Inspection on 21/03/06 for Amadeus

This inspection was carried out on 21st March 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

Amadeus 24/09/07

Amadeus 12/09/06

Amadeus 25/10/05

Amadeus 18/03/05

Amadeus 21/09/04

Amadeus 11/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Amadeus Hampden Grove Patricroft Eccles Gtr Manchester M30 0QU Lead Inspector Judith Morton Unannounced Inspection 10:00 21st March 2006 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 Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Amadeus Address Hampden Grove Patricroft Eccles Gtr Manchester M30 0QU 0161 787 8638 0161 707 1014 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) Mr Bradley Scott Jones Mr Russell Scott Jones Mrs Kathryn Hewitt Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (1) of places Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That a maximum of 21 older people be accommodated in 15 single rooms and 3 double bedrooms. That care staffing levels do not fall below the minimum staffing levels specified in the Residential Forum Guidance for Staffing in Care Homes for Older People. That dependency levels of service users are assessed on a continuous basis and staffing levels adjusted where appropriate to ensure continued compliance with the Residential Forum Guidance for staffing in Care Homes for Older People. That the home only operates within its registered category and numbers. One named service user is accomodated who is below 65 years of age. If this person no longer requires the service, the category will revert back to older people (OP). 25th October 2005 3. 4. 5. Date of last inspection Brief Description of the Service: Amadeus is a private residential care home providing accommodation for 21 older people, requiring personal care only. The home is registered in the name of Mr Bradley Jones and Mr Russell Jones. The home is a detached property set out on one level, located on a quiet grove, close to Eccles shopping centre and market and accessible to bus routes located on Liverpool Road. There are 15 single bedrooms and 3 double bedrooms. Communal space comprises of a large lounge and dining room in the centre of the building. There is a smaller conservatory style seating area to the front entrance. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 ¼ hours. It covered the requirements of the last inspection and the key standards that had not been checked this inspection year. It should therefore be read along with the first inspection report. Two residents files were checked and three staff files. The owner, manager and three care staff, together with the activities coordinator were spoken with. Three residents were also spoken with. What the service does well: What has improved since the last inspection? What they could do better: Creative ways of meeting the communication needs of those residents who have limited or no verbal communication skills could be explored. In the same way staff should find ways of meeting the needs of the residents who are showing signs of confusion, dementia or short-term memory loss through old age. The use of symbols or photographs on doorways might prolong their independence. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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 Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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): 1, 4 & 5 Amadeus displays sufficient information for residents and their relatives to know what services are provided. They are also able to visit before making a final decision about whether the home can meet their needs. EVIDENCE: There was a Statement of Purpose and Service User Guide on display in the foyer of the home. It contained all the information needed for people to know what services are offered by Amadeus and whether the home could meet their needs. The manager said that the Service User Guide would be given to those residents who could understand it otherwise it would be given to their relatives. They would also be given a copy of the statement of purpose and the last report from the Commission for Social care Inspection if they requested it. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 9 However, the Service User Guide should be produced in a large clear font with the addition of symbols, as this would make sure that the majority of residents, or prospective residents, could read it. (See recommendation 1) There was an initial assessment of each resident’s needs on the files checked. This had been completed by the Social worker of the placing authority. The manager had also assessed the needs of the resident and from this produced a plan of care. The manager said that any prospective residents are encouraged to visit and stay for a meal before making a decision as to whether they feel the home could meet their needs. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 The restructured care files and the use of labelled dividers has made it easier for staff to locate specific information and makes sure that all information relating to the individual is held together. EVIDENCE: There were care plans on each of the files. The care plans clearly identified the needs of each resident. The headings on the care plans still read, ‘nursing/diagnosis/assessment’ and ‘nursing action’. The manager was aware of this and had re-designed the forms to omit this. The new forms would be used when making up a file for a new resident or adding to the plan of an existing resident. The resident’s files had been re-designed with dividers added to clearly identify sections, making information easier to locate. Risk assessments were now also being held on the individual resident’s files. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 11 There was obvious improvement in the content of the daily recordings, some staff being more consistent than others. To gain consistency the manager should review the daily recordings periodically and discuss any problems that some of the staff may be having with recording, during their supervision. (See recommendation 2) It would be good practice for staff, whenever possible, to seek the views of those residents able to express them and to record these in the daily recordings. (See recommendation 3) A social history on each file would help staff to get to know the resident, their hobbies and interests, their family, their work and in some cases their temperament, if this has changed due to degenerative illness. It would also assist staff in promoting conversation. In some instances this may have to be done by, or with, the resident’s family. (See recommendation 4) The residents’ photographs have been laminated onto dividers and added to the medication file. During the inspection the staff were seen to interact with, and address each resident with respect. The manager said she had spoken to all of the staff to ensure that the residents are treated with dignity and respect. The manager said that the wishes of all of the residents in the event of their death were now recorded. The question is asked routinely of any new residents. