Inspection on 09/03/09 for Amberley House

This inspection was carried out on 9th March 2009.

CSCI found this care home to be providing an Good service.

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

Amberley House 17/04/08

Amberley House 01/10/07

Amberley House 17/07/06

Amberley House 28/11/05

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Amberley House 44-48 Amberley Road London N13 4BJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diaman Balraj     Date: 0 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Amberley House 44-48 Amberley Road London N13 4BJ 02088860611 02088861436 dhunnoo@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Waterfall House Residential Home care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Amberley House is a privately owned care home for older people who are over the age of sixty five. The home is registered to accommodate sixteen older people, who may also have a diagnosis of dementia. There are fourteen single bedrooms and one shared room. There is a shaft lift and a chair lift. The dining room and lounge are situated on the ground floor overlooking an attractive garden. The home is situated in Palmers Green, with good bus and train links. All the amenities of Palmers Green are within a short distance, including restaurants, shops, churches and Broomfield Park. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. The registered manager reported that the current scales of charges are from: - #500 to #550 per week. Additional charges are made for hairdressing, chiropody, private Care Homes for Older People Page 4 of 25 Over 65 0 16 16 0 Brief description of the care home telephone and newspapers. At the time of this inspection there were 16 people living at Amberley House. Currently there are 14 women and 2 men in residence. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection, which took place over 7 hours. The inspection was undertaken by Dia Balraj, lead inspector. The registered manager was on long term sick leave on the day of the visit. The responsible individual, Mr Haresh Dhunnoo and the Deputy Manager were available throughout the visit to aid the inspection process. Discussions took place with the the owner, deputy manager, care staff and domestic staff. We spoke to 5 residents and a GP and where possible residents were asked to give their views on the service and their experience of living in the home. Care staff were asked about the care that residents receive and were also observed carrying out their duties. A tour of the premises, including laundry and kitchen was undertaken. The files of 3 residents were checked. Three care staff files as well as home records were examined. These included medication administration, staff training and recruitment procedures Care Homes for Older People Page 6 of 25 and files, maintenance rerecords and complaints. Information was also taken from an Annual Quality Assurance Assessment(AQAA); which was completed and returned to us prior to the inspection. Surveys were sent out prior to the inspection for completion by staff and residents. We would like to thank the residents and staff for their input during the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive pre-admission assessments are undertaken for all residents. This enables staff to have detailed information to enable them to determine whether or not the home can meet a prospective residents needs. Evidence: In order to assess the standards we examined the assessments carried out on two residents including the most recent admission. From the evidence seen we are satisfied that the home undertakes a comprehensive pre-admission assessment from which a care plan is developed. Information is obtained from the resident where possible, family members where appropriate, and health and social care professionals. A resident told us that she came to visit the home with her family and staff made them feel very welcome and answered all their questions. The home does not provide intermediate care. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are set out in an individual plan of care and they are treated with respect and dignity by staff. Residents are protected by procedures for dealing with medicine . The health records of residents demonstrate that health checks are carried out and recorded, thereby ensuring that residents health needs are met. Evidence: The files of three residents were reviewed. There was evidence of assessments, care plans, reviews of care plans , daily records and health records. Care plans were reviewed on a monthly basis. All residents have 2 key workers. The key workers complete a progress sheet on the care provided to residents. Monthly reviews are currently undertaken by the Deputy manager. Care staff are being trained to do monthly reviews. Health records are comprehensive and there was evidence of medical, optical and dental checks being carried out and recorded. There was evidence of residents specific religious needs being identified. A nun from the local church and the vicar visit residents on a regular basis. The interaction between staff and residents was observed. it was noted that staff Care Homes for Older People Page 11 of 25 Evidence: assisted people with eating, going to the toilet, etc in a discreet and respectful way. I asked four residents for their opinions. They stated staff are kind and helpful. One resident stated It is all right here we are looked after very well. Personal care is usually given by a member of staff of the same gender and meet residents choice. I looked at the medication stored in the home and a sample of one weeks medication and the medication charts of three residents. Medication records were in order. There were no controlled drugs in the home at this inspection. Staff who give medication have been trained to do so. None of the residents manage their own medication. Observations and discussions with staff and residents showed that the privacy and dignity of residents was respected. