Inspection on 16/10/06 for Allington Court

This inspection was carried out on 16th October 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 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

Allington Court 01/10/09

Allington Court 21/01/09

Allington Court 04/10/07

Allington Court 05/10/05

Allington Court 03/02/05

Allington Court 31/08/04

Allington Court 11/03/04

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

CARE HOMES FOR OLDER PEOPLE Allington Court Lye Lane Bricket Wood St. Albans Hertfordshire AL2 3TN Lead Inspector Jeffrey Orange Unannounced Inspection 16th October 2006 08:35 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 Allington Court DS0000019266.V315990.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. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allington Court Address Lye Lane Bricket Wood St. Albans Hertfordshire AL2 3TN 01923 894542 01923 894544 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) www.bupa.com BUPA Care Homes (BNH) Limited Mrs Angela Naylor Care Home 44 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (44) of places Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 5th October 2005 Brief Description of the Service: Allington Court is registered to provide accommodation and nursing care to 44 older people with dementia, 10 of who may be below 65 years of age. It is owned and operated by BUPA Care Homes Limited and is situated in extensive grounds, adjacent to another BUPA care home in a semi-rural location in the village of Bricket Wood, within easy access of the M25 and M1 motorways. There is ample parking space provided at the font of the building. The home was purpose built for this service user group and is in the form of a hexagon with two internal courtyards, which, together with the attractive and secure grounds provide ample additional communal space where service users can walk and exercise, or simply sit and enjoy the gardens and views. The majority of service users are accommodated in single rooms and there are four lounges, an activity room and dining room. There is an information folder in the reception area of the home that includes contact details for the Commission for Social Care Inspection. (CSCI). Weekly fees are £1398 (as at October 2006) additional charges apply for hairdressing, personal toiletries and newspapers and any chiropody, dentistry and opticians’ services where these are subject to charge. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit took place over five and a half hours and provided an opportunity to speak to service users and to observe the care they receive and also to talk to both the manager and her staff. A tour of the premises and grounds was undertaken and a very informative conversation with a relative was also possible during this inspection visit. A series of records were spot-checked, including those for the recruitment and training of staff and medication. This report also takes account of any information received by the CSCI about Allington Court since the previous inspection in October 2005. What the service does well: What has improved since the last inspection? What they could do better: The process of formal staff supervision needs to be more structured and better recorded. Some areas of the home, for example communal bathrooms need prioritising for redecoration in order to further enhance the experience of service users. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 6 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. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 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 Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 3 5 (Standard 6 does not apply to Allington Court). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are admitted only following an assessment to ensure that the home can fully meet their needs. They have the opportunity to visit the home and assess its facilities and are provided with the information they need in order to be able to make an informed decision about the home. EVIDENCE: The assessment process for a recently admitted service user was inspected and found to be sufficiently thorough to provide confidence that their needs would be appropriately met. The relative of one service user described the information he had received prior to their admission and also the visits made to the home prior to admission and indicated that the home had met all his expectations from that process. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are treated with respect and dignity. Individual care plans provide details of service users’ health and social care needs and how these are being met. Service users have access to the health care services that they require, and where their medication is administered by the home’s staff, this is done safely. EVIDENCE: The way care was being provided by staff was observed during this inspection visit to be appropriate and respectful and maintained the dignity of service users. A series of care plans, including both for recent admissions and long-standing service users were seen and included evidence of a robust process of assessment and review and of the involvement of a range of healthcare professionals in service users’ care. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 10 One error in medication records was found, the overall standard of recording and administration found was however satisfactory and provides for the safe administration of medication in line with the home’s policies and procedures. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 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. 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. Care is provided in a person centred way that takes account of service users’ preferences and offers them choice in their daily activities and experiences. Activities in particular are varied and arranged to suit individual preferences. Service users are able to maintain close links with their family and friends. Meals provided are nutritious and the menu is varied and offers choice and alternatives. EVIDENCE: Care plans include life histories of service users, which are used to identify their interests and preferences and how these may be recognised and met when arranging activities or carrying out the routine tasks associated with daily life. The activities team are well resourced and resourceful and the activities programme is varied and imaginative. The activities room was being used as a focal point for their day by a number of service users. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 12 A series of meetings and social events involving residents’ carers and relatives are organised by the manager and her team. Observation of a meal and discussions with the chef and service users provided positive evidence for a responsive and varied menu and catering service in the home. Service users were seen to be able to eat in a variety of locations as they chose and were assisted where necessary in a sensitive and dignified way. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 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. 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. The home’s complaint procedure is robust and readily accessible by service users and those responsible for them. Any complaints made are dealt with appropriately in line with the complaints policy and procedure of the home. EVIDENCE: Staff receive training in the identification of abuse and what action to take if it is seen or suspected. The Home complies with the policy for the protection of vulnerable adults of Hertfordshire County Council. Previous complaints have been found to be dealt with within the expected time-scale. There have been no complaints recorded in the home or received by the CSCI since the last inspection in October 2005. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are well maintained and the grounds are safe, tidy and attractive so that those living and working in the home enjoy a comfortable and safe environment. Some of the communal bathrooms are in need of brightening up and redecoration and are adversely affected by being used for the storage purposes of the home. EVIDENCE: The member of the staff team responsible for maintenance was active throughout this inspection visit and the premises were clean and largely free from any unpleasant smells. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 15 The grounds are a particular feature of this home and are well kept and provide a pleasant facility for those service users who like to enjoy the outdoors, weather permitting. One bathroom has been imaginatively improved in order to enhance the bathing experience for service users, this does now highlight the need for similar action to be taken in respect of the other communal bathrooms, particularly when these are cluttered with the storage of ancillary items and in the case of the yellow unit bathroom a wardrobe and some noticeable stains on the wall. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. 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. The home has an effective staff team who have the necessary skills and support to help them meet the assessed needs of the home’s service users. Services users are protected by the home’s recruitment policy and procedure. EVIDENCE: Discussion with the staff member responsible for staff training and examination of her records provided very good evidence of a comprehensive and structured process of training for staff. Those staff spoken to felt that they were well supported, especially in terms of access to NVQ training at a high level. Recruitment files for recently recruited members of the staff team were examined and found to contain the required information, this should give confidence to service users and those responsible for them, that they are in safe hands at all times. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home is well managed and benefits from a consistent and stable staff team who put the needs of service users at the heart of its activity. There are robust risk assessments in place for the protection of service users and staff. Formal staff supervision does not take place as regularly as it should. EVIDENCE: One relative spoken with during this inspection noted how his mother’s key workers had remained the same for over two years, which provided her with a consistency of care that she found reassuring. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 18 Although some staff turnover is inevitable, there is a remarkable consistency in the staff team at the home and this clearly benefits service users. The manager has an open door policy and those members of staff that were spoken with indicated that they felt able to raise any problems with the manager. Staff supervision is focussed more on group and “on the job” supervision rather than formal one to one sessions and whilst each form of supervision has its place, increased formal supervision should be introduced. Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 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 3 X 3 X 3 2 X 3 Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP19 OP21 Good Practice Recommendations The manager should ensure that medication balances are checked routinely in order to identify and address any recording errors at the earliest possible opportunity. The storage needs of the home should be audited by the manager and action taken to address any shortcomings revealed. The bathing experience for service users should be reviewed and where this can be enhanced by the redecoration of communal bathrooms and shower rooms, this should be done with increased priority. Formal one to one supervision sessions should be carried out and recorded appropriately, this should be in addition to the existing group and informal arrangements that are in place. 4 OP36 Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Allington Court DS0000019266.V315990.R01.S.doc Version 5.2 Page 22 - 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!