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Inspection on 02/06/06 for Altham Court Nursing Home

Also see our care home review for Altham Court Nursing Home for more information

This inspection was carried out on 2nd June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 residents are cared for in a safe, well-maintained, homely environment by staff, who are aware of their needs. Care plans identify residents` needs in detail and this helps staff to provide consistent care. People who use the service are happy with the care they receive. The staff team work well together and have established an excellent working relationship with the community health care teams and local GPs.

What has improved since the last inspection?

There were no requirements made at the last inspection in July 2005. There are no requirements identified at this inspection.

What the care home could do better:

The registered manager is recommended to review the record for staff supervision to ensure that the National Minimum Standards continue to be met.

CARE HOMES FOR OLDER PEOPLE Altham Court Nursing Home Altham Terrace Lincoln Lincs LN6 7SP Lead Inspector Mr Ken Hague Unannounced Inspection 2nd June 2006 09:00 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 Altham Court Nursing Home DS0000002528.V297801.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 Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Altham Court Nursing Home Address Altham Terrace Lincoln Lincs LN6 7SP 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) 01522 511373 01522 511471 www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Mrs Linda Carol Burrows Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (10) of places Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th September 2005 Brief Description of the Service: The home is owned and run by the BUPA organisation and employs a care manager and social care manager (deputy manager). This home is situated in a quiet lane within walking distance from the City Centre. The home has extensive and well-kept gardens, which have garden furniture for the comfort of service users. Altham Court is registered for forty-eight service users, 10 of whom have a physical disability, and provides both personal care and nursing care for older people. This is a purpose built home with all services situated on ground floor level, with two double-shared bedrooms and forty-four single rooms with en-suite facilities giving total number of beds of forty-eight. Car parking is to the front of the building and there is a bus service close by, which relatives can use to visit this home. The homes statement of purpose states that its aim is to provide our customers with the highest quality service. We will use our health and care knowledge, specialist skills and values to deliver an individual service to our customers. Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours, which included a four-hour site visit. A tour of the premises was undertaken with the assistance of the registered manager and discussion and feedback was given at the end of the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of five residents were sought. A Preinspection questionnaire was supplied by the care home to the commission for social care inspection prior to the site visit being made. The commission received 21 residents’ feedback forms (“have your say documents”) from residents at the care home. This form asked residents 12 questions regarding services provided by the care home. All of these forms were analysed and their contributions are included in this report. What the service does well: What has improved since the last inspection? What they could do better: The registered manager is recommended to review the record for staff supervision to ensure that the National Minimum Standards continue to be met. Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Altham Court Nursing Home DS0000002528.V297801.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 Court Nursing Home DS0000002528.V297801.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 & 6 Quality in this outcome area is Good. This judgement has been made using the available evidence including a visit to this service. A detailed assessment, which includes a risk assessment, is carried out before any new resident is admitted to the care home. An intermediate care service is not provided by this care home. All residents have a copy of the terms and conditions for the estate at the care home. EVIDENCE: Residents case tracked during this inspection had a comprehensive assessment carried out prior to them being admitted to the care home. The assessment was found on their individual care file. A copy of the terms and conditions for residents stay at the care home was also on their individual file. The registered manager confirmed intermediate care is not offered by the care home. Altham Court Nursing Home DS0000002528.V297801.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home identifies the health, personal and social care needs of each resident and records them on their care plan. This enables staff to meet their needs in a manner, which is described within the individual’s care plan. The medication policy of the home is being followed. Staff respect the dignity and privacy of residents. EVIDENCE: The “have your say surveys” supplied by residents to the Commission for Social Care Inspection were analysed. These provided confirmation that residents stated they receive medical care. These views were again expressed by all of the residents interviewed during the site visit who stated they always receive medical care when required. They confirmed that staff will arrange for a GP to visit them at any time. Discussions held with residents confirmed that they are happy that staff respect their privacy and dignity. Care records contained evidence that there is a close working relationship between the home and community health care services. There are policies and procedures Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 10 in place to ensure that all residents receive appropriate medical care and medication is managed in accordance with National Minimum Standards. The details of dental care, eye care and foot care are recorded on resident’s individual files. One have your say document states “if my sister needs a doctor staff will see to it, the staff will always listen to you if youre worried about something”. A second resident state “the GP visits whenever I need one” Altham Court Nursing Home DS0000002528.V297801.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 at least once during a 12 month period. 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 the available evidence including a visit to this service. The home provides organised activities some on a one to one basis. Family and friends are encouraged to visit the home and keep contact with residents. The home offers a menu, which provides choice and meets the dietary needs of individual residents. Residents are able to have choices and control over their own lifestyle. EVIDENCE: The home supplied a copy of their menu which demonstrated choice was being offered to residents. This standard was met at the last inspection in July 2005. The report states “The home offers a set menu, which is chosen by residents and accommodates individual preferences. Meals are well presented and nutritious”. The have your say document returned for this inspection provided evidence that residents continued to be satisfied with the care homes menu Resident spoken to during the site visit stated that our friends and relatives are encouraged to visit the home. Relatives and friends were observed to come into the care home during the site visit. Staff were seen to make them welcome. Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 12 The register manager gave the Inspector a copy of the activity programme for the home. She stated the home’s activity organiser regularly talks to residents to discuss and decide future activities. Some residents who are less able are provided with activities on a one-to-one basis. There are some residents who choose not to take part in all of the organised activities. The residents survey form provided residents confirmation that the opinion the residents appropriate activities were been provided. The last inspection report in July 2005 states “The home employs an activities coordinator and provides a good range of activities and leisure interests both within the home and community. These are based on residents preferences who are encouraged to make choices about their preferred lifestyles and routines”. Altham Court Nursing Home DS0000002528.V297801.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. Residents are protected by procedures, which are in place for the management of complaints and any allegations of adult abuse. Staff know what actions to take in event of this occurring ensuring that the residents are safe. Residents are confident in being able to raise any concerns with a member of staff or through resident’s meetings. EVIDENCE: The complaints policy is displayed in the care home. Residents stated that they felt confident to raise any concerns with any member of staff or the registered manager. Residents spoken to as part of this inspection confirmed that they were aware of the formal complaints procedure. One resident quoted the home’s formal complaints procedure to the inspector. Staff stated in formal interviews that they had received training in the recognition and prevention of abuse. They were able to describe the appropriate action to take in respect of suspecting that any abuse may be occurring within the home. All residents spoken to as part of this inspection stated that they felt the home is a safe place in which to stay. There have been no complaints made to the home since the last inspection. The Commission for Social Care Inspection has carried out one investigation relating to an incident in 2002 where it was alleged care records had not been completed appropriately. This complaint was not substantiated. Evidence from an Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 14 independent investigation by the social services department supported this judgement. Altham Court Nursing Home DS0000002528.V297801.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Residents live in a comfortable, homely, clean environment with a choice of communal areas and personalised bedrooms. The infection control policy of the home is being followed. EVIDENCE: The inspection report in July 2005 made the following judgement “The home is well maintained with an on-going programme of redecoration and maintenance. It provides comfortable and clean accommodation for residents who are involved in the choice of décor and furnishings of the home and are able to personalise their bedrooms as they wish. The home provides equipment to promote residents independence within the home”. The residents surveys completed in May 2006 provided evidence that in the opinion of residents the home was always clean and smelt fresh. During the Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 16 site visit all the areas seen by the Inspector were clean and tidy. Five residents spoken to during the site visit stated their satisfaction with environment of the care home. Evidence was seen of ongoing maintenance being carried out within the care home during this visit. The registered manager and staff stated the infection control policy of the home was being followed. No infection control problems were identified during the site visit Altham Court Nursing Home DS0000002528.V297801.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 at least once during a 12 month period. 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 the available evidence including a visit to this service. The home is recruiting staff safely and ensuring by training and evaluation that they can meet the needs of individual residents. Residents are therefore being provided with safe care. EVIDENCE: Staff training records provided evidence that staff had received appropriate training to be able to meet the identified needs of the residents who were being case tracked. The registered manager stated that staffing levels are reviewed as the occupancy changes. Care staff interviewed stated that they felt they were able to meet the needs of the residents with present staffing levels. Residents stated they felt that there was sufficient staff on duty to meet their needs. The residents survey provided further evidence that the residents were satisfied with the present staffing levels. In discussions with residents during the site visit the feedback comments became easier to understand. A number of residents had misinterpreted these two questions. Residents stated at the site visit that there is always sufficient staff available to help them but they would like more staff available to talk to them socially The recruitment policy of the care home has been followed. The Inspector looked at three personal files for new members of staff. This provided evidence that the recruitment policy of the care home is being followed all appropriate Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 18 information required under the care home regulations have been obtained prior to employment being offered. New members of staff have been provided with an induction. Altham Court Nursing Home DS0000002528.V297801.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. The home is well run, with good leadership and guidance from the registered manager who has worked for many years in the provision of community care. The health and safety and welfare of service users is promoted EVIDENCE: All staff interviewed as part of the site visit stated the registered manager is very supportive “Shes is very approachable, her door is always open”. The register manager encourages all staff to take up training opportunities. Evidence for this statement was found in staff discussions and the inspection of training records. Resident stated they felt the home was run in the best interests of all residents. One resident’s feedback form states “I couldnt wish for a better placement when I want something staff deal with it as quick as Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 20 they can”. “Staff treat me like a friend”. The final statement on this form is “this is the best home I have lived in”. The financial records, for the management of resident’s personal allowances was discussed with the registered manager. A sample of resident’s records was seen and found to meet the National Minimum Standards. There were no health and safety issues or infection control issues identified at this inspection. The registered manager was advised to review her record keeping for staff supervision to ensure the National Minimum Standards were being met. Altham Court Nursing Home DS0000002528.V297801.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 x 3 3 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 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 4 17 X 18 4 3 X X X X X x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 x 3 3 x 3 Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP36 Good Practice Recommendations Records for staff supervision should be reviewed to ensure that the National Minimum Standards are being met. Altham Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Court Nursing Home DS0000002528.V297801.R01.S.doc Version 5.2 Page 24 - 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!