 2 2 3 2 2 2 1 STAFFING Standard No Score 27 1 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 1 1 x 2 3 x 1 x x Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 24 Are there any outstanding requirements from the last inspection? NO *indicates that these requirements are outstanding from the last inspection STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard *OP1 Regulation 4(1)(c) Requirement Timescale for action 31.08.05 2. OP2 3. OP7 4. OP7 5. OP7 6. OP7 The registered provider must ensure that the information in the Statement of Purpose and the Residents Guide is up to date and gives an accurate description of staff and the environment. Schedule The registered provider must 4(8) ensure that the Terms and Conditions of Residency reflect the actual handling of residents personal monies and the rights of the residents. 15, The registered provider and the 13(4)(b)(c manager must ensure that the ) care plans are up to date and Schedule meet with relavent clinical 3(1)(b) guidelines. 15(1)(2)( The registered provider and the a)(c)(b) manager must ensure that the Schedule resident and/or their families are 3(1)(b) involved in the process of assessment and development of care plans. 152)(b)(c) The registered provider and Schedule manager must ensure that all 3(1)(b) care planned is evaluated monthly and this must be evidence in the care profiles. 15 The registered provider and E53 S4383 Allambie Court V235591 060705 Stage 4.doc 31.08.05 30.09.05 30.09.05 30.09.05 30.09.05 Page 25 Allambie Court Version 1.40 Schedule3 (1)(b) 7. OP8 17(1)(a) 15(2)(b) 14(1)(a)( 2) 17(1)(a)S Schedule 3 Schedule 4 13(1)(b) 8. OP8 9. *OP9 13 (2) 17(1)(a) Schedule 3(3)(i) 12(4)(a) 10. *OP10 11. OP12 4(1)(c) 16(2)(m)( n) Schedule (1)(9) 12. OP15 16(2)(i)(4 ) 13(4)(a) 13. OP15 manager must ensure that the care precribed reflects the actual assessed needs of the residents. The registered provider and manager must ensure that all residents have a full risk assessment for pressure development, nutritional risks and falls, where appropriate preventative care plans must be devised and evaluated monthly. COntinued risk assessments must be carried out. The registered provider and manager must ensure that psychological assessments are carried out on a regular basis and changing needs are recorded and suitable plans of action devised where required. The manager must ensure that the medication administration charts are appropriately completed after each administration of medication. The manager and staff of the home must ensure that all personal care including hairdressing is conducted in private areas. The registered provider and manager along with the activity organiser must develop a suitable programme of activities that reflect the interests and needs of the group and individual residents. This must be made public and available to the residents and their families. The registered provider must ensure that the residents are given sufficient wholesome and nutritious food at all meal times. The registered provider and manager must ensure that the cleaning schedules are completed and that the kitchen cleanliness is up dated. 31.09.05 30.09.05 31.08.05 31.08.05 31.10.05 31.08.05 30.09.05 Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 26 14. OP15 16(2)(j)(k ) 15. *OP18 12(1)(a) 13(6)(7)( 8) 16. OP19 23(2)(o)( n) 17. *OP19 36 18. *OP19 & OP24 16(2)(j) The registered provider and manager must ensure that the dining environment is free from unpleasent smells, clean and pleasant. The Perspex window in the first floor lounge must be removed and replaced with glass affording a proper veiw of the front areas of the home. The registered provider must ensure that there are the appropriate policies and procedures related to the protection of vulnerable adults; these must include: a: Whistle Blowing Policies and Procedures, b: Policies and procedures that reflect the local procedure for reporting incidents of actual or suspected abuse. c: Policies and procedures that give clear guidance on the elements of abuse and how these can be recognised in line with government guidance in No Secrets. The registered provider must ensure that the rear of the property is maintained to a suitable standard for as long as it remains part of the home and the residents areas. The registered provider must ensure that compliance to requirements for care practices and the environment are met as required by the Commission of Social Care Inspection and evidence of action plans that meet these needs must be made available including clear time scales and costs that are sufficient to complete these. The registered provider must replace all worn and damaged furniture in the residents bedrooms. 