Inspection on 25/10/05 for Amadeus

This inspection was carried out on 25th October 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.

Other inspections for this house

Amadeus 24/09/07

Amadeus 12/09/06

Amadeus 21/03/06

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 25th October 2005 10:00 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 Amadeus DS0000041691.V257195.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.V257195.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 Mr Russell Scott Jones 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.V257195.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). 16th March 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.V257195.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 five and a half hours. The acting manager was on holiday therefore the Senior Carer was in charge and assisted with the inspection. Three residents files and three staff files were reviewed. Eight residents, and four visitors were spoken with along with three staff members. The administration of medication and the lunchtime was observed. What the service does well: 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. Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 Page 6 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.V257195.R01.S.doc Version 5.0 Page 7 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, 2 & 3 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 combined 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. However, a separate Service User Guide, produced in large clear font and with the addition of symbols would make sure that the majority of residents, or prospective residents, could read it. (See recommendation 1) Contracts were available for each resident, which included the number of the room they were to occupy. The resident or their representative had signed these. Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 Page 8 Each resident had an assessment on their file, which covered potential areas of need. From this the care plans had been devised. Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 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 & 11 The needs of the residents would be fully met by staff following the care plans available. Detailed completion of the daily records would reflect both how the resident’s needs were met and the hard work being done by the staff. 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 read, ‘nursing/diagnosis/assessment’ and ‘nursing action’. These headings should only be used in nursing homes and are inappropriate for a residential care home. The documentation should be changed accordingly. (See recommendation 2) Although risk assessments were available for each resident they were kept together in a separate risk assessment file. It would be easier for new or agency staff to read these together with the care plans to know how to safely meet the resident’s needs. Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 Page 10 (See recommendation 3) There was a lot of documentation held loosely with the care file. The manager should consider developing a care file, which has appropriate dividers and headings so that all documentation relating to each resident can be held securely and in one place. (See recommendation 4) The daily recordings did not reflect the amount of work being done by the staff to meet the residents’ needs. Neither did they show any involvement or consultation with the residents. On all of the files read the phrase ‘all care given’ was recorded frequently in the daily/nightly records. On one file this phrase was used 18 times between 04/10/05 and 12/10/05. The manager should randomly read the content of the daily records to make sure that they are being written properly and address any issues with staff in supervision. The staff must record how they have met the needs that are identified in the care plan. Whenever possible they should also ask the resident their view on how they feel their care has been met and record their response. (See requirement 1) There was a sheet available on each file for the recording of visits from professional workers such as GP’s, District Nurses and podiatrist etc. This showed that the residents’ health care needs were being met. Lunchtime medication was given out during the inspection. This was done in a safe manner and followed medication policy and procedure. Some of the residents did not have their photograph on the medication file. This would make sure that the resident was easily identifiable to new or relief staff and ensure greater safety. (See recommendation 5) On the whole the resident’s privacy and dignity was upheld and residents spoken with were happy with the staff’s approach and manner. However, during the inspection a member of the care staff entered a resident’s bedroom without knocking first. The resident was in the middle of a conversation with the inspector and also had two visitors in the room with her. Without excusing herself, the staff member interrupted the conversation by asking the resident if she would like a biscuit and left the room without acknowledging the two visitors. Staff should treat all residents with respect and knock on doors before entering. (See requirement 2) Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 Page 11 The residents’ wishes in the event of terminal illness or death had not been completed, although the question was included on the front sheet. The senior carer said that she had asked the relatives of some of the current residents but still had a number outstanding. She ensures that the question is asked of any new resident as a matter of course when completing the information front sheet. (See requirement 3) Amadeus DS0000041691.V257195.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, 13, 14 & 15 Daily activities would make sure that the residents are stimulated and kept active both physically and mentally. Residents are able to make some decisions and therefore have some control over their life at Amadeus. EVIDENCE: The residents spoken with were able to tell of some activities that took place in the home. This related particularly to a singer that visits once a month. There is also another singer and an accordion player who visit once a month to provide entertainment. There is a very large cinema style TV in the lounge and DVDs and videos are available for residents. Occasionally staff will put music tapes on for the residents in the lounge. One member of staff conducts a session called, healthy hearts and hips, once a week for residents. Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 Page 13 The home no longer has an activities co-ordinator and this is reflected in the lack of a regular, guaranteed programme of activities to occupy and stimulate the residents. (See requirement 4) Visitors are welcome at Amadeus at any reasonable time. There were a number of visitors at the home throughout the inspection. The residents could meet with their visitors in the privacy of their own room if they wished. The residents are free to spend time in their room or in the lounge as they wish. Some residents choose to stay in their room throughout the day and to take their meal in their room. The residents were given a choice at mealtime. One resident spoken with confirmed that an alternative sweet had been provided as she did not like the sweet offered. The residents spoken with said they enjoyed the food that was provided. 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. (See recommendation 6) Amadeus DS0000041691.V257195.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): 16 & 18 The residents would be protected by the policies and procedures followed at Amadeus. EVIDENCE: The home’s complaints procedure sets out the method to have concerns, or a complaint about the service, dealt with and details the role the Commission takes in the investigation of complaints. 