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 The residents will have an increased variety of activities available to them on a more regular basis with the introduction of a part time activities co-ordinator. This will ensure that the residents are active and stimulated. EVIDENCE: One member of staff conducts a session called, healthy hearts and hips, once a week for residents. She has now effectively become the activities co-ordinator and a regular, guaranteed programme of activities to occupy and stimulate the residents is being planned. The manager was able to show some of the equipment that was available for activities, such as beanbags and darts. She said that singers visit the home twice a month, there are befriending events and some of the residents occasionally go out to a tea dance. The activities co-ordinator should record the activity that was planned and whether the resident has participated or refused to join in so that the individual likes and dislikes of all residents can be established over time. (See recommendation 5) Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 13 The co-ordinator may also consider producing the activities timetable with photographs supporting the typed word. Photographing the equipment, games, singer and outings etc would enable an activities directory to be formed. The activity of the day could be displayed in a prominent area of the home, frequented by the residents and be a visual prompt for those residents whose reading skills, vision or memory have deteriorated. (See recommendation 6) There is currently no choice of meal offered at lunchtime, although the manager said, if a resident does not like what is provided an alternative is given. However, an alternative meal must be offered so that residents can choose what they feel like eating and not always whether they like particular food. This need not be a complete change of meal, for example, if fish chips and peas was on the menu and alternative such as chicken or sausage could be offered. (See requirement 1) In a similar way the manager may consider producing a photographic menu displaying both choices of meal. Those residents, who are no longer able to read or communicate verbally, can point to the meal that they would prefer. The photographic menu of the day can also be displayed in the dining area and serve as a reminder for those residents whose memory is deteriorating. (See recommendation 7) Additionally, laminated enlarged pictures of past times in Manchester and the surrounding areas, or famous people from history, might stimulate discussion and conversation by both staff and residents if they were used as place mats during meal times. (See recommendation 8) Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The provision of adult abuse awareness training for the staff will ensure they can recognise all forms of abuse. EVIDENCE: There is a policy on the protection of vulnerable adults. Staff are directed to any new policies that are introduced or changes to existing policies and are asked to sign to say they have been read. Adult abuse awareness training had been provided to staff on 09/01/06. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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, 20 & 26 The residents live in a comfortable, bright and clean environment. EVIDENCE: The pest control company has now eradicated the problem of mice from the home. The side door to the building was only being opened when staff were having their break, ensuring the warmth of the home was maintained. The manager said that all of the radiators had been risk assessed and those that would pose a risk had covers placed in front of them. The black patch on the wall of bedroom 5 had been washed away. The manager said this had been caused by the resident’s radio and was not damp. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 16 The residents have access to a large communal lounge with the dining area off. Additionally there is a small conservatory to the front of the building. Amadeus was warm, clean and free from offensive odours on the day of inspection. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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 & 30 Increased staffing levels will ensure that the residents’ needs could be met without delay. EVIDENCE: The manager acknowledged that staffing levels had been a problem but that this was now being addressed and a number of new staff were to be employed. In addition to the manager, on the day of the unannounced inspection there were six staff on duty, including the cook, laundry assistant and domestic staff. The activities co-ordinator was also working for part of the day at the home. Equality and diversity and adult abuse awareness training had been provided to staff. The manager is qualified to NVQ level 4, one member of staff has a State Enrolled Nurse qualification, another staff member holds NVQ level 3 and a further three staff have NVQ level 2. One member of staff has NVQ level 1 in housekeeping. Additionally six staff have been enrolled onto NVQ level 2 training. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 18 Consideration should be given to providing training specific to the client group, such as sensory loss and impairment, communication, memory loss and dementia. (See recommendation 9) Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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): 31, 35 & 38 The residents’ financial interests are safeguarded by the practices followed by the manager in invoicing and providing receipts for spending. EVIDENCE: Since the last inspection the manager has been registered with the Commission for Social Care Inspection. The manager said that the home does not hold large amounts of money for the residents. One resident is subject to Court of Protection and their money is obtained through Client Affairs. Receipts and invoices are provided. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 20 Community and Social Services in Salford manage the finances of 7 residents and the manager requests spending money directly from them on behalf of the residents. Again invoices and receipts are provided. The families of the other residents manage their finances on their behalf. Advice had been sought from health professionals on the appropriate cleansing products and procedure for staff after caring for residents with MethicillinResistant Staphylococcus Aureus (MRSA). An anti bacterial foam cleanser had been provided so that staff could prevent the spread of (MRSA); They were now able to clean their hands immediately after attending to a resident with this diagnosis, before interacting with the other residents. Regular fire drills were carried out and the response time of the staff was recorded, together with the names of the staff that had participated. A different area was chosen to represent where there was a fire on each occasion. However, the area that had been identified was not recorded in the fire drill book. The manager should add this information so that consistent poor responses when the fire is in a specific area can be highlighted and advice and training given to increase the response time. (See recommendation 10) Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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 3 X X 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 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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. 1 Standard OP15 Regulation 12 Requirement An alternative choice of meal should be offered at the main meal of the day. Timescale for action 01/10/06 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 3 4 5 6 Refer to Standard OP1 OP7 OP7 OP7 OP12 OP12 Good Practice Recommendations The Service User Guide should be produced in alternative formats, including the use of large print and the addition of symbols where necessary. The details that are recorded in the daily records of how assessed needs were met should be consistent from all staff. Wherever possible staff should seek the views of those residents who are able to contribute them and include their responses in the daily records. A social history should be obtained from the resident and/or their family and recorded on each file. A record of the type of activity and the residents who participated or refused should be kept. The activities co-ordinator should consider making a photographic file of activities available to residents living DS0000041691.V267273.R01.S.doc Version 5.0 Page 23 Amadeus 7 8 9 10 OP15 OP15 OP30 OP38 at Amadeus and displaying the daily activity in photographic form as well as in print. A photographic menu should be produced and the daily choice displayed. The use of enlarged, laminated old photographs or pictures of the local area should be considered as place mats to promote conversation at meal times. Specific training in sensory loss and impairment, communication, memory loss and dementia should be provided for staff. The manager should add the zone that had been identified as having a fire on the same sheet as the fire drill sheet. Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Amadeus DS0000041691.V267273.R01.S.doc Version 5.0 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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