Inspection on 02/10/07 for Altham Care Home

This inspection was carried out on 2nd October 2007.

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

Altham Care Home 28/05/09

Altham Care Home 31/01/07

Altham Care Home 15/11/05

Altham Care Home 24/05/05

Altham Care Home 25/01/05

Altham Care Home 03/09/04

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

CARE HOMES FOR OLDER PEOPLE Altham Care Home Burnley Road Clayton-le-moors Lancashire BB5 5TW Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 2nd October 2007 07:15 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 Altham Care Home DS0000009438.V346896.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. Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Altham Care Home Address Burnley Road Clayton-le-moors Lancashire BB5 5TW 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) 01254 396015 01254 871335 Mr Rajinder Singh Mrs Mary Fell Care Home 36 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (13) of places Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 13 service users requiring personal care who fall into the category of OP. A maximum of 23 service users requiring personal care who fall into the category of DE(E) The registered provider, must, at all times, employ a suitably qualified and experienced person who is registered with the Commission For Social Care Inspection as Manager of Altham Care Home. 31st January 2007 Date of last inspection Brief Description of the Service: Altham Care Home offers 24 hour personal care for up to 36 older people including 23 people with dementia. The property is purpose built with a car park and garden. It is located in Clayton-Le-Moors close to local amenities and public transport. Accommodation is provided on two levels in thirty single and three twin-bedded rooms. Twenty of these rooms have en-suite facilities. Communal rooms include two separate lounge areas with television, and two dining rooms. One dining room has a kitchenette for residents to make their own drinks and snacks. Toilets and bathrooms are conveniently located close to communal rooms and bedrooms. The current fees charged at Altham Care Home are £345.35 to £435 per week. Additional charges are payable for hairdressing and newspapers. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Altham Care on 2 October 2007. One additional visit has been made since the last key inspection. This was a random inspection on 7 March 2007 to check if residents were allowed to choose the time they got up. Three completed surveys were received from residents, three from the relatives of residents, five from members of staff and two from residents GP’s. At the time of this inspection 33 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty and residents were spoken to. Discussions also took place with the provider and quality manager regarding issues raised during the inspection. Wherever possible the views of residents were obtained about their life at the home. Due to memory and communication difficulties, some of the residents suffering from dementia were unable to express their views about their experience of living in the home. Therefore, a period of two hours was spent making close observation of how staff communicated and attended to certain residents and how they reacted to this. What the service does well: Members of staff were observed attending to residents in a polite and friendly manner. One resident said she was happy living at the home and described the staff as wonderful. Another resident said the staff are marvellous. The relative of a resident wrote on the survey, ‘they have quite a lot of staff on every time I go and all seem to treat the people they are looking after with kindness.’ A member of staff commented on the survey, ‘relevant courses are made available and staff are encouraged to do NVQ qualifications.’ All care workers except one, and she was working towards NVQ level 2, had NVQ qualifications at level 2 or above. Care workers with an NVQ level 2 were encouraged to do level 3. All the residents asked said the meals were good. One resident said, “The meals are lovely, there’s a new cook and she’s really good.” Altham Care Home DS0000009438.V346896.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. Altham Care Home DS0000009438.V346896.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 Altham Care Home DS0000009438.V346896.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough admissions procedure ensured sufficient information was obtained in order to identify the needs of each resident. EVIDENCE: A senior member of staff visited and assessed prospective residents in hospital or their own home before admission. The care records of the most recently admitted resident contained a preadmission assessment. This assessment provided important information for the care plan. Prospective residents or their relatives received confirmation in writing that their needs could be met at the home. Standard 6 is not applicable to this service. Altham Care Home DS0000009438.V346896.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents individual care needs were identified and their privacy and dignity promoted. Medication was managed safely. EVIDENCE: The individual care plans of two residents were inspected. These care plans clearly identified the health and social care needs of each resident but did not always explain fully how these needs were to be met. Appropriate risk assessments for falls, pressure sores and nutrition were in place for each resident. A report about the care and condition of each resident was written during each shift. Care plans and risk assessments were reviewed monthly. Resident’s relatives were invited to attend an annual care review meeting. Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 10 Residents were registered with a GP and had access to other healthcare professionals. A dentist visited the home every six months and when required. Medication was stored correctly and administered by appropriately trained care workers. Records for the management of medication were seen. Controlled drugs were stored securely and a stock check was satisfactory. One resident said she had her medication at about the same time everyday. During the detailed observation period members of staff were observed attending to residents in a polite and friendly manner. Personal care was carried out in the privacy of the resident’s own room or the bathroom. Two members of staff explained in detail how they promoted privacy and dignity for all residents. One resident said, “The staff are very good.” Altham Care Home DS0000009438.V346896.