Inspection on 06/12/05 for Amber House

This inspection was carried out on 6th December 2005.

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 10 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 17/05/07

Amber House 09/06/06

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 Linda Wells Unannounced Inspection 6th December 2005 02:00 Amber House DS0000027371.V268432.R01.S.doc Version 5.0 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.V268432.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 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.V268432.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Amber House Address 68 Avondale Road Gorleston Great Yarmouth Norfolk NR31 6DJ 01493 603513 01493 656702 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 Mrs Denise Kelly Care Home 10 Category(ies) of Learning disability over 65 years of age (10) registration, with number of places Amber House DS0000027371.V268432.R01.S.doc Version 5.0 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. 19th July 2005 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 an older style, semi-detached, three-storey house with five single and two double bedrooms on the first floor and one double bedroom on the ground floor, some of which contain a washbasin. There is no assisted passage to the upper floors and service users have communal use of two bathrooms and three toilets, a lounge, dining room and conservatory. There is a small well-kept garden to the rear of the building and roadside parking to the front of the property. This is one of two homes owned by the proprietor, the second being 70, Avondale Road, which accommodates twelve service users with a learning disability. The homes are situated in the town of Gorleston 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 Gorleston 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 and 70 Avondale Road for a period of 40 years and some of the residents have been living there since the service began. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken on the 6th December 2005 over four hours and was carried out as part of a routine inspection plan. Since the last inspection a new manager is in place and is in the process of registering as the manager of Amber House and 70, Avondale Road. The report for Amber House will be similar to 70, Avondale Road because both homes are run as one establishment. The proprietor owns the property between Amber House and 70, Avondale Road and over the last two years has been converting it to enable Amber House and 70, Avondale Road to be connected via the middle property and to improve the accommodation provided. This has resulted in some necessary redecoration and refurbishment in Amber House and 70, Avondale Road not being carried out until after the building works have been completed. The proprietor estimates that this will be in approximately six months time. On the day of inspection residents were seen to return from their day care, to be sitting in the lounge and dining room watching television, listening to music and having a main meal. The home had been decorated for Christmas and although conversation was limited for some of the residents, staff members were seen to talk openly and inclusively with all residents in a warm, respectful manner that promoted choice. The inspection took the form of a tour of the premises and of the building works in the middle house, individual discussion with five residents, two staff members, the manager and the proprietor, observation of two residents individually and in a group, examination of care plans, records, certificates and compliance of requirements and recommendations from the last inspection. What the service does well: What has improved since the last inspection? Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 6 Residents have benefited from an increased activities program at the weekend and have had the opportunity to enjoy regular outings to the Theatre, the pub and for meals. What they could do better: The property between Avon House and 70, Avondale Road has been completely redesigned, rewired, a new roof fitted, has new double glazed windows, a new kitchen installed, a glass walkway built, a fire alarm system installed and is awaiting the completion of the fitting of fire doors and connecting doors to Avon House and 70, Avondale Road, decoration, carpeting and furnishing. Once finished, residents will have an additional communal lounge/games room, lounge, dining area, bathroom, toilets and for some residents a larger bedroom. Disruption to residents by the building works has been kept to a minimum and it has been agreed that the following requirements will be completed as the final stage of the three homes being connected. • • • • All radiators must be guarded. The toilets and bathrooms must be refurbished and redecorated. Most bedrooms must be redecorated. The carpets must be replaced where worn and/or stained. To ensure that residents and staff are consulted and protected the following six requirements have also been made and must be completed within the given timescales at the end of this report. • • • • • • The hot water into the washbasins must be regulated to ensure residents and staff members are protected. Repeated requirement. The person centred plan held for each resident must be developed to ensure that the personal choices and opinions of residents on all aspects of their life and plan of care are known, recorded and carried out. The arrangements at death for each resident must be recorded in their plan of care to ensure that their wishes are known and carried out. The quality assurance system produced must be further expanded to include the views of staff members to ensure everyone is consulted. Supervision carried out with staff members must be increased to ensure residents are fully protected. A photograph of each staff member must be held in their staff file to ensure residents are protected. 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. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 7 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.V268432.