Inspection on 07/02/06 for Allonsfield House Care Home

This inspection was carried out on 7th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Allonsfield House Care Home 13/01/09

Allonsfield House Care Home 19/11/07

Allonsfield House Care Home 07/02/07

Allonsfield House Care Home 04/07/05

Allonsfield House Care Home 15/03/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Allonsfield House Care Home Allonsfield House Campsea Ashe Woodbridge Suffolk IP13 0PX Lead Inspector Helen Fontaine Unannounced Inspection 7th February 2006 11:00 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 Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Allonsfield House Care Home Address Allonsfield House Campsea Ashe Woodbridge Suffolk IP13 0PX 01728 747095 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) Kingsley Care Homes Ltd Mrs Linda Ann Soer Care Home 23 Category(ies) of Dementia – over 65 years of age (2), Old age, registration, with number not falling within any other category (23) of places Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 Bedroom 9 may be used as a shared bedroom only for those persons whose name was made known to The Commission For Social Care Inspection on 25th January 2005. 2 The home can provide care for 2 named older people with dementia, as agreed with the commission, and set out in letter dated 19/12/05 4th July 2005 2. Date of last inspection Brief Description of the Service: Allonsfield House is situated in Campsea Ashe and is registered to provide care for 23 people aged over 65 years including one person with dementia. The home is owned by Kingsley Care Homes, who took over the running of the home in December 2004. Campsea Ashe is a small village in a rural location, close to the town of Woodbridge. The home is located opposite the village church and 400 meters from the local train station, which has direct trains to Lowestoft, Ipswich and London. Woodbridge offers a range of amenities, which include, restaurant, garden centres, shops, Library, banks, post office, Riverside Theatre and swimming pool. The home a former farmhouse has been refurbished and adapted over the years. Located on two floors, residents can access all parts of the home using chair lift, ramps or stairs. Although all the bedrooms are single, one large bedroom is currently being used as a double for the named occupants only. All the bedrooms have a toilet and wash hand basin, 12 also have en-suite shower or bath fitted. There are communal bathrooms and toilets located close to bedrooms and lounge areas. Choice of 4 lounges, dining room and large gardens make up the communal areas. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Allonsfield House took place over four hours and was the second statutory inspection visit in the inspection programme for 2005/6. Over the course of the two visits, all core standards have now been assessed. Two requirements and six recommendations were set at the previous inspection and the home has complied with all of the required action. Two further requirements and one recommendation were identified at this inspection. The manager and the deputy manager were present during the inspection, a number of residents were spoken to and one was visited in their room. A number of documents were looked at and a tour of the home was undertaken. The assistance of the manager staff and residents during the inspection was very much appreciated. What the service does well: What has improved since the last inspection? The home was assessed as having two requirements and six recommendations from the last inspection and all of these were looked at during this inspection. The staff training and the homes procedures around the issues of reporting abuse, has now been addressed. Staff files looked at evidenced that staff have now received re-fresher training and the procedures have been updated. The staff files now give a full history of previous employment, with explanations of any gaps. The staff’s medical questionnaire now covers in more detail the physical and mental wellbeing of the staff that work in the home. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 6 The homes Statement of Purpose now documents that there are 23 place at the home and it has a description of each of the rooms, with the size and facilities. The document has also been amended to say that the home has stairlifts and not a lift. The homes care plans have also been amended, this now supports residents with poor eyesight. The care plans now have large bold print and are typed rather than handwritten. The care plans also document the activities that the residents have taken part in, although some of the activities observed were spontaneous rather than organised. This is not a negative point, clearly the residents were observed to be thoroughly enjoying themselves. The home have had the limescale from the toilets treated chemically, however the manager indicated that they felt they would need to be replaced. The home is about to have an extension built, the manager indicated that it would be appropriate to replace existing toilets once it was built. What they could do better: The homes care plans were looked at and whilst they were very much improved around the issue of being more visible, there were parts of the care plan not completed. At the end of each care plan, printed off was a sheet set out for the signature of the resident, carer/family and staff. Since there had been signatures in other areas of the care plan, it is recommended that the home either complete this or remove it from the care plan. The homes practices around medication are considered by the Commission to be in appropriate. The member of staff was observed by the inspector to take out of the medication cupboard all the medication packs and boxes for the residents midday medication. This was placed in an unsecured plastic tray and carried round the home with the Medical Administration Records (MAR) charts. Although the Medical Administration Records (MAR) charts were completed appropriately, there is a risk that the medication not being administered would be accessible. The home must make sure that all medication that is not being administered, is kept in a locked container. This judgement is based on the RPSGB guidance ‘The Administration and Control of Medicines in Care Homes and Children’s Homes 2003’ and Nursing & Midwifery Council guidelines as enshrined in the Standard 9.4 of the Care Homes for Older People, National Minimum Standards Care Homes Regulations. The water temperature charts were checked during the inspection and it was documented that one bathroom was 46°C. The inspector tested this with a thermometer and found it was 46°C, the manager must make sure that the water temperatures are within the limits that are set out in The National Minimum Standards. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 7 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. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 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 the following standard(s): 1 Residents can expect to receive accurate information, to be able to make a choice about moving into the home. EVIDENCE: At the last inspection the home received a recommendation about the wording of the home’s Statement of Purpose. The home have changed the wording of the Statement of Purpose, it now documents the right number of residents living in the home. It now also documents that the home does not have a lift, but has stairlifts to access the other areas of the home. The inspector looked at the document called the information pack, the manager indicated that the provider is in the process of developing a new Statement of Purpose. The information pack did have documented that some of the areas of the home can be difficult to access and that staff will always support residents with any difficulty. The information pack had a laminated cover and covered the areas of, 1) Statement of Purpose, 2) Quality of care, 3) Underpinning elements, 4) Resident/service user guide, 5) Facilities and services Offered, 6) Copy of contract, 7) Complaints procedure and finally 8) Resident’s charter. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 People who use this service can expect to be treated with respect, have their health needs met and have an individual plan of care drawn up. However residents cannot be assured that the present system of administering medication will protect them. EVIDENCE: The home’s care plans were looked at, as the previous inspection had identified that the care plans were not easy for the residents with poor eyesight to read. The home have had some of the pages in the care plan done in large bold print, the other pages were printed with black print on white paper. The issues around the resident’s health care needs were also documented on the care plan in a way that was clear to read. During the first part of the inspection the District Nurse was present, they were observed to be documenting their visit on the residents care plan. The section in the care plan around health care, covered areas such as, water flow risk assessment, weight chart and risk assessments around the use of hoists. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 11 The homes practices around the issues of medication were observed during the inspection. The medication trolley was secured in the manager’s office with a cable to the wall and the trolley was kept locked. However the member of staff came with a plastic box and removed all the medication and the Medical Administration Records (MAR) charts, for resident’s midday medication. The medication was carried round in the plastic box, this box was not able to be locked. This practice is considered by the Commission to be inappropriate as there is a risk that the medication not being administered is accessible. The home must make sure that all medication that is not being administered, is kept in a locked container. This judgement is based on the RPSGB guidance ‘The Administration and Control of Medicines in Care Homes and Children’s Homes 2003’ and Nursing & Midwifery Council guidelines as enshrined in the Standard 9.4 of the Care Homes for Older People, National Minimum Standards Care Homes Regulations. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 The home provides a range of interesting and stimulating activities for service users. EVIDENCE: The residents files looked at during the inspection did have a list of activities that the residents had been involved with. The inspector during the inspection was able to observe the interaction of the residents during their midday meal and during the afternoon activities. The residents were observed to be encouraging each other to go for lunch and the dining room was a busy with a great deal of interaction. Residents were offered a drink, wine, sherry or beer and this instigated quite a lot of debate between the residents. A short time after lunch a number of residents began to move into the lounge and a member of staff set up a game. Having spent sometime undertaking this exercise the residents decided that they wanted to play scrabble. The member of staff assisted the residents to set this up, but then was able to leave them to play. The residents were very much involved in this game, encouraging each other to remember whose turn it was and words that they were trying to recall. The residents became quite noisy and a member of staff came immediately to put on some calming music and assist the players with the game. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 13 However there was a great deal of laughter and this then involved other residents and visitors using the lounge. It was clear from the interaction and discussion with the manager that this was a frequent event in the home. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Residents can expect to be protected by the home’s policies and staff training. EVIDENCE: At the previous inspection the home were assessed and given a requirement around staff training and refresher training in the procedures for identifying and reporting abuse. The manager was able to bring up on the home’s computer the dates that the staff had attended a course on preventing abuse for care workers. The manger said that a number of staff are currently on or doing the National Vocational Qualification level two, which also had a workshop on Adult Abuse. The manager also produced an in house training pack, which had a video that covered what is abuse, minimising the risk from abuse, responding to abuse, roles and responsibilities. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 26 People who use this service can expect to live in a clean and well-maintained home. EVIDENCE: During the inspection a tour of the home was undertaken and all areas of the home were found to be clean and well-maintained. The recommendation from the last inspection around the build up of limescale in the toilet u-bends, has been addressed. The manager indicated that the home has treated all the toilets for the removal of limescale. The manager said that once they have completed the new extension, it would be necessary for the existing home to be renovated. The home was found to be very comfortable and warm, the lounge being particularly attractive. This was an area that resident’s use quite often, there is a small area off the main lounge where residents can sit quietly or have visitors. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30 The homes recruitment practices are robust and offer protection to service users. Staff are trained to do their job. EVIDENCE: The issues around recruitment and staff training were looked at during this inspection. The home had received a requirement about the issues with recruitment and a recommendation in regard to the staff’s medical questionnaire. Two staff files were looked at, one was the file of the newest member of staff and one for a member of staff who has been working at the home for sometime. On the files there was an application form and on the form there was information about gaps in employment. The staff file had a photo of the member of staff, a contract of employment and one of the contracts was in the staff’s native language and English. It was noted during the inspection of the staff files that the contracts of employment were all signed by the member of staff. The files also had the induction form, documented supervision, two references, identification with a photo and where necessary a work permit. The Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) first check was also on the file. The home have also added into their staff medical questionnaire a section about the fitness, both physically and mentally to undertake the job they are applying for. The home have a database with all the staff training and this documented what courses the staff had undertaken and when the refresher course would be Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 17 needed. Some of the training documented was the chemists dosage system, National Vocational Qualification (NVQ) level two, basic fire prevention, foot health education and basic food hygiene. Other courses documented were dignity in bereavement, grief and mourning. The deputy manager was undertaking dementia care mapping and the National Vocational Qualification (NVQ) level three. It was noted that the training database evidenced that the home had exceeded the National Minimum Standard and had over 50 of the staff with National Vocational Qualification (NVQ) two. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 and 38 The home is run in the best interests of the service users but residents are not protected by the homes practices around health and safety. EVIDENCE: During the inspection the homes quality assurance and quality monitoring system was looked at. The home undertakes this quality monitoring process each year and this is undertaken with questionnaires for the residents, staff and family/carers. The resident’s questionnaire was looked at and covered areas such as catering and food, personal care and support, daily living, premises and management. The home also have a different questionnaire for new residents to the home and asks questions like, were you given enough information about the home and was your room clean, in good repair and all the equipment and facilities working. The manager indicated that all the completed forms go to the homes registered provider. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 19 Issues around the residents personal finances, the manager said that the home do not deal with any personal monies for the residents. The extra’s that the home charge for are billed and sent to either the resident, family/carer or a representative. The homes practices around Health and Safety were looked at and it was noted on the water temperature checks the water variance was 30°C - 46°C. The home must make sure, that the water temperatures are as close to 43°C as possible. Other areas checked were fire alarm testing, the servicing checks on the hoists, stairlifts, electrical equipment checks, call alarm, fire equipment checks. All the certificates and service records for all the equipment and facilities in the home were all documented and up to date. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 20 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X 3 X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 1 Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 21 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. 1. 2. Standard OP9 OP38 Regulation 13(2)(4) 13(4) Timescale for action The Registered manager must 08/05/06 review current medicine administration practice. The Registered Person must 08/05/06 ensure that water temperatures at the home are regulated to a safe temperature. Requirement 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 OP7 Good Practice Recommendations The home either use the final page of the printed care plan and it is completed in full or it is removed from the document. Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Allonsfield House Care Home DS0000062861.V282978.R01.S.doc Version 5.1 Page 23 - 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. 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