Inspection on 17/07/08 for Allenbrook Nursing Home

This inspection was carried out on 17th July 2008.

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

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

Allenbrook Nursing Home 06/09/06

Allenbrook Nursing Home 26/10/05

Allenbrook Nursing Home 01/06/05

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Allenbrook Nursing Home 34 Station Road Fordingbridge Hampshire SP6 1JW Lead Inspector Gina Pickering Unannounced Inspection 17th July 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allenbrook Nursing Home Address 34 Station Road Fordingbridge Hampshire SP6 1JW 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) 01425 656589 01425 655410 allenbrook@bmlhealthcare.co.uk Allenbrook Care Ltd Post Vacant Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability (PD) 2. Old age, not falling within any other category (OP) The maximum number of service users to be accommodated is 43. Date of last inspection 6th September 2006 Brief Description of the Service: Allenbrook is a large Georgian period country house situated in extensive grounds and it was converted for use as a nursing home. It is owned by Allenbrook Care Ltd, a company formed with the specific purpose of purchasing and owning the care home and the day-to-day operation is the responsibility of managing agents, Affinity care Homes. The home is located within a quarter of a mile of the small country town of Fordingbridge, with all its amenities. There is limited bus service from Fordingbridge to the centres of Ringwood and Salisbury the nearest large centres of population. The nursing home has three floors on which service users are accommodated. A passenger lift provides access to all floors. The home’s communal rooms comprising a lounge dining room and a separate lounge and a large sun lounge/conservatory are all located on the ground floor. Communal WCs and baths are located on all floors. Other facilities provided include a laundry service and full board. The home provides a limited meals on wheels service to people living in the local community. Potential residents are sent a brochure and given verbal information about the services the home provides they are also invited to visit the home. When an individual moves into the home they receive a welcome pack that includes the home’s Service Users Guide and a copy of a report of the last inspection made of the home by the Commission for Social Care inspection. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 5 At the time of the fieldwork visit to the home on 6th September 2006, the home’s fees ranged from £500 to £690 per week. The fees did not include the cost of hairdressing; chiropody; the installation and running costs of private telephones and dry cleaning. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is two stars. This means that the people who use this service experience good quality outcomes. The inspection considered information received by the Commission about the service since the last key inspection in September 2006. This includes information provided to the Commission in the form of the home’s Annual Quality Audit Assessment form in which the registered provider or manager tells the Commission how the service has developed over the past twelve months and how they propose to continue to improve the service. We surveyed people who use the service, relatives, staff and health care professionals who have input into the service. Information received from these surveys has been used to inform the inspection process. A visit was made to the service on 17th July 2007. We looked at documentation relating to four people using the service. We had conversations with the recently appointed manager, the regional manager, four staff members, eight people who live at the home and three visitors as well as looking at various documentation as part of the inspection process. What the service does well: Effective assessment processes that include the provision of good information means that people are confident their needs will be met when they move into the home and they have an understanding about the running of the home. Good care planning procedures means that people using the service receive the care and support in the manner they prefer. People living at the home have their health care needs met by the use of effective health care assessments and monitoring and prompt referrals to health care professionals. People living at the home have opportunity to take part in meaningful activities. People living at Allenbrook enjoy a varied nutritious menu that provides them with choice at mealtimes. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 7 People living at the home are confident that complaints will be taken seriously and be responded to promptly. People living at the home are protected from the effects of abuse by a staff team that has a good understanding of safe guarding procedures. Good staff development and training provision ensure that people living at the home are cared and supported by a highly skilled and knowledgeable work force. Effective management, that incorporates the views and wishes of people living at the home into the development of the service, means the home is run in the best interests for people living there. What has improved since the last inspection? What they could do better: The service must ensure the fixation of the controlled drug cabinet complies with the Misuse of Drugs (Safe Custody) Regulations 1973. The service tells us it is seeking ways to ensure staff members that have completed NVQ training but have not received their certificates because of the Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 8 training company going into liquidation manage to obtain their NVQ qualifications. The recently appointed manager must apply for registration with us. The service tells us it seeking to improve the environment for people living at the home by extending the building. They are in the process of seeking planning permission for the extension. