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Inspection on 21/06/05 for Amberdene Lodge

Also see our care home review for Amberdene Lodge for more information

This inspection was carried out on 21st June 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents said that they are supported well by the staff and are encouraged to exercise freedom of choice in their daily activities. The residents said, "the staff are very helpful and patient" more than one said, "the staff are very caring and kind". The home caters for the individual needs of the resident on an individual basis. An example of this is the that they provide food which is specific to the wishes of the of the resident and does take in account their ethic and cultural background. The case files, which are kept for each resident, were full of relevant information and clearly instructed the staff on how to meet the various needs of the residents. This results in the residents receiving steady and reliable care.

What has improved since the last inspection?

The acting manager stated that the staff group has become very stable since the last inspection and this has lead to a more consistent approach to the care of the residents.

What the care home could do better:

When the home appoints new staff they are supposed to do a CRB check, which is similar to a police check; this has not been happening at the home. As a result of this resident could be put at risk of abuse as staff unsuitable to work with vulnerable adults would not be detected.

CARE HOMES FOR OLDER PEOPLE Amberdene Lodge 40 - 42 The Boulevard Kingston upon Hull East Yorkshire HU3 2TA Lead Inspector George Skinn Unannounced 21 June 2005 9:30 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 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. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Amberdene Address 40 - 42 The Boulevard Kingston upon Hull East Yorkshire HU3 2TA 01482 587774 01482 587774 Telephone number Fax number Email 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 Graham Abel Elaine Kathryn Grant Care Home 25 Category(ies) of OP Old Age (25) registration, with number DE(E) Dementia - over 65 (25) of places Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11/11/04 Brief Description of the Service: Amberdene is a large care home comprising of two Victorian houses on The Boulevard, off Anlaby Road in the west of Kingston-upon-Hull. Local services on Anlaby Road include a chemist, a GP surgery, taxi office, pubs and the Hull Royal Infirmary. Bus services to the city centre and out of the city are a short walk away. The home provides residential care for a maximum of 25 older people, who may have dementia.There are thirteen single rooms and six doubles on two floors, accessed via a passenger lift. None of the bedrooms have en-suite. There are three bathrooms and nine WC’s. The home has two lounges and a dining room. There is a garden to the rear of the house, which is now accessible via a concrete ramp.There is car parking for two cars at the front of the building. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 6 hours. The building was looked at and some records were inspected. The majority of the residents and seven of the staff group were spoken with. This included the manager. This is the first visit to the home since the last inspection in November 2004. What the service does well: What has improved since the last inspection? The acting manager stated that the staff group has become very stable since the last inspection and this has lead to a more consistent approach to the care of the residents. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 6 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. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 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 standard(s) 3 All residents including those who are self-funding are assessed prior to their stay at the home thus ensuring that their needs can be met by the home. EVIDENCE: Residents sign their plans of care, which are in large print making them easier to read. The majority of those interviewed knew that the home kept records and information about them. The Manager completes an enquiry form following any contact with care coordinators or placement officers from social services departments. She then completes a new client assessment detail form once it has been decided the prospective resident will be spending a trial stay in the home. The Manager consults the residents’ and their relatives or representatives during the stay to make a complete assessment of the residents’ needs. The Manager uses all of this information, along with risk assessments and staff observations to compile a resident plan of care. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 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 standard(s) 7, 9 &10 Resident are encouraged to be as independent as possible. Their health and personal care needs are well met by the home and privacy is respected during this process. EVIDENCE: A plan of care is compiled using information gathered and observations undertaken before and during the trial stay. Relatives and residents are involved with this process. The care plan contains documents such as risk assessments, action plans it is in large print for residents to make reading easier and there is a space where residents can sign to say they agree to the plan those files seen were signed. Reviews of the care plan are held monthly and six-monthly in a more formal setting. Due to the dependency levels of the residents only one was aware that the home kept information about them. The home has a good medication