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Inspection on 24/05/05 for Altham Care Home

Also see our care home review for Altham Care Home for more information

This inspection was carried out on 24th May 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager carried out a detailed assessment of the care needs of prospective residents prior to admission. Residents were treated with respect and personal care was carried out in private. Members of staff were described as "very nice", "staff are smashing, really good" and "very kind". A variety of activities were organised and residents were taken out in the minibus when the weather was nice. One resident said, "I can have visitors anytime. I get out in the summer in the mini-bus down the Ribble Valley." Comments about the meals included, "all the meals are very good", "the new cook is wonderful, if you don`t like what there is he will make you something else" and "the chef makes lovely meals I have bacon and egg every morning.

What has improved since the last inspection?

The manager has made considerable improvements to care planning since the last inspection. This ensured that the needs of individual residents were identified and met. Self-closing devices, activated by the fire alarm, have been ordered for the double doors in the ground floor corridor. When fitted this will help to protect the residents in the event of a fire. Members of staff have received training in moving and handling. This will help to promote the health and safety of both residents and staff.

What the care home could do better:

Medicines administration records must clearly indicate whether a resident has refused their medication or if it has been omitted. If medication has been omitted the reason for this must be recorded. This ensures that all prescribed medication is administered according to the doctor`s instructions. In order to promote the health and safety of residents and staff fire drills must take place at regular intervals. The manager must also ensure, by keeping records, that all members of staff regularly attend fire drills.