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 9 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 Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effective assesment procedures that include the provision of good information about the home mean people move into the home confident they will receive the support and care they need and with an understanding about the running of the home. The home does not provide intermediate care. EVIDENCE: The AQAA told us the service provides comprehensive information about the service to people interested in living at Allenbrook in the form of brochures, website, viewings, pre admission assessments and discussions. During our visit to the home we looked at the brochures which include details about the running of the home and the services offered at the home such as contact details of the registered provider and manager, a description of the staffing numbers and skill mix at the home, a sample of the contract a person will Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 11 enter into if they move into the home, details about the environment, visiting times, provision of meals, routines and activities at the home and the complaints procedure. People who use the service and their relatives told us that they received enough information about the home prior to moving into the home. The AQAA told us that a detailed assessment process is completed before a person moves into the home. We looked at two assesment documents as part of the inspection process. The assessments detail the personal, physical, health and mental health needs of the person as well as information about their social interests and hobbies, next of kin and any legal instructions. Following the assessment process people are informed in writing as to whether the home is suitable to meet their health and personal welfare needs. Copies of such letters were seen in the documents relating to people living at the home. This means the home has complied with a requirement made about this at the previous key inspection in September 2006. Staff told us that there is good information about a person when they move into the home to allow care and support to be given to as needed immediately. People living at the home were unable to remember the processes that had taken place before they moved into the home, but their relatives confirmed that assessments had taken place before the person moved into the home. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care planning processes mean that people living at the home receive the support and care they need in the way they like. People living at the home have their health care needs met by a work force that has a good understanding of health care issues, by effective monitoring and assessments and by prompt referral to health care professionals when needed. Good medication practices and effective monitoring of these mean that people using the service have their wellbeing protected. Good practices and provision of equipment means that a person’s privacy and dignity is protected. EVIDENCE: The AQAA told us of several improvements that have been made to improve the health and personal care received by people living at the home. These Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 13 included the introduction of end of life pathways, increased training for staff and a change in the way medications are ordered. As part of the inspection process we looked at four plans of care. The admission information confirmed that all assessments including moving and handling, falls and skin integrity are complete within twenty-four hours of the person moving into the home. Care plans incorporate personal preferences with regard to sleeping and rising routines, daily routines, whether they prefer to be cared for by a female, male staff or do not mind and other personal preferences such as one person does not like to be alone in a room or hobbies they like to take part in. Details about how a person likes to be supported in their personal and health care is found in the plans. Discussion with people living at the home, staff members and a visitor indicated that people’s wishes as documented in care plans are adhered to. Nutritional assessments are made using a professionally recognised tool and a care plan is developed if nutritional risks are identified. Professionally recognised tools for pain assessment, moving and handling and dependency are used and a plan of care developed accordingly if a risk or a need is identified. Care plans are reviewed monthly and changes made to the care plans according to any changes in individuals needs or risk assesment. Staff at the home told us that people living at the home and their representatives are encouraged to be involved in the care planning and review processes. The statement of purpose details that people living at the home and their representatives are encouraged to be involved in the care planning process. But staff told us in reality not many people do become involved. Each person is given the opportunity to state whether they wish to be actively involved in the care planning process. Forms were seen in the care plan documents that detailed whether the person living at the home or their representative wished to be involved in the care planning process. Of the four plans we looked at two of them contained signatures of the person living at Allenbrook or their representative. The manager told us she has commenced a programme of auditing the care plans to ensure they contain the relevant assessments, reviews and information to ensure people receive the care they need and wish for. We saw a sample of these audits. The team of trained nurses working at the home facilitate the health care of people living at the home. Documentation evidences the contact people have with doctors and other health care professionals including GP’s, chiropody, physiotherapy, and opticians. Instructions from doctors about a person’s health care are recorded in the doctor’s notes of the care planning documentation as well as being incorporated into the care plan and medication administration record sheet if needed. Relatives told us the home attends well to people’s healthcare, GP’s are called out when needed and that the home informs them promptly of any changes in a person’s health condition. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 14 Throughout the inspection process information was obtained evidencing the privacy and dignity of people living at the home is promoted and protected. Care plans detail people’s wishes about personal care and their wish to have either a male or female carer supporting them with their personal care. Staff members were observed talking with and assisting people at the home in a friendly and pleasant manner. No breaches of privacy were observed throughout our visit to the home; staff were always seen to knock on a persons bedroom door and wait for a response before entering the room. The AQAA told us that improvements to medication systems in the form of regular audits of the medications and a change in the way medications are ordered. A sample of medication audits was seen detailing that checks are made on the way the medications are detailed on the administration chart, the documentation of medications ordered and received, how variable doses are recorded to ensure the exact amount of medication a person has is detailed, and a check that medications are not out of stock which would result in a person not receiving their prescribed medications. We looked at the medication administration records for four people living at the home. They record clearly states the dosage and time each medication is due to be administered. Medications altered by medical staff are clearly documented and are detailed in the persons care plan documents. The nurse administering the medications signs for all medications taken by a person, and the reasons for any missed doses are documented on the record sheet. Training records details that all nurses receive training about the management of medications. The medication storage area was looked at; this is kept in a clean and orderly manner. We looked at the storage area for controlled medications; this does not comply with the Misuse of Drugs (Safe Custody) Regulations 1973. At present controlled drugs are stored in a small metal cupboard that is secured to a larger metal medication cabinet that is in turn secured to the wall. There are two boltholes for independent securing of the controlled drug cabinet to the wall but bolts have not been used to secure the cabinet in this manner. A requirement has been made about this. The AQAA told us that end of life pathways are being introduced to improve the care a person receives in the final days of their illness. Training records evidenced that staff have received training in the Liverpool Care Pathway which is a nationally recognised tool and care pathway for supporting and caring people in the their final days of life. As this care pathway was only just being implemented staff have not had the opportunity to evaluate the effect it has on outcomes for people living at the home yet. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have the opportunity to take part in meaningful activities and to maintain contact with their family and friends. People living at the home are able to exercise choice and control over their life. People living at the home benefit from a varied and healthy diet. EVIDENCE: The AQAA told us that a part time activity coordinator is employed to facilitate activities for people living at Allenbrook. When we visited the home a new activity coordinator had recently been appointed. This provides the home with two activity coordinators. Details about peoples past and present interests are obtained during the preadmission and ongoing assessments at the home. The activity coordinators use this information as well as discussing with people to ensure there are suitable activities planned that people who live at the home have an interest in. During our visit to the home a group of people were enjoying card games in one of the lounge areas of the home. During our visit to the home people told us there are activities they can join in or they can Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 16 occupy themselves either in the communal areas or in their own bedrooms. They told us staff find time to sit and have chats with them giving them one to one attention. The newly employed activity coordinator told us that she is still in the process of developing an activity programme based on the interests expressed by people living at the home. One example of the plans being made as a result of listening to people living at the home is the plan to establish a gardening club. Many of the people living at the home have expressed the fact that they used to be keen gardeners and would like to be able to continue with some form of gardening. The AQAA told us that there are no limitations on visiting times; people at the home can choose when to receive their visitors. This is also detailed in the information a person receives before moving into the home. Visitors we spoke to during our visit to the home confirmed that they can visit at anytime of the day. The visitor’s book detailed that visitors enter the home at various times of the day. Throughout the inspection process evidence was gathered confirming that people living at the home are able to make choices in their daily lives. Examples of these include being able to make choices about involvement in activities, where and when to take their meals and their wishes regarding care support being included within the care planning process. People were observed being able to move freely or with assistance around the home, choosing whether to use the communal areas or sit in their bedrooms. One gentleman likes to take himself outside in his electric wheelchair, he enjoys sitting outside the entrance of the home watching the ‘comings and goings’. Details about his wishes are included in his care plan along with any risks associated with this activity and the action to be taken to reduce the impact of any risks. People living at the home told us they are able to make choices about their daily lives, when to get up, whether to have bath or shower and where to spend the day, in the communal areas or in their private bedrooms. The statement of purpose and service users guide provides information about the meals provided at the home and tta people living at the home have the choice of where to take their meals. The manager told us she has asked people living at the home whether they want one of the lounge areas made into a dining room but at the moment people have rejected this. They prefer to eat in the lounges with their meals on pull up tables. Discussion with people living at the home confirmed that they have been asked about their preferences for eating areas and they do not want a dining room. People living at the home are offered choices at mealtimes and all said they enjoy the meals provided at the home. Records are kept of food provided. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home are confident that complaints will be taken seriously and responded to promptly. People who use the service are protected from the effects of abuse by a staff team that has a good understanding about safeguarding procedures. EVIDENCE: A complaints procedure is in place and is displayed in the home. People living at the home and their representatives are made aware of the complaints procedure during the assessment processes, conversation and through information provided in the statement of purpose and service users guide. People living at the home and their representatives confirmed they know how to and to whom to address and complaint and they are confident that all complaints or concerns made will be taken seriously and managed effectively by the manager. The AQAA told us that the home has received six complaints in the last twelve months. We looked at the homes record of complaints that evidenced that all complaints are investigated and responded to within 28 days in line with the homes complaints procedure. Policies and procedures are in place about the protection of vulnerable adults including the local authorities safeguarding adult’s procedures. Staff training records indicate that staff have had training about the mental capacity act Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 18 which the manager and staff said incorporated issues about abuse. Staff were able to demonstrate in conversation a good understating about the effects of and how to recognise if abusive practices happening and the procedures to follow if they suspect abusive practises have occurred. There have been no safeguarding referrals made in the past twelve months. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from living in a safe and comfortable environment, which is suitably furnished and maintained. EVIDENCE: As part of the inspection a tour was made of the environment looking at a sample of bedrooms, bathing facilities, communal areas, the kitchen, the laundry and the gardens. The AQAA told us there is an ongoing maintence and refurbishment plan for the home. Examples of refurbishment that has occurred that improves outcomes for people living at the home include the declutering of the entrance hall to provide a comfortable seating area for both people living at the home and people visiting the home, the refurbishment of one of the bathrooms to make a large wet room giving people the choice of having a bath Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 20 or shower and the provision of seating in hallway areas to give people a greater choice of where to spend their time. During our visit to the home we observed both the seating in the entrance a hall and in the hallways being used by people living at Allenbrook. Bedrooms are to varying degrees personalised with the person’s own belongings such as ornaments, pictures and small items of furniture. Bedrooms that are shared have screening available to promote the privacy and dignity of the people sharing the bedroom. One person told us that although she does not want her room decorated she believes that if she asked the home would redecorate her room and paint it in a colour of her choice. Communal areas consist of a two large lounges and a large conservatory area. Art present one of the lounges is a quiet lounge and the other has a television and CD player for the use of people living at the home. People using the television lounge told us that they are able to make choices about what to watch on television, but it has to be agreed between all that are watching the television and that there has to be a degree of compromise sometimes. All the communal areas are decorated in a homely manner. As discussed n the section about social activities the manager has approached people living at the home to find out whether they would like one of these communal areas to be made into a dedicated dining room but at the moment their decision is that they do not want this to happen. During the course of our visit to the home we observed both the lounge areas and the conservatory area being used by people living at the home. A shaft lift enables people to access both floors of the home. There are sufficient bathing and toileting facilities for people who live at the home. There is a large landscaped garden for people to use. At present there are some areas of the garden that the home have identified as posing a risk to pole for example a low wall around the patio area which is located at the top of a steep bank. The manager told us that this is being addressed by the planed provision of railings to reduce the risk of people falling down the bank. As previously stated in the section about social activities there are plans to involve people living at the home in the development of the garden by the formation of a gardening club. There is also an area of the garden that is labelled as a sensory garden. This has fallen into some neglect and the manager informed us that wok is due to commence to redevelop the sensory garden to make it an area for people to enjoy. Policies and procedures are in place about hygiene practices and the control of infection. The AQAA tells us that these were last reviewed in March 2007. A team of housekeepers are responsible for the cleaning of the home. During our visit the home was observed to be clean and tidy with no offensive odours. The homes laundering facilities are on the ground floor. The position of laundry and good laundry practices reduce the risks of cross infection from dirty Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 21 laundry. The laundry floors and walls are easily cleanable and were clean and tidy on the day our visit. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good staff development and training provision ensure that people living at then home are cared and supported by a skilled and knowledgeable work force in suitable numbers. Robust recruitment procedures mean that people living at Allenbrook are supported and cared for by staff suitable to work in the caring profession. EVIDENCE: A staff rota displayed in the home details who and in what capacity, such housekeeping, kitchen or care staff, is on duty at any one time. Both people living at the home and their relatives told us there is usually enough staff on duty at any one time to meet the needs of people living the home. Observation during our visit to the home showed that staff members have time to sit and talk with people living at the home and call bells were answered promptly indicating that there were sufficient numbers of staff on duty at that time. We looked at a sample of staff records. These evidence that good recruitment practices are followed ensuring that no one commences employment at the home prior to two written references being received and CRB and POVA information being obtained. These processes protect the welfare of those Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 23 living at the home and evidences that the home has complied with a requirement made about obtaining pre employment checks following the previous