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 The admission procedure and written information available is adequate and enables residents and staff to make a decision on whether the home will meet the needs of anyone wishing to live there. EVIDENCE: Residents have access to sufficient information about the home in the form of the Statement of Purpose, Service User Guide and a copy of the Terms and Conditions contract that was seen to be held in the plan of care of each resident. To ensure that the needs of residents are identified as being able to be met by the home the manager said that an assessment is completed prior to admission to the home and includes the views of residents, their family members and other professionals. The manager said that residents and their family and/or friends are encouraged to visit the home prior to admission, often stay for a meal or short stay to ensure that they have an opportunity to decide if the home and the facilities are suitable for their needs and have a months trial period. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 10 The personal and health care needs of residents were met but records did not fully demonstrate that residents were consulted and their wishes known. EVIDENCE: Residents were well looked after and three individual plans of care were examined and found to have improved and to contain relevant personal, health and social care information. This includes daily records, involvement with healthcare professionals, risk assessments, a photograph, self help skills, routine, preferences, communication, diet, weight records, program of attendance at day care facilities, sheltered work placement or educational establishments and monthly key worker reviews. Residents and staff members spoken to said that residents are encouraged to be independent and are supported by staff in taking risks within their daily lives by maximising their potential around self-care and promoting life skills. The manager has begun the process of introducing person centred planning into the home but the records seen demonstrated that the information held was a repeat of the plans of care held on each resident. A requirement was made that the person centred plans be further developed to include “first person” accounts on all aspects of the life and plan of care of each resident to Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 10 fully show that residents have been consulted, that their wishes and opinions are known and that they lead their lives and receive care and support in the manner they prefer and choose. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15, 16, 17 Social activities and meals are planned and varied and provide interest and stimulation for those living at the home. EVIDENCE: Residents take part in planned activities during the evenings and at the weekend such as the Lion’s Club, Gateway Club, bowling, shopping and walking along the beach. Most of the residents attend work placements, educational courses or day care services for one day or more each week and activities have been increased for those residents who remain at home during the day to include art, craft, music and games. 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 the examples residents gave of going to the Theatre, to the pub for a drink and out for a meal. Residents said that their families and friends visited the home and gave examples of going out with their families and speaking to them on the telephone. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 12 The meals provided were balanced and varied and the residents spoken to all said that they enjoyed their meals. The manager said that she devised the menus weekly and then organised the shopping at local venues where mainly fresh produce was purchased. She said that she compiled the menus based on the likes and dislikes of residents, any dietary need and the fresh produce available. Records were seen to be held on the food consumed daily by residents and improvements have been made to informing residents of the daily choice of meals by the displaying of the menu. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 21 Personal support is given to residents in the way they prefer, their needs are met but their wishes were not fully known and recorded. EVIDENCE: Residents said they were encouraged to do things for themselves and that staff gave them help with the things they could not do themselves, that they were happy to have staff members assist them with their personal care and they indicated that their privacy was protected. The staff members spoken to gave examples of how they work with residents to support them in their personal development by encouraging each resident to be independent and to make choices whilst ensuring that the rights of each resident were promoted and protected. Medication policies and procedures protected residents, staff had undertaken training and medication was stored, administered and recorded correctly. Records held on residents showed that residents had not been consulted on their arrangements at death and a requirement was made that the wishes of each resident be recorded in their plan of care to demonstrate consultation and agreement of each resident. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The home has a complaints system in place that protects residents and supports the investigation of any cause for concern. EVIDENCE: Residents are protected by the home’s complaints policy and procedure and the home had not received any complaints. The residents spoken to said that they would speak to their key worker or the manager if they were unhappy and agreed that they would be listened to and the appropriate action taken to resolve the problem to the satisfaction of all concerned. Residents are protected from abuse, neglect and self-harm by the objectives, policies and procedures of the home and staff have undertaken training in Adult Abuse to help them recognise, prevent and deal with any potential abuse. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28, 30 The standard of the environment within this home is mainly satisfactory and will be improved when the building works have been completed. EVIDENCE: Residents live in an environment that is decorated to a reasonable standard but their health and safety is not completely protected at the home and the radiators require guarding, the toilets and bathrooms require refurbishment and redecoration, some bedrooms require redecoration and some carpets in the home require replacing. Due to major building works taking place in the property next door and the plan to knock through into the home to increase the size of the home and link the home to 70, Avondale Road it has been agreed that these four requirements will be completed as the final stage of the build, which the proprietor said should be within six months. A requirement was repeated that the hot water into the washbasins be regulated to ensure residents and staff at the home are protected. Resident’s benefit from a home that is comfortable, clean, tidy and odour free, have the use of communal space and were seen to have personalised their bedrooms to reflect their personal choice and style. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36 The procedure for the recruitment and training of staff provides safeguards to offer protection for the people living at the home but records were incomplete. EVIDENCE: Residents are cared for by competent staff with the experience and knowledge to meet the range of needs of those that live at the home. The three staff members spoken to said that they were supported by the senior carer and manager, attended staff meetings and took part in occasional supervision. Records showed that although supervision took place it was not in sufficient frequency for all staff and therefore a requirement was made that supervision be carried out with all staff at least six times a year to review their work practise, clarify the aims and objectives of the home, the care provided to each resident and to identify, plan and review their training needs. The staff records seen demonstrated that residents were protected by the recruitment checks carried out and CRB, proof of identity, references and personal details. However, a photograph of each staff member was not held and a requirement was made that one be held in each staff file to support proof of identity. Staff had undertaken training and the staff spoken to had completed induction, foundation, Adult Abuse, medication, NVQ2 and NVQ3 training. Copies of certificates were held in staff files and the manager spoke of the TOPPS Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 17 training staff members had commenced and the Nutrition and Health course the senior carer had started in September 2005. Improvements had been made to the staff training records that were seen and demonstrated that staff undertook training and timely updated training courses to ensure that the needs of residents were fully met. Residents were cared for by adequate numbers of staff and the staff spoken to said that staff numbers were increased when necessary to meet the needs of residents. Two male staff members seen at the home had been employed to meet the needs of a male resident. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 39, 40, 41, 42, 43 The home is well run and the acting manager provides clear leadership, guidance and direction to staff to ensure that residents receive a good standard of care. EVIDENCE: Residents are protected by the management and administration procedures carried out in the home. The acting manager has worked in the home for nine years, has been the acting manager for nine months and is in the process of completing her application to be registered as the manager. She has completed NVQ 2 and NVQ 3 training and has commenced the NVQ 4 Registered Managers award in September 2005. On completion of this award this part of the standard will be met. The best interests and rights of residents are promoted but the quality assurance system that has been produced requires further development to ensure staff members are consulted and feedback sought on the quality of care and facilities provided. A requirement was repeated for the second time that a quality assurance system must be in place that takes into account the views of Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 19 residents, staff, other professionals and visitors to the home and an action plan produced from the findings. 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. To ensure that the health and safety of residents is protected the servicing and testing of all equipment in the home had been carried out and relevant and timely certificates were held. Residents benefit from the financial management of the home and the manager said that she did not have any reason to doubt that the home was financially sound. Amber House DS0000027371.V268432.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X 3 X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 2 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X 3 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Amber House Score 3 X X 2 Standard No 37 38 39 40 41 42 43 Score X 3 2 3 3 3 3 DS0000027371.V268432.R01.S.doc Version 5.0 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA8 Regulation 12.3 Requirement The registered person must develop the person centred plans to include the personal wishes, choice and preferences of each service user. The registered person must ensure that the arrangements at death for each service user are known and recorded. The proprietor must ensure that the carpets that need replacing are replaced. (Previous timescale of 31st March 2006 will not be met) The proprietor must ensure that the toilets and bathrooms are refurbished and redecorated. (Previous timescale of 31st March 2006 will not be met) The proprietor must ensure that all radiators are guarded. (Previous timescale of 31st March 2006 will not be met) The proprietor must ensure that the bedrooms in need of redecoration are redecorated. (Previous timescale of 31st March 2006 will not be met) The proprietor must ensure that the hot water temperature is DS0000027371.V268432.R01.S.doc Timescale for action 31/03/06 2. YA21 12.2 31/03/06 3. YA24 23.2.b 30/06/06 4. YA24 23.2.b 30/06/06 5. YA24 23.2.b 30/06/06 6. YA24 23.2.d 30/06/05 7. YA24 13.4 31/03/06 Amber House Version 5.0 Page 22 8. YA34 9. YA36 10. YA39 regulated at all sources. (Previous timescale of 31st October 2005 has not been met) 19.1.sch 2 The registered person must ensure that a photograph of each staff member is held in their staff file. 18.2 The registered person must ensure that staff members receive supervision at least six times a year. 24.1.2.3 The registered person must further develop the Quality Assurance system that is in place. 31/03/05 01/03/06 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Amber House DS0000027371.V268432.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. 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