31.10.05 31.08.05 31.10.05 31.10.05 31.10.05 Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 27 19. OP19 23(4)(5) 20. OP20 23(2)(b) 21. OP21 13(4)(c) 22. OP22 23(2)(n) 23. *OP22 23(2)(l) 24. OP24 12(4)(a) 25. OP25 23(1)(a) (2)(p) 26. OP26 13(3) 27. OP26 16(2)(e) 23(2)(c) The registered provider must ensure that the building meets with the requirements of the local fire service. The registered provider must ensure that all areas of the home are decorated and maintained to a suitable standard. Particular attention is required in the dining areas and a number of bedrooms. A plan of action with time scales must be forwarded to the Commission. The registered provider and manager must ensure that all sluice room doors are locked when not in use to prevent harm to the residents. The registered provider and manager must ensure that there are grab rails in the residents toilets and showers to maintain their independence and assist with mobility. The registered provider and manager must ensure that there is suitable storage for hoists and wheelchairs in the home. The registerd provider must ensure that suitable locks are fitted to all bedrom doors that canbe accessed in an emergency to afford privacy to the residents. The registerd provider and manager must ensure that the lighting in corridors and residents bedrooms is brighter to prevent injury and accidents. The registered provider and the manager must ensure that there are disposable towels at all times in the laundry area to allow staff to wash and dry their hands after handling soiled and dirty linen. The registered provider must ensure that the tumble drier is 30.09.05 31.10.05 31.08.05 31.08.05 30.09.05 31.10.05 30.09.05 31.08.05 30.09.05 Page 28 Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 repaired or replaced, 28. *OP26 16(2)(j)(k ) The registered provider and manager must ensure that the unpleasent smells in the lounges, dining areas and residents bedrooms are dealt with. The overall cleanliness of the home must also be addressed. 18(1)(a)(c The registered provider must ) ensure that at minimum of 50 of care staff have a National Vocational Qualification in care. A plan to this is to be forwarded to the Commission with projected time scales. 19 The registered provider must Schedule ensure that all staff employed 2 after October 2004 have a Protection of Vulnerable Adults (POVA) check prior to employment and where the Criminal Record Bureau check hasnot been received supervision at all times is maintained. 18(4) The registered provider and manager must ensure that all care staff receive the full Codes of Practice from the General Social Care Council. 18 (1)(c) The registered provider must ensure that the Induction Programme meets with the National Training Organisation specifications and that all new staff are appropriately inducted and trained to carrry out job. 10 The registered provider must make provision for the manager to work supernumerary to enable tasks to be completed that ensure suitable running and management of the home. 24 26 The registered provider and manager must ensure that there are suitable quality assurance and monitoring systems in place and that records of this are E53 S4383 Allambie Court V235591 060705 Stage 4.doc 30.09.05 29. OP28 31.09.05 30. OP29 31.08.05 31. OP29 30.08.05 32. *OP30 31.09.05 33. OP31 31.08.05 34. OP33 31.10.05 Allambie Court Version 1.40 Page 29 available for inspection. 35. *OP36 18(2) The registered provider nad manager must ensure that all care staff are formally supervised six times a year, clear records must be maintained and available for inspection. All other staff must be supervied at least yearly. 31.08.05 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 OP10 Good Practice Recommendations It is advised that the home write a procedure for using the shower room that leads directly into the corridor near the ground floor lounge to ensure that the privacy of residents is maintained at all times. The home should allocate a budget to activies allowing the activity organiser to develop suitable activity programmes for groups and individual residents. 2. OP12 Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 30 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Allambie Court E53 S4383 Allambie Court V235591 060705 Stage 4.doc Version 1.40 Page 31 - 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. 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