Inspection on 29/12/06 for Almadene Care Home

This inspection was carried out on 29th December 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

Similar services:

Ashlong House

Norbury Crescent (30)

Henry Nihill House

Birchwood

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

The Infirmary

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

CARE HOMES FOR OLDER PEOPLE Almadene Care Home 19-21 The Avenue Highams Park London E4 9BL Lead Inspector Robert Sobotka Unannounced Inspection 29th December 2006 10:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Almadene Care Home DS0000067385.V321321.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. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Almadene Care Home Address 19-21 The Avenue Highams Park London E4 9BL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8527 6643 Goodcare Limited Ms Carol Anne Bryan Care Home 16 Category(ies) of Dementia (8), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (1), Old age, not falling within any other category (16) Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Dementia (DE) 8 over the age of 60 years. Date of last inspection N/A Brief Description of the Service: Almadene Care Home is a 16-bedded residential care home for older people. It is situated in a residential area in Highams Park. The home is close to shops, transport and other local amenities. The home has a well-maintained garden with established shrubs and flowers. The garden can be accessed either by steps or a ramp. The home has 12 single and 2 double bedrooms. Three of the single bedrooms would be difficult to access for people with mobility problems. There is a lift providing access to the first floor accommodation. The home has recently been bought as a going concern and subsequently reregistered with the Commission for Social Care Inspection on 21/06/06 with the new name of Almadene Care Home. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day (morning and early afternoon) and was unannounced. As part of the visit, the inspector spoke to some of the service users and two care staff working in the home, including the registered manager. He also conducted a tour of the premises and viewed various records. The aim of this unannounced inspection was to check the home’s compliance with the National Minimum Standards for Care Homes for Adults (18-65) and The Care Homes Regulations 2001. What the service does well: This care home provides good quality of care to those accommodated at Almadene. The home had good admission and care planning systems in place and there was evidence that views of service users and their relatives were obtained as part of the care planning process. Those service users who spoke to the inspector expressed their satisfaction with the way they were cared for and the condition of the premises. The healthcare needs of those accommodated in the home were being appropriately addressed. At the time of this inspection the home provided services to 16 service users, which included 5 service users diagnosed with dementia and the inspector was satisfied that their assessed needs were being met. Staff working in the home were observed treating service users with dignity and respect. Spiritual needs of those accommodated in the home were also addressed. The home provides a very wide range of activities on offer. The premises were well maintained. The home was appropriately managed and care was provided by knowledgeable and skilled members of staff. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Almadene Care Home DS0000067385.V321321.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 Almadene Care Home DS0000067385.V321321.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, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose and the Service User’s Guide required revision/updating. The home had appropriate admission system in place and all service users were appropriately assessed by the registered manager prior to moving into the home. EVIDENCE: The home’s Statement of Purpose and the Service User’s Guide required revision/updating to reflect the information displayed on the home’s certificate of registration. There have been three new admissions to the home since the last inspection visit. During the course of this visit, the inspector checked care plans of the two most recently admitted service users. The inspector was satisfied that each person was appropriately assessed by the registered manager prior to offering a placement in the home. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 9 Potential service users and their relatives are given an opportunity to visit and assess the quality, facilities and suitability of the home. At the time of this inspection, there were no vacancies in the home. At the time of this inspection the home was appropriately meeting the assessed needs of those living in Almadene Care Home. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 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. 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. There was a good care planning system in place and all assessed needs of those accommodated in the home were appropriately met. Medication systems were well maintained. EVIDENCE: Each service user living in the home had a care plan. The inspector viewed 4 individual service users care plans, which were chosen at random. All care plans viewed were well written and contained comprehensive information in relation to each service user. Each care plan also described how each person’s needs would be met. There was evidence that care plans were reviewed on a monthly basis, or more often if required, and that service users and/or their relatives were involved in the care planning process. Each care plan had a “Getting to know you” document and service users and their relatives were asked to contribute to the development of this document. Care plans viewed listed actions needed by care staff to ensure that all healthcare, social, cultural and personal needs of each service user and there was evidence that views of each service users and or/their relative were taken into account. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 11 Each care plan viewed contained appropriate risk assessment, including moving and handling assessments and falls risk assessment, where required. All service users were registered with a General Practitioner. Those living in the home were also able to access any specialist healthcare facilities, when required. Good accident/incident recording systems were in place and there was evidence that they were reviewed by the manager to prevent accidents from reoccurring. Satisfactory medication systems were in place. Records of medication brought into the care home, administered to service users, and disposed of was maintained. Medication stocks were checked and found correct at the time of this inspection visit. The inspector spoke to several service users as part of this inspection. Those spoken to gave positive comments about the way the home is run. There was a very friendly and relaxed, yet professional atmosphere in the home. Service users were treated by staff working in the home with dignity and respect. Each care plan contained a section where service user’s wishes in respect of ageing, dying and action to be taken following service user’s death were recorded. The registered manager stated that training in palliative care was being organised for members of staff working in the home. The inspector recommended that the End of Life Care Programme be introduced in the home for those service users who are terminally ill. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 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. 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. The home offers a wide range of activities. Those living in the home are supported to exercise choice and to take control over their lives. Service users enjoyed food provided in the home, however record of food offered to the service users required improvement. EVIDENCE: The home provides a good range of activities. On the day of this unannounced inspection, there was a live entertainment in the home. Other activities on offer included trips to West End, quizzes, flower arranging and trips to local parks. As previously stated, service users interests and hobbies were recorded in their individual care plans. Service users are consulted about which activities they would like to be offered during regular service users meetings. The home is a commended for meeting spiritual needs of those accommodated the. The registered manager stated that regular services are organised in the Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 13 home for the service users who belong to the Church of England and those of Roman Catholic denomination. Service users spoken to on the day of this inspection said that they were happy with the quality and variety of activities on offer. The inspector spoke to a relative of one of the service users, who visited the home on the day of this inspection. She said that visitors are always welcome to the home and that the manager and staff working in the home provided good quality of care. She also said that any issues are promptly resolved and acted upon. The home had a visitor’s book in place. Care plans viewed included information about service user’s preferences as to when they would like to get up and assisted with personal care. Service users have choice in the clothes they wear. Menus reflected choice of foods at mealtimes. Service users were seen making choices on the day of this inspection and those who spoke to the inspector confirmed that their choices and preferences were respected by staff working in the home. The inspector was invited to have lunch with service users. There was a choice of food on offer. Meals were attractively presented, nutritious and served at correct temperature. Service users enjoyed food served in the home. Kitchen premises were kept clean and food was appropriately stored. There were sufficient food supplies in the home. Fridge/freezer temperatures were recorded. Record of food served to the service users required improvement. The registered manager must ensure that record of the food provided for the service users is maintained and it is in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and any of the special diets prepared for individual service users. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 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. 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 had a good complaints system in place. Service users were protected from abuse. EVIDENCE: The home continues to have a good complaints system in place. There has been one complaint about the home since the last inspection, which has been promptly resolved. There was a written evidence to show that complaints were acknowledged and that the registered manager deals with them without delay. Staff spoken to stated that they would support service users in raising complaints on their behalf. The home had an appropriate protection policy and staff working in the home were aware of adult protection issues and have received relevant training. The home also had an Adult Protection Procedure of the London Borough of Waltham Forest. Record of accidents and incidents were appropriately maintained and monitored by the registered manager. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25, 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users continue to benefit from a homely, comfortable and safe environment, however offensive odour in one of the service user’s bedroom must be eliminated. EVIDENCE: The inspector carried out a tour of the premises as part of this inspection. The home was found it to be consistently clean and decorated to a high standard. The home is close to shops, transport and other local amenities. The home has a well-maintained garden with established shrubs and flowers. The garden can be accessed either by steps or a ramp. The home has 12 single and 2 double bedrooms. Three of the single bedrooms would be difficult to access for people with mobility problems. There is a lift providing access to the first floor accommodation. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 16 The home employs a person to oversee the maintenance and repairs, who works 12 hours per week. He attends quarterly health and safety meetings with the manager and provider when potential hazards or poor practices are discussed and addressed. The inspector viewed several bedrooms during this visit, all of which were attractively decorated and equipped with sufficient furniture. Bedrooms seen were personalised to reflect service user’s interests. It was noted that one of the bedrooms had an offensive urine odour. This must be eliminated. This issue was discussed with the registered manager during the visit and the inspector suggested that the registered manager might have to consider replacing the carpet with laminated flooring. There were sufficient communal areas on the ground floor of the building. Lighting in communal areas was sufficiently bright and positioned to facilitate reading and other activities. Appropriate clinical waste disposal arrangements were in place. The premises were found to be clean at the time of this unannounced visit. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. 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. Service users are supported by competent and well-trained staff. The home’s recruitment practices were satisfactory. EVIDENCE: Service users are supported and cared for by members of staff who are well trained and appropriately supported. The quality of care in the home was good. There are appropriate staffing levels in the home at all times. Duty rosters were maintained. They showed that there were two or three carers on a morning shift and at least two staff in the evening. In addition the register manager works mainly from Monday to Friday between the hours of 9 am and 5 pm. The home operates a waking night system and there are two members of staff who are awake during the night. There is always a designated person in charge at all times. The home also employs a domestic person who works between 9 am and 2 pm each day, as well as the chef. The home does not employ agency staff to ensure the continuity of care to the service users. Throughout the visit, the inspector received positive comments from the service users and one relative about the registered manager and staff working in the home. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 18 As part of this inspection visit, the inspector reviewed personnel files of the two most recently appointed staff. The inspector was satisfied that all appropriate recruitment checks were carried out prior to confirming their employment in the home. Each staff personnel file contained record of any training attended by staff, as well as their supervision and appraisal records. Staff working in the home told the inspector that the training offered to them was very good. The majority of staff working in the home have obtained NVQ (National Vocational Qualification) Level 2 or above. At the time of this inspection visit 10 care staff were in possession of NVQ qualifications. The inspector was satisfied that all staff working in the home receive very comprehensive training. All staff have attended dementia training and the registered manager has recently attended training organised by the Alzheimer’s Society. All new staff receive a comprehensive induction programme based on the TOPPS induction programme. Completed induction records were available for inspection. The inspector spoke to two members of staff following staff team handover. They all felt that there were sufficient staffing levels in place and that they were appropriately supported by the registered manager and the proprietor. At the time of this visit, the staff team consisted of females only. There were two male service users accommodated in the home. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. 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. The home was well managed with the service users’ interests and needs treated as a priority. Appropriate quality assurance systems were in place. Health and safety was generally well maintained, however record of hot water temperatures must be maintained. EVIDENCE: The home is managed by an experienced manager and as previously mentioned the inspector received positive comments about her managerial skills and practices throughout this visit. She is in possession of appropriate qualifications required by law to manage the residential care home for elderly. Appropriate quality assurance systems were in place. Since the last inspection visit, the registered manager has devised a new form (in large print) to obtain Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 20 the views from the service users about the quality of care offered to the service users. The registered manager stated that service users’ relatives’ and advocates’ views are obtained on behalf of the service users with dementia. The home was appropriately insured for its purpose. All members of staff were appropriately supported and received annual appraisals. Team meetings were held on regular basis and minutes from these were available for inspection. Staff spoken to said that they felt well supported by the management team. Majority of the health and safety checks were in place, however record of hot water temperatures has not been maintained for several months and must be reintroduced. The registered manager must ensure hot water temperatures tests are carried out and recorded. Appropriate health and safety risk assessments were in place. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x 3 3 3 2 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 3 x 2 Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4, 5, 6 Requirement Timescale for action 15/02/07 2. OP15 17(2) Sch 4.13 3. OP26 16(2)(k) 4. OP38 23(2) The home’s Statement of Purpose and the Service User’s Guide must be reviewed/updated to reflect the information displayed on the home’s certificate of registration. The registered manager must 15/02/07 ensure that record of the food provided for the service users is maintained and it is in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and any of the special diets prepared for individual service users. The registered manager must 01/03/07 ensure that an offensive odour in one of the service user’s bedrooms is eliminated. The registered manager must 15/02/07 ensure hot water temperatures tests are carried out and recorded. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 23 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 OP11 Good Practice Recommendations It is recommended that the End of Life Care Programme be introduced in the home for those service users who are terminally ill. Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Almadene Care Home DS0000067385.V321321.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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