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s decisions were respected and they were supported by care workers to have a fulfilling lifestyle. EVIDENCE: Social activities were advertised in the home. These included aromatherapy, dominoes, snakes and ladders, movement and music, ball games and craft e.g. making cards. Several residents said they thoroughly enjoyed the karaoke sessions, which were held every weekend. Arrangements had also been made for residents to go to concerts in Burnley and Bolton. An outside entertainer visited the home every two months. During the detailed observation period several residents enjoyed playing snakes and ladders with care workers. Another resident enjoyed a game of dominoes. However, music was playing in one part of the lounge and the television was on in the other part of the lounge with the sound very low. This meant residents sitting in that part of the lounge could not comfortably watch television or listen to the music. Residents were offered hot and cold drinks throughout the morning. Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 12 Residents were encouraged to make decisions about their lifestyle and daily routine. On arrival at the home at 7.15 am several residents were having breakfast. The residents asked said they liked to get up early. One resident said, “It’s very nice here.” During the morning the cook asked each resident to choose either corned beef hash or fish in sauce for lunch. One resident didn’t want a cooked meal and was offered a sandwich. The menu was also written on a chalkboard in the dining area. All the residents asked said the meals were good. One resident said, “The meals are good you can have what you want more or less.” Visitors were welcomed into the home at anytime and offered refreshments. Altham Care Home DS0000009438.V346896.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt able to express their concerns. Staff had the training necessary to ensure residents were protected from abuse. EVIDENCE: A copy of the complaints procedure was included in the statement of purpose and service user guide. Detailed records of all complaints, the investigation and action taken were seen. Policies and procedures for the safeguarding of vulnerable adults were in place. Notices were also displayed in the home asking staff to report any concerns. Safeguarding was included in the induction programme for new members of staff. This issue was discussed with two members of staff. They understood the procedure and said they would report any concerns immediately. Altham Care Home DS0000009438.V346896.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises were well maintained and provided a comfortable and ‘homely’ environment for the residents. EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. Recent improvements to the premises include redecoration and new curtains to all communal areas. The grounds and gardens were well kept and accessible to all residents. Laundry facilities were appropriate for the size of the home. An infection control policy was in place. Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 15 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 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Members of staff have the skills and knowledge necessary in order to meet the needs of the residents. Recruitment procedures are thorough to safeguard residents. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts to meet the assessed needs of the residents. The files of three members of staff appointed since the last inspection were examined. These files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. It was evident from discussion with members of staff and the provider that training for all staff was actively encouraged. This included induction training for new employees, moving and handling, first aid, basic food hygiene and fire safety. Training opportunities were advertised on the notice board and discussed at staff meetings. All care workers except a recent employee had an NVQ qualification at level 2 or above. The recently employed care worker was working towards NVQ level 2. Care workers with an NVQ level 2 were encouraged to do level 3. Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 16 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 and 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 effectively managed. The views of residents and their relatives are considered when decisions about the care and facilities provided at the home are made. EVIDENCE: The registered provider and quality manager are responsible for the day-today management of the home. The home has achieved the nationally accredited Investors in People award. Anonymous satisfaction questionnaires are given out annually to residents and their relatives. The results of the survey carried in April of this year are included in the service user guide. Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 17 Residents and relatives meetings were held twice a year. The next meeting was planned for 23 October. An annual development plan to help monitor the quality of the service and further improve outcomes for residents was in place. Transactions involving resident’s money were seen to be well maintained and up to date. Fire alarms and emergency lighting were tested regularly when a fire drill was held. A staff attendance record at fire drills was kept. A fire risk assessment was also in place. Records of the routine servicing of equipment were seen. These included an up to electrical installation certificate and records of the testing of small electrical appliances in February 2007. Although the gas boiler was serviced in July 2007 a gas safety certificate was not available. The registered provider was advised to obtain one as soon as possible. Records maintained in the kitchen included fridge, freezer and food temperatures. Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 18 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 19 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 OP7 Regulation 15(1) Requirement To ensure all members of staff are fully informed about the care needs of each resident care plans must fully address all care needs. Timescale for action 30/11/07 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 Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Altham Care Home DS0000009438.V346896.R01.S.doc Version 5.2 Page 21 - 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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