Inspection on 17/04/07 for Amberleigh House

This inspection was carried out on 17th April 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 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

Amberleigh House 06/06/06

Amberleigh House 29/11/05

Amberleigh House 31/05/05

Amberleigh House 06/01/05

Amberleigh House 05/07/04

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

CARE HOMES FOR OLDER PEOPLE Amberleigh House Longmoor Lane Liverpool Merseyside L9 7AL Lead Inspector Jeanette Fielding Unannounced Inspection 17th April 2007 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 Amberleigh House DS0000025198.V332060.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 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. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amberleigh House Address Longmoor Lane Liverpool Merseyside L9 7AL 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) 0151 525 8047 www.c-i-c.co.uk. Community Integrated Care vacant post Care Home 38 Category(ies) of Dementia - over 65 years of age (38) registration, with number of places Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 38 Personal Care and 19 Nursing Care within the total number of 38. To accommodate one named service user under 65 years old Date of last inspection 6th June 2006 Brief Description of the Service: Amberleigh House is registered to provide nursing and personal care for up to thirty-eight elderly persons who have dementia. The home was formerly called Longmoor Lodge. It is located within the grounds of Fazakerly Hospital, on the corner of Longmoor Lane and Lower Lane. All service users are provided with a single bedroom with en-suite facilities. Recent work has been undertaken within the home to provide full access to all areas, redecoration and refurbishment. A number of communal areas are provided to enable service users to choose which area they spend their day. Service users are free to use their bedroom or any of the communal areas as they wish. All décor is good. Bedrooms are appropriately furnished and decorated and the staff strive to provide a homely environment. The fees charged by the home are in line with those paid by the Local Authority. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of six hours and was completed in one day. The care files relating to the service users were inspected. The format of these files has continued to improve due to the changes in the documentation format. Staff are recruited in accordance with the owners robust policy and procedure. Training is given to staff on a regular basis and the recent recruitment campaign has proved successful. A new manager has been appointed to provide greater stability within the home. Tests on the fire detection equipment are now made in accordance with the advice of Merseyside Fire Authority. Service users are provided with a good quality environment and have a high number of activities to provide them with stimulation and entertainments. What the service does well: What has improved since the last inspection? What they could do better: Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 6 Some damage has occurred to specialist chairs and the staff should take care when moving these. The advice of the Fire Prevention Officer should be sought with regard to the suitability of the repairs to these chairs. 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. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed pre admission assessments are undertaken on prospective service user to ensure their care needs are identified to enable staff to meet their needs. EVIDENCE: All prospective service users are fully assessed prior to their admission to the home. The assessment is undertaken by one of the qualified nurses, for those service users to be accommodated for nursing care, or by a team leader when personal care is required. The care files of service users recently admitted to the home were inspected and the assessments were found to be detailed and informative. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 9 Information is gathered regarding the service users nursing, care and social needs together with information regarding their dementia and how this is displayed. Information is generally gathered from family members and other health care professionals as the service users cannot usually contribute. The service users are encouraged to participate in the assessment, however, the problems that they have with their memory has the potential for some information not being provided. Details are recorded of the persons involved with the assessment and the contribution made by them. Details are recorded about individual preferences, usually from the family, to ensure that these preferences can be provided by the home. Bedtime and rising preferences are recorded together with favourite foods and dislikes. Sufficient information is recorded to enable a plan of care to be prepared in readiness for their admission to the home. The home does not offer intermediate care. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care files contain sufficient information to enable the staff team to provide the appropriate level of care to each individual service user and therefore meet their needs. EVIDENCE: Individual care files are prepared for each service user. These include the service users history together with information on how their assessed needs are to be met. New documentation is now in use on all service users files and are greatly improved from previous inspections. The files contain full information to enable the staff to meet their individual needs. Risk assessments are in place and risk management plans are in place to reduce or remove those risks and therefore protect the service users. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 11 Care plans were inspected for service users new to the service together with those for service users who have been accommodated for some time. Reviews are made on a monthly basis and whenever the service users’ needs change to ensure that their individual care needs are identified and met. Assessments are made on an individual basis to identify nutritional, personal care and other specific needs and an appropriate plan set in place to meet these needs. Care staff are provided with a daily worksheet to give them information about the tasks that they are to undertake for the day with individual service users. Daily handover sheets are prepared to give information to the staff on the following shift to maintain continuity of care. Records are held of visits made to and by doctors and other healthcare professionals. The advice of other healthcare professionals is sought whenever necessary and this is evidenced on the care files. Daily records completed by the staff are detailed and informative and provide evidence of the actual care given. None of the service users are able to administer their own medications. The home has a detailed policy and procedure for the administration of medications and only the nurses and identified carers are permitted to administer these. The management of medications has improved since the last inspection. All records were found to be accurate and up to date. The medications room has had improvements made and was found to be clean and organised. Appropriate arrangements are in place for the disposal of unwanted medications. The views of the service users could not be obtained due to their cognitive impairment and so a number of relatives were spoken to. One relative stated that he was completely satisfied with the care given to his relative. He stated that the staff were extremely caring and did everything they could to provide his relative with a comfortable place to live. Another relative commented that the changes in manager over the last couple of years had given cause for concern but said that the nurses could be approached if there were any issues that needed to be raised. All service users are accommodated in single bedrooms, each with en-suite facilities. Personal care is give in service users bedrooms or in the bathrooms as appropriate to protect their privacy and dignity. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A high number of activities and social events take place within the home to provide service users with stimulation and social interaction. EVIDENCE: An activities co-ordinator is employed on a full time basis and provides a full programme of activities and stimulation. Activities include games, reminiscence, foot spa, massage, gardening, nail care, music videos, and relaxation therapy. Ecumenical church services are held monthly. Comprehensive records are held regarding each service users involvement with the activities which includes their willingness to participate, their interaction with others and their enjoyment of the activity. From these records, it is possible to identify the particular activity that each service user enjoys. Visitors are welcome at the home at any time and can meet with the service user in their bedroom or in one of the communal areas. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 13 Many of the service users are unable to express their individual preferences regarding food, social or daily living expectations. The home seeks this information from family members and other visitors to enable the staff to meet the preferences that the service users would have expressed. The home provides two dining rooms and service users are encouraged to take their meals in a communal environment to help promote social interaction. Meals can be taken in their own bedroom if they prefer or if they are unwell. Staff assist service users to take their meals wherever necessary. The menus have recently been reviewed and offer a good variety of nutritious foods. Special diets are available on request or on the advice of the GP or dietician. No specific diets have requested by service users i.e. vegetarian or ethnic but the cook stated that this would not present a problem if they were requested. The meals served on the day of the inspection smelled appetising and were attractively served. Service users were observed, discretely, to be enjoying their meal and staff were seen to be assisting service users appropriately. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of adult protection issues to protect service users from harm or abuse. EVIDENCE: The home has a comprehensive complaints procedure which is detailed in the statement of purpose and is also displayed on notice boards within the home. Complaints received by the home have been dealt with in line with the procedure and within the designated timescale. Training is given to staff on the various types of abuse and of the action to be taken in the event of it being suspected. Information is held in the home on the action to be taken in accordance with Liverpool City Council Adult Protection Unit. Staff spoken to were able to demonstrate their knowledge of adult protection issues and said that if they suspected abuse, they would report it to the person in charge of the home. Records relating to complaints were found to be well maintained and up to date. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home strives to provide a warm and homely environment to give the service users a pleasant place in which to live. EVIDENCE: Amberleigh House is single storey, purpose built home, where service users are all provided with a single bedroom with en-suite facilities. The décor throughout the home is good, with bedrooms being personalised by staff and relatives to reflect individual tastes and lifestyles. The home provides a number of small lounges, together with a main lounge which also has a conservatory. This provides service users with the Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 16 opportunity to spend time alone or with their visitors in private or with other service users as they wish. The home provides a central courtyard with seating and a gazebo to protect service users from the sun. This is a safe area for service users to sit and can be accessed from various points within the home. Some of the specialist chairs used by service users have become damaged and have been repaired with tape. The advice of the Fire Prevention Officer should be sought to verify whether this form of repair provides sufficient fire retardant protection to the infill of the chairs. The protective lap strap on one of these chairs has been reported as faulty and the records show that a temporary repair had been made. The manager stated that this had now been appropriately repaired, however, there were no records held in the home to provide evidence of this. Three new profiling beds have been purchased for designated service users to protect them from the risk of pressure sores. These beds have integral bed rails to prevent accidents and can be raised or lowered as necessary to assist both the service users and the staff. The hot water at the washbasin in the toilet by the main lounge was found to be excessively hot. Appropriate action is to be taken to ensure that service users are protected from risk of scalding. Records are held of the tests made on the temperature of hot water outlets and of action taken to adjust the thermostats as necessary. All areas throughout the home were found to be clean and no offensive odours were noted. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs a well-trained staff team that work positively with service users to improve their quality of life and to ensure their protection. EVIDENCE: The home employs Registered Mental Nurses and Registered General Nurses together with care assistants to provide care for the service users. A programme of recruitment has been effective and the home employs sufficient staff to meet the needs of the service users. Agency staff are employed to cover sickness, annual leave and vacancies, however, due to the employment of additional staff, the number of agency staff used by the home has significantly reduced. The sickness record has been improved through a programme of support. All prospective staff are recruited under the CIC recruitment procedure. This involves the completion of an application form prior to being selected for interview. Two references are taken together with checks on the Criminal Record Bureau and Protection of Vulnerable Adults registers. All new staff follow a five day induction training programme. One of the days is spent in the home and four days undertaking training in health and safety, moving and Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 18 handling, basic food hygiene and first aid. An employee handbook is issued which clearly lists all the training topics and these must be signed to indicate that they have been completed during the following few months. A high number of training courses have been made available to staff with appropriate training in relation to nurse practice. Records are held in the home of all training undertaken by the staff and forthcoming courses were clearly displayed on the staff notice boards. Additional training is provided where this is identified as necessary to meet service users specific care needs. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive records are held to provide evidence that staff and service users are protected. EVIDENCE: A new manager has recently been appointed to the home and the application forms to register the manager are being completed in preparation for submission to CSCI. The new manager is a qualified nurse with considerable management experience. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 20 Responses have been made to a questionnaire sent out to relatives by the owners of the home, CIC. The findings will be made available for viewing in the foyer of the home when they have been evaluated. It is evident from the care records, and from observation, that the home is run in the best interests of the service users. Interaction between staff and service users was more positive with choices being offered and individual preferences being met. Comprehensive records are held of all monies held on behalf of service users and receipts are held for all purchases made. None of the service users have the ability to attend to their own finances. The owners of the home act on behalf of five service users in relation to their finances and all other service user have their financed dealt with by relatives or advocates. All safety checks have been made and records are held of tests made on the fire detection equipment. Regular fire drills are now undertaken together with training for the staff team. Certificates of safety are held when tests are made on equipment by outside agencies or companies and all were found to be in date. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP31 OP19 Good Practice Recommendations The completed application form to register the manager should be submitted to CSCI for processing. The advice of the Fire Prevention Officer should be sought to ensure the suitability of the repairs to the specialist chairs. Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Amberleigh House DS0000025198.V332060.R01.S.doc Version 5.2 Page 24 - 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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