key inspection September 2006. Staff records also contained copies of certificates for courses attended and qualifications obtained by staff members. The manager has developed a training matrix that clearly identifies the training staff have had and what training they need to update. Recent training that staff have received includes moving and handling, fire safety, dementia, care of the dying, pressure area care and for the trained nurses medication management and venepuncture. We were told that the registered providers are developing their own training organisation to support the facilitating of training at the home. During our visit to the home training was being provided to staff members about moving and handling. Staff told us their induction programme covered what they needed to know to begin supporting and caring for people at the home. The manager confirmed that induction programmes follow Skills for Care common induction standards and we saw a copy of the induction programme used by the home to confirm this. The AQAA told us that only 10 of the care staff have NVQ level 2 or above in care. The manager told us that the reason for this was because a large number of care staff had undertaken the NVQ course with a training company, had completed the course work and had been told they had succeeded. But before the course work was returned and certificates were awarded the company went into liquidation resulting in care staff having no evidence to support the fact that they have completed their NVQ level 2. The manager told us she and the regional manager are in the process of trying to obtain the course work and certificates that belong to the relevant care staff and are also sourcing a different provider for NVQ training. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that is effectively managed and seeks the views of those using the service to influence the development of the home. Robust procedures ensure that the finances of people using the service are protected. Good health and safety practices protect all people at the home. EVIDENCE: A new manager has been appointed to the home since the last inspection and at the time of our visit to the home she had been in post six weeks. She told us she is the process of obtaining all the relevant information to submit an application to us to be registered as manager of the home. Also since the last inspection the registered providers have appointed a different management Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 25 company to take over the management of the home. The manager and management company have already demonstrated their commitment to the development of the home to improve outcomes for those people living there. Examples of this include the provision of a wet room giving bathing choices, the tidying up of cluttered areas making them into pleasant seating areas, the implementation of regular auditing of care plans and medication administration charts along with proposed plans for the development of the home that includes an extension to improve the environment for people at the home. The manager is a trained nurse and has many years experience of managing care homes for large organisations. The manager told us she makes herself available for staff and people living at the home to see her. Both staff and people living at the home were seen to have a comfortable relationship with the manager. The AQAA told us people who use the service, their relatives and visiting professionals are surveyed about the service provided at the home as well as similar information being gathered during resident meetings. Information from these is used to influence the running and development of the home. Examples of this include a television being provided in the conservatory area for one lady who does not want to sit n the television lounge but does not want to spend all her time watching television in her own room, more varied activities, a review of the menus resulting in the provision of a more varied choice and not changing one of the lounge areas into a dedicated dining area. Conversations with people living at the home confirmed that meeting are held during which they are able to voice their opinions and wishes about the running of the home. The provider’s monthly reports about the quality of the service provided by the home contribute to quality assurance processes at the home. These reports are available at the home and include views of the people who live at the home as well as audits of documentation and the environment and views of staff at the home. Procedures are in place about the handling of money for people who live at the home. People can make use of a safekeeping facility if they wish. Records are kept of monies held for people including details of income and expenditure. The AQAA told us the home has a health and safety policy that was last reviewed in January 2007. Records indicted that staff receive training about health and safety issues. We saw risk assessments for the environment that detail working practices to be followed to reduce identified risks. Suitable moving and handling equipment is available. The fire logbook indicates that fire safety checks are carried out in accordance with the Fire and Rescue Services guidelines. The home has a policy for the control of substances hazardous to health known to staff. Chemicals and other items are securely stored in locked cupboards. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 26 The home had a food hygiene inspection in October 2007 following which seven requirements were made. The manager and cook could demonstrate to us that these requirements have been met. The AQAA told us that the cook and many of the care staff have undergone training about food hygiene practices. No concerns have been raised to us about food hygiene practices at the home. We looked at a sample of service certificates evidencing that services and equipment are maintained at manufacturers recommended intervals. This protects the wellbeing of all at the home. Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements 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 OP9 Regulation 13(2) Requirement The controlled drug cupboard must be secured to the wall that complies with the Misuse of Drugs (Safe Custody) Regulations 1973. Timescale for action 17/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Allenbrook Nursing Home DS0000064164.V367029.R01.S.doc Version 5.2 Page 30 - 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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