trail for handling medicines: receipted, correctly stored and appropriately administered or disposed of. The staff Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 10 follow a medication policy for administering medicines and there is a selfmedication policy for residents who self-medicate. Staff receive training from Peter Blythe Pharmacy on medication administration. The Manger and Deputy Manager have completed a Boots Advanced Care in Administering Medicines course. Only the management team or senior carers administer medication. The Venalink Monitored Dosage System is in use, and medication administration record sheets are used and accurately maintained. Storage arrangements are good and each resident has their own lockable cabinet in their room should they wish to self-medicate. Staff respect the residents’ rights to privacy and dignity, and any personal care is given in private telephone calls can be made by residents in the office if they have no line of their own, and mail is received unopened by the residents. Screening is provided in double rooms. Family and friends can be seen in residents’ own rooms if they wish, but the tendency is to visit in the lounge and talk to several people. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 & 15 Residents are enabled to maintain contact with the community and their relatives. Residents’ meals are wholesome varied and balanced and choice is maintained. EVIDENCE: Residents’ wishes in relation to contact with family and friends are recorded in their plans of care. There are no restrictions on visiting unless imposed by the residents themselves. Bedrooms are used for receiving visitors or if preferred the lounges and dining room are available. Activities within the local community are accessed upon request and the residents meet with residents from Amberdene’s sister home to undertake joint ventures and functions. Residents spoken to were satisfied with the meals provided comments included “the food is just like home cooking nothing fancy which suits me”. One resident assists to cook his own meal due to being from the Caribbean and liking spicy foods. At least three full meals a day are offered, one is always a hot cooked meal, and snacks are also available. Any religious or cultural diets would be and are catered for, as are medical diets. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 12 Menus are produced after consultation with residents and take into consideration their likes and dislikes; menus are displayed, or explained to residents these are changed according to requests or the seasons. Mealtimes are set, but in reality become flexible due to residents individual needs. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Residents’ views are listened to recorded and acted upon. The protection of residents would be enhanced by improvements to the homes recruitment procedures. EVIDENCE: Those resident spoken with knew who to complain to and were confident that complaint are taken seriously. The home has the Hull and East Riding Vulnerable Adults Procedure and procedures in place, which includes a whistle blowing policy. The Manager and the Deputy Manager have completed POVA training, which accompanies the Hull and East Riding procedure, and have cascaded this information to the rest of the staff. Staff sign to acknowledge their understanding of the procedure. Records would be maintained of any allegations made by residents or other stakeholders. The home has currently had experience of a vulnerable adults referral and in dealing with this they followed all the right procedures to protect the residents. The home recruitment procedures do not currently protect residents from abuse. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 14 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 standard(s) 26 Resident live in a home which is kept clean hygienic and free from offensive odours. Systems are in place for the control of infection. EVIDENCE: The home is clean and tidy all areas both communal and private are well maintained and welcoming. There is an infection control policy in place to protect the residents from the risk of cross infection. Staff were seen to be using protective clothing again to eliminate the risk of cross infection for the residents. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 The residents are not protected by the homes recruitment policy and practise. EVIDENCE: There is a recruitment and selection policy in place and a procedure in operation, which includes the taking of two written references and a Criminal Records Bureau (CRB) check. Staff are given contracts of employment and statements of terms and conditions. Equal opportunities are followed. Staff work in line with codes of conduct adapted from the codes of conduct and practice published by the General Social Care Council. Those files inspected however indicated that some staff had been employed prior to the completion of satisfactory CRB check being obtained. This does put the residents at risk. Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x x x x x x x Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 18 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 29 Regulation 18 & 19 Requirement the registered person must ensure that no staff member comences employment proir to a satisfactory CRB check being obtained. Timescale for action from the time of the next recruitmen t. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Amberdene Lodge J54_s832_Amberdene Lodge_v228728_210605_Stage 4.doc Version 1.30 Page 20 - 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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