CARE HOMES FOR OLDER PEOPLE Altham Care Home Burnley Road Clayton-Le-Moors Lancashire BB5 5TW Lead Inspector Susan Hargreaves Unannounced 24 May 2005 10:00 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 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 F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Altham Care Home Address Burnley Road Clayton-Le-Moors Lancashire BB5 5TW 01254 396015 01254 871335 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Rajinder Singh Mrs Mary Fell Care Home Only Personal Care 36 Category(ies) of Dementia- over 65 years of age (DE)(E) 23 registration, with number of places Old age, not falling within any other category (OP) 13 Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 A maximum of 13 service users requiring personal care who fall into the category of OP. 2 A maximum of 23 service users requiring personal care who fall into the category of DE(E) 3 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. Date of last inspection 25 January 2005 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 ares 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. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours. No additional visits have been made since the last unannounced inspection. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? The manager has made considerable improvements to care planning since the last inspection. This ensured that the needs of individual residents were identified and met. Self-closing devices, activated by the fire alarm, have been ordered for the double doors in the ground floor corridor. When fitted this will help to protect the residents in the event of a fire. Members of staff have received training in moving and handling. This will help to promote the health and safety of both residents and staff. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 6 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. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Admission procedures were thorough. A pre-admission assessment was completed for each resident prior to admission. EVIDENCE: Individual records of four residents were inspected. Each contained a preadmission assessment of need. The manager or a senior member of staff visited prospective residents in hospital or their own home prior to admission. The manager confirmed in writing to prospective residents that their care needs could be met at the home. The assessment of need provided useful information for the care plan. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, and 10 The health, personal and social care needs of the residents were identified and met. Care was given in a manner, which promoted the privacy and dignity of all residents. Medicines administration records did not clearly indicate if medication had been refused or omitted. EVIDENCE: The individual care plans of four residents were inspected. These identified the needs of each resident and explained how these needs were met. Appropriate risk assessments were in place. Records of the visits of other healthcare professionals e.g. GP, dentist, chiropodist, district nurse etc. were included in the care plans. Care plans were reviewed regularly. A letter had been sent to all relatives asking if they wanted to be involved in reviewing care plans. Members of staff were observed attending to residents in a friendly and professional manner. All the residents consulted praised the staff for their care and kindness. Comments included, “helpers are very good”, “ staff treat me with respect” and “everybody is friendly, they care about us”. Medication was stored correctly and administered by appropriately trained members of staff. However, it was unclear from the medicines administration records, on a number of occasions, whether medication had been refused or Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 10 omitted. Hand written instructions on the medicines administration records were not signed or witnessed by a second member of staff. Privacy and dignity was discussed with three members of staff. They all described in detail how they promoted residents dignity when helping them with personal care. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12.13, 14 and 15 A variety of social activities to meet the needs and preferences of residents were organised. Visitors were welcome at anytime. The meals were varied and offered choice. Special diets and individual tastes were catered for. EVIDENCE: Social activities were advertised in the home. These included games, craft activities and trips out when the weather permitted. Outside entertainers regularly visited the home. During the inspection several residents played dominoes while others played a ball game with members of staff. One visitor said, “I can visit anytime. My mother plays dominoes and cards and goes on trips out.” Two residents said that got up and went to bed when told to do so by members of staff. One member of staff explained that residents got up early if they were incontinent or restless. The manager was advised to record in the care plans the preferred time of getting up and going to bed for each resident and the reasons for this if the resident is unable to make an informed choice. Three other residents consulted during the inspection said that the daily routine was flexible and they chose when to get up and go to bed. All the residents spoken to during the inspection said the food was good. The chef was observed asking residents individually what they would like for lunch. One resident said, “I really enjoyed my dinner.” A resident on a special diet said, “ They do it very well.” Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 12 The meal at lunchtime was appetising and wholesome. Lunch was a leisurely meal allowing time for residents to chat and enjoy their food. Members of staff were seen helping residents with feeding in a sensitive manner. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Complaints were taken seriously and investigated. Appropriate procedures were in place to ensure the protection of residents at the home. EVIDENCE: A comprehensive complaints procedure was in place. Five complaints had been made to the home since the last inspection. Written records of all complaints, the investigation and any action taken were available. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with three members of staff. They were aware of the procedure and said that they would report any concerns immediately. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26 The home was clean, comfortable and well maintained. Laundry facilities were appropriate for the size of the home. EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. This provided a safe and comfortable environment for the residents. A number of residents commented on the ‘homely’ atmosphere and cleanliness of the home. Residents were encouraged to personalise their rooms with ornaments, photographs etc. One lady said, “ I like my room, there’s a nice view from the window. A planned programme for the routine redecoration and refurbishment of the premises was in place in order to maintain and improve the environment at the home. Laundry facilities were appropriate for the size of the home. Two new washing machines and dryers had been installed recently to ensure an efficient laundry service was available for the residents. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 15 The proprietor explained that self-closing devices had been ordered for the double doors on the ground floor corridor, these were often wedged open. This will help to protect residents in the event of a fire. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were thorough. Training for all members of staff was actively encouraged. 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 four members of staff appointed since the last inspection were checked. These indicated that all the required pre-employment checks to ensure protection of the residents had been completed. It was evident from discussions with the manager and three members of staff that training was actively encouraged. This included, induction training for new members of staff, moving and handling, first aid, dementia awareness, challenging behaviour and NVQ level 2 and 3. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Appropriate policies were in place to safeguard the health, safety and welfare of residents. However, fire drills did not take place. EVIDENCE: A member of staff qualified to administer first aid was always on duty. Records of the routine servicing of equipment were seen. Although the fire extinguishers had not been serviced since February 2005 arrangements were made, during the inspection, for them to be serviced on the following day. Training in fire safety had been arranged for June, July and August to ensure all members of staff received this training. Fire alarms were tested regularly. However, the three members of staff spoken with during the inspection had not attended a fire drill. The manager explained that fire drills were not carried out for fear of upsetting the residents. Discussion took place about how fire drills could be done with very little involvement of the residents. Safety notices were displayed in the home. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x 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 2 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 2 Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 19 NO 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 9 Regulation 17(1)(a) Schedule 3 (i) Requirement The registered person shall maintain (i) a record of all medicines kept in the care home for the service user, and the date on which they were administered to the service user. The registered person shall after consultation with the fire authority- (e) ensure, by means of fire drills and practices at suitable intervals, that persons working at the care home and, so far as practicable, service users, are aware of the procedure to be followed in case of fire, including the procedure for saving life. Timescale for action 29 July 2005 2. 38 23(4)(e) 29 July 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. Refer to Standard 9 14 Good Practice Recommendations All handwritten instructions on the medicines administration records should be signed and witnessed by a second member of staff. Information relating to a residents preferred time of F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 20 Altham Care Home getting up and going to bed should be recorded in the care plans.The reasons for this should also be recorded if the resident is unable to make an informed choice. Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road, Clayton-Le-Moors Accrington Lancashire. BB5 5BJ 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 Altham Care Home F57 F07 S9438 Altham Care V226027 270505 Stage 4.doc Version 1.30 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!