Inspection on 17/05/07 for Amber House

This inspection was carried out on 17th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Amber House 29/02/08

Amber House 09/06/06

Amber House 06/12/05

Amber House 19/07/05

Amber House 07/12/04

Amber House 22/07/04

Amber House 18/01/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Amber House 68 Avondale Road Gorleston Great Yarmouth Norfolk NR31 6DJ Lead Inspector Andy Green Unannounced Inspection 17th May 2007 11:30 Amber House DS0000027371.V341608.R01.S.doc Version 5.2 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 Amber House DS0000027371.V341608.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 Adults 18-65. 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. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amber House Address 68 Avondale Road Gorleston Great Yarmouth Norfolk NR31 6DJ 01493 603513 01493 656702 amberhouse2@ntlworld.com 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 John White Mrs Pauline White Ms Paula D Algar Care Home 10 Category(ies) of Learning disability over 65 years of age (10) registration, with number of places Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 10 elderly people who may have learning disabilities and who may be over 65 years of age. 9th June 2006 Date of last inspection Brief Description of the Service: Amber House is a residential care home that provides accommodation and care for up to ten residents with a learning disability, some of whom may be over the age of sixty-five. The home is a semi-detached, three-storey house with five single and two double bedrooms on the first floor and one double bedroom on the ground floor. Residents have access to two bathrooms and three toilets, a lounge, dining room and conservatory. There is a small well-kept garden via the rear of the next-door property owned by the proprietor and there is roadside parking to the front of the property. The home is situated in the town of Gorelston close to the sea front and within easy walking distance of the shops and other facilities. There is a 24 hr bus service that links Gorelston to nearby Great Yarmouth and Lowestoft, each with many amenities and places of interest. There is easy access to the local doctors, dentists, opticians and other health care professionals. The proprietor has owned Amber House for a period of 40 years and some of the residents have been living there since the service opened. Major building works are near completion, which will link the two adjacent properties to eventually provide one registered service. It is anticipated that the building work will be completed by the end of July 2007. The fees range from £337 to £356 per week Copies of CSCI’s inspection reports are made available to the residents and their relatives upon request from the home’s office. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Andy Green, Regulation Inspector, undertook this key unannounced inspection on 17th May 2007. The inspector met with one of the providers, the manager and inspected a number of documents including care plans, staff files, training records, medication records, fire records and the provider’s management visits. A tour of the premises was undertaken and the inspector spoke to residents and members of care staff on duty. The report for Amber House will be similar to the nearby service at 70 Avondale Road because both homes are run as one establishment. 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. The summary of this inspection report can be made available in other formats on request. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides information to prospective service users and their relatives before they move in to ensure that they are aware of all the services provided. EVIDENCE: The home has a Statement of Purpose, which provides information to prospective residents and their relatives regarding the services provided in the home. There have been no changes to the Statement of Purpose since the last inspection. However, the manager stated that this document would be completely updated to accurately describe the service when the major building works have been completed and when there is one overall registered manager for the whole complex. An assessment is completed prior to admission to the home, which includes the views of prospective residents, their family members and other professionals. Prospective residents and their family or representatives are encouraged to visit the home prior to admission. This can include a meal or an overnight stay to ensure that they have an opportunity to decide if the home and the facilities are suitable for their needs and preferences. There is a month’s trial period. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are treated with dignity and respect and receive personal care to meet their assessed needs. However the care planning process needs to be improved. EVIDENCE: Three care plans were inspected and they contained information to give staff guidelines in how to meet the resident’s health, social care needs and activities. The persons likes and dislikes are recorded along with a personal profile. The care plans also contain risk assessments, which provide guidance to staff about how to manage situations assessed as being of medium to high risk. There was evidence that the care plans had been reviewed with notes in place following the first formal review for the resident. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 9 Person centred planning has been introduced into the home and records were seen to demonstrate that the person centred plans included “first person” accounts on aspects of the resident’s life. Residents have been consulted and their wishes and opinions are incorporated so that they can maximise their independence as much as possible and receive care and support in a manner that they prefer and choose. However, the care planning system needs to be reviewed and developed, as there are two sets of care planning documents, which is confusing. A number of entries were also not dated or signed. The manager stated that she would review the whole care planning system in consultation with the staff to ensure that all documents are understood and accurately recorded. A requirement will be made regarding the care planning process. Daily records are kept for each of the residents, detailing information about events that have occurred during their day in the home. Residents are clearly encouraged to take part in the day-to-day running of the home and join in with domestic chores with staff assistance where possible. Staff were observed to offer choices to the residents and to ask them their views about a range of issues. Staff were supportive and friendly and spoke to residents in an appropriate and sensitive manner. CSCI received comment cards from residents, relatives and a healthcare professional, which were complimentary about the service, and no significant concerns were raised. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff provide appropriate support to ensure that service users can access the community to engage in activities appropriate to their needs. Service users have a choice of meals, which are prepared and served in a homely manner. EVIDENCE: The home is near to the seaside which provides a pleasant and scenic aspect to the home. Residents continue to take part in a range of activities during the daytime and evening such as the Lion’s Club, Gateway Club, bowling, church, snooker, shopping and walks by the sea. There are opportunities for personal development and a number of residents continue to attend work placements, educational courses or day care services throughout the week. There are in-house activities for those residents who wish to remain at home during the day eg; art, craft, television, newspapers, music, bingo and board games. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 11 A record was seen of the activities that residents had undertaken and residents and staff said that the activities were based on the leisure interests of residents. This was supported by examples that residents gave of going to the pub for a drink, visiting friends and relatives, frequent trips to the local shops/amenities and walks by the nearby seaside. Residents confirmed that their families and friends could visit the home at any time and they also gave examples of going out with them or remaining in frequent contact by telephone. Records demonstrated that the rights of each resident were respected and promoted by staff and that they were supported to be independent and to make their own choices as much as possible. Holidays and daytrips are also regularly organised throughout the year for groups and individual residents Meals are balanced and varied and residents spoken to all confirmed that they enjoyed the meals that are provided. Menus are devised weekly based on the food residents liked to eat with due regard to their dietary needs. Shopping trips to local supermarkets are regularly organised where mainly fresh produce is purchased. Records are held on the food consumed daily by residents and choices of meals are displayed in the menu. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear guidelines regarding the safe administration of medication. A risk assessment procedure is in place to protect service users. EVIDENCE: Care staff continue to support residents with personal care where necessary and also to assist residents to access out patient appointments at the local hospital as necessary. Health care is detailed in individual care plans and reviewed on a regular basis. Residents have access to a variety of healthcare professionals including GP appointments, opticians, chiropodists and dentists. There is access to psychiatrists and CPN’s on a regular basis. The home continues to use a monitored dosage system of drug administration and the records of medication administered were satisfactory. A pharmacist is available to provide advice when required. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 13 There have been no further changes to healthcare arrangements in the home since the last inspection. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints process to ensure that service users and their representatives are able to raise concerns. There are suitable arrangements for ensuring the protection of service users from neglect or harm. EVIDENCE: Residents are protected by the home’s complaints policy and procedures and the home had not received any complaints since the last inspection. Residents confirmed that they would speak to their key worker or the manager if they were unhappy. A record book for all complaints is in place, but no complaints have been received as yet. The manager stated that the complaints process has recently been provided in an audio CD format to aid residents understanding of how to raise concerns regarding their care or the facilities that are provided. Residents are protected from abuse by the policies and procedures of the home and staff confirmed that they have undertaken training in POVA to ensure that they recognise, prevent and deal with any potential abuse. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The environment of the home provides service users with a comfortable and clean place to live. However there are a number of requirements to be completed from the last inspection. EVIDENCE: The building work to connect the premises to form one establishment is nearing completion and it is anticipated that all works and refurbishments will be finished by the end of July 2007. The provider has incorporated the premises that they own at 69 Avondale Road to connect the two existing homes. This will include two further bedrooms, communal areas, office, new large kitchen and laundry for the whole service. The premises were clean and tidy and residents spoken to were keen to see the new refurbishments that will be provided for them when work has been completed Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and processes ensure that service users are protected from harm. Training is provided to make sure that care staff are competent to deliver care to the service users they support EVIDENCE: The manager stated that the home is fully staffed at present and that agency staff are only used in emergency or for special occasions i.e. daytrips or other social functions. Residents continue to be cared for by staff with the experience and knowledge to meet the range of needs of those that live at the home. Two staff spoken to confirmed that they had received mandatory training throughout the year along with POVA, NVQ at levels 2 and 3, challenging behaviour, dementia and Downs Syndrome. Supervision has improved and staff confirmed that they received formal recorded sessions by the team leader or the manager every 6/8 weeks. staff members spoken to said that they were supported attended staff meetings and took part in occasional supervision. Records showed that supervision takes Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 17 place regularly for all staff to monitor care practice and training and development needs. The staff records demonstrated that residents were protected by the recruitment checks carried out and CRB, proof of identity, references and personal details were in evidence plus a photograph of each staff member to support proof of identity. There were sufficient numbers of staff on duty to meet the needs of the residents. The staff spoken to stated that staff numbers were increased when necessary to meet the needs of residents for individuals or for social events. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The home is well managed and the staff are supported to ensure that service users receive good quality care. However health and safety needs to be improved. EVIDENCE: The manager at the adjacent service at 70 Avondale Road is on sick leave at present so the manager at Amber House is providing management support to both services, which CSCI are aware of. One of the providers is also in daily contact with the home to provide further support to the manager. It is clear that there is an opportunity to review the whole service and the manager stated that she is keen to review policies and processes with the provider, staff team and residents to proactively develop the service. The manager has successfully completed the NVQ 4 and the Registered Managers Award. It is anticipated that she will become the overall manager of Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 19 the service when the building works have been completed. An application regarding the re-registration of the whole service and manager will be submitted to CSCI on completion of the building and refurbishments. The policies, procedures and records held in the home protect residents and offer safeguards that promote the rights and best interests of residents and staff members. Fire records were inspected and it was noted that alarm testing had not been carried out since 7/3/07 and the emergency lighting had not been tested since 28/2/07. The manager stated that she would action this immediately (testing was carried out during the inspection). However a requirement regarding adequate fire equipment testing will be made. Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15(2) (b) Requirement The care planning process must be reviewed to ensure that all information is recorded accurately. The proprietor must ensure that the carpets that need replacing are replaced. (Previous timescale of 31st March 2006, 30th June 2006 and 31st December 2007 have not be met) The proprietor must ensure that the toilets and bathrooms are refurbished and redecorated. (Previous timescale of 31st March 2006, 30th June 2006 and 31st December 2007 have not be met) The proprietor must ensure that all staff members have completed training in food hygiene. Fire equipment testing must be carried out to ensure that residents are protected from harm. DS0000027371.V341608.R01.S.doc Timescale for action 31/07/07 1. YA24 23(2) (b) 31/07/07 2. YA24 23 (2) (b) 31/07/07 5. YA35 18 (1) (c) 30/06/07 6. YA42 17(2) 17/05/07 Amber House Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Amber House DS0000027371.V341608.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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