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. The visitor’s book was being signed so that staff were aware of who was in the home and at what time. Amadeus DS0000041691.V257195.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, 21, 23, 24, 25 & 26 The residents are provided with a fairly comfortable and clean room at Amadeus, that they can furnish to their own liking. The staff need to be mindful of the safety, warmth and health risk to residents when they leave the side door to the home open. EVIDENCE: The home was bright and clean. The lay out enables service users to access all areas as there are no steps to negotiate. There were a number of environmental and maintenance issues identified. These were in relation to field mice being seen in the building and a side and kitchen door being left open. The senior carer said that the pest control had visited the home on three occasions and had left blue bait in areas not used by the residents and black boxes in the bathrooms that residents would be using. The pest control is due to return again the next week. Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 Page 16 The side door to the building was wide open at the beginning of the inspection. This leads to a small concrete area, which in turn backs onto a grassed area. A resident in the room next to this door confirmed that it was often left open. This must be kept closed, as the warmth of the home will be attractive to rodents. Additionally, the safety of the residents and staff could be compromised should someone be intent on entering the home. Staff must be aware of the needs of the residents and the effect their actions can have on them. The side door must be kept closed. (See requirement 5) The resident in room 5 said her room often felt cold, particularly when the side door was left open. She had a long sleeved blouse, long sleeved jumper and a gilet on but said she would also put a crocheted blanket around her shoulders when it was closed. Her radiator, which was at its maximum, was uncovered. This and any other radiators must be covered to reduce the risk of burning. (See requirement 6) Additionally there was a black patch on the wall next to the resident’s bed in room 5. The resident’s bed must be moved away from the wall and she should be asked if she would be willing to change rooms at least until the cause is established and the situation is resolved. (See requirement 7) The residents had access to a large lounge with dining facilities and a small conservatory at the front of the home. The resident’s rooms were decorated with some of their own belongings. This varied from photographs, paintings, ornaments and small items of furniture. There were sufficient lavatories and bathrooms to meet the needs of the residents. The home was clean and free from offensive odours. Amadeus DS0000041691.V257195.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, 29 & 30 The resident’s needs may be neglected if staffing levels are inadequate for the number and dependency of the residents at Amadeus. The recruitment practices would support and protect the residents. EVIDENCE: The senior carer was in charge as the acting manager was on holiday. In addition there were two care assistants. The cook was off ill and had been for some time; therefore the senior care said she was also going to be cooking the meals and doing the dishes. The senior was informed that this was unacceptable. Fortunately a member of the night staff was in the building for her NVQ assessment and offered to stay to help out. The staffing levels must be reviewed and a relief cook employed from an agency if ever the situation arises again. (See requirement 8) Three staff files were reviewed and all contained the appropriate information to show that the recruitment policy was being followed thoroughly. An induction programme is provided for new staff and mandatory training is also provided. Amadeus DS0000041691.V257195.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 8) Amadeus DS0000041691.V257195.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, 36 & 38 The residents and staff health would be further protected if appropriate cleansing materials were provided. EVIDENCE: The acting manager was in the process of being registered with the Commission for Social Care Inspection. She had provided evidence of her experience and qualifications in care work and was due to attend for a fit person interview the following week. When the manager is registered she will be able to discharge her responsibilities as manage fully. There was evidence that supervision was occurring for all staff. Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 Page 20 One resident had returned from hospital and had contracted MethicillinResistant Staphylococcus Aureus (MRSA); she was being cared for in her room. The staff did not have any hand rub or anti-bacterial cleanser immediately available so that they could clean their hands before leaving her room and interacting with the other residents. Advice must be taken from health professionals on the appropriate cleansing products and procedure for staff after caring for residents with MRSA. (Requirement 9) Amadeus DS0000041691.V257195.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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X 3 3 3 3 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 X 2 Amadeus DS0000041691.V257195.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 OP7 Regulation 15 Requirement Timescale for action 01/02/06 2 3 OP10 OP11 4 OP12 5 6 OP19 OP19 Daily recordings must reflect how the residents’ needs were met. They should also show that whenever possible, the residents were consulted with on how well they feel the staff have achieved this. 18 Residents and their visitors must be treated with respect at all times 12 The residents’ wishes in the event of terminal illness and death must be established and recorded on their file. 16 Regular guaranteed daily activities must be provided to occupy and stimulate the residen0ts. An activities coordinator would assist in this. 13, 23 The side, fire exit door must be kept shut to protect the health and safety of the residents. 13, 16, 23 The cause of the black patch in room 5 must be established and resolved. 16, 23 Any radiators without protective covers must be risk assessed. 01/12/06 01/02/06 01/02/06 01/02/06 01/02/06 7 OP19 01/02/06 Amadeus DS0000041691.V257195.R01.S.doc Version 5.0 Page 23 8 OP27 18 9 OP38 12, 13 Staff numbers must be reviewed and suitable replacement staff employed to cover staff absence or leave, including domestic and kitchen staff. Advice must be taken from health professionals on the appropriate cleansing products and procedure for staff after caring for residents with MRSA. 01/02/06 01/02/06 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 Refer to Standard OP1 OP7 OP7 OP7 Good Practice Recommendations A separate service user guide using large font and possibly symbols should be provided to make the document accessible to as many residents as possible. Nursing documentation should be removed and replaced with documentation suitable to the residential status of the home. Risk assessments should be held on the resident’s individual files. A single file, appropriately divided and labelled, should be used for each resident and contain all the information relating to that resident, including the paperwork currently held loosely with the care file. Photos should be placed on all medication administration sheets. A photographic menu should be provided and displayed so that residents are aware of which meals are on offer each day. Training, specific to the client group, should be provided to staff. 5 6 7 OP9 OP15 OP30 Amadeus DS0000041691.V257195.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.V257195.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. 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. 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