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are treated with respect and are part of their local community. The care home provides activities and supports people to pursue their interests. The home provides a balanced and varied diet. Evidence: The evidence was obtained by interviewing the deputy manager, the responsible individual, four residents, two care staff and observation. The activity records and the menu were also examined. We also observed residents in the lounge and dining room. Following a requirement from the last inspection there is now a varied activity programme to suit residents preferences. Residents stated that they enjoyed individual shopping trips with members of staff as they liked going to the town centre. Reminiscence sessions and games such as recall and recollect are organised. The owner stated that casino games are organised on a two monthly basis. On the day of inspection some residents were doing puzzles with staffs help. Other activities include ball games, skittles and sing along. A trip to Broxbourne Park has been planned for the 8th July 2009. Some residents are happy to continue with their interests of reading, television and listening to music. Books are provided in the home by the local library and this was observed on the day of inspection. Care Homes for Older People Page 13 of 25 Evidence: The owner said that approximately 50 of residents have regular contact with their families. I observed a resident receiving a visitor. Residents spoken to stated that they enjoyed receiving visitors and staff were welcoming to their visitors. Residents can choose to manage their own money but in practice this is carried out by relatives or their placing authority. They are encouraged to bring in their own personal items to the home and an inspection of a sample of bedrooms showed that people had done so. There was evidence from examining menus that there was a choice of two main courses. On the day of this inspection it was observed that residents had chosen what they wanted to have for lunch. There was a good selection of vegetables and fresh fruits were offered. It was noted that although fruit was available none of the residents had requested any fruit. It is recommended that fruit be cut in small portions or a fruit salad be offered to residents to ensure that they take advantage of the fruits on offer. Four residents interviewed stated that the food was good and one resident stated that if she did not like what was offered she was given an alternative of her choice. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisation ensures that problems and concerns are acted upon. Residents and their relatives can be confident that their complaints and concerns will be listened to and acted upon. The majority of staff working at the home have received training in safeguarding vulnerable adults to ensure that there is a proper response to any suspicion or allegation of abuse. Evidence: The homes complaints procedure is displayed in the entrance hall so that it is visible to residents of the home and their visitors. The complaints procedure is also included in the Service user Guide. Examination of the complaints Book showed that there had been no complaints in the last 6 months, since the last inspection. We noted that in the record of a residents meeting in November 2007, that the procedure for making a complaint was explained to residents. The outcome of complaints was recorded in the Complaints Book. There have been no safeguarding alerts since the last inspection, which means there have been no allegations of abuse. 7 staff members have undergone training in Abuse. There was evidence that staff were reminded during hand overs and staff meetings to report any incident of abuse. Residents interviewed stated that they were generally satisfied with the service provided. One resident stated that the responsible individual is available on a regular basis and is very attentive to their needs. All five residents interviewed knew how to Care Homes for Older People Page 15 of 25 Evidence: make a complaint. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, safe and well maintained. The residents say they are happy with the facilities. Evidence: In order to assess these standards we looked at all communal rooms and areas and five individual bedrooms. The home was clean and tidy throughout and maintained to a satisfactory standard. Bedrooms are kept safe and tidy by staff and there was evidence that people have been encouraged to bring in items of furniture to make the room more homely. In one of the bedrooms visited we recommend that the bed and two arm chairs be varnished. The seat to the bath in the first floor bathroom was chipped and it is recommended that this be replaced and the toilet sink stain be removed. The lounge has enough space for the number of residents and one resident sits in the entrance hall by choice. Some residents prefer to stay in their own room for greater privacy and this is also respected. The dining room does not comfortably sit all the residents but one or two people sit in the lounge where there is a small table. This was used for a resident who needed help with feeding and was a more relaxed and private environment for them. There is an attractive well maintained garden. Residents said they were happy with the environment. There are two staircases. Residents of the first floor use a shaft lift which meets their needs. There is a chair lift on one staircase. This is used only if the shaft lift is not in order. Regular 6 monthly checks of both the chair lift and the shaft lift are carried out to ensure the safety of Care Homes for Older People Page 17 of 25 Evidence: service users. The home has a few visual aids to assist the needs of service users. These include clocks with large characters, a board showing the Day, Date, month and year displayed in the lounge. The menu was also displayed in the lounge. It is recommended that facilities including signs are provided to assist the needs of all service users, taking account of the needs, for example, of those with hearing impairment, visual impairment or dementia or other cognitive impairment. Three residents were asked for their views on the home and all said they were happy with the facilities and had no suggestions for improvement. Two residents mentioned that they liked to look out at the garden. Garden furniture was provided and the responsible individual stated that residents sit out in the garden in Summer. A resident said that she had enjoyed having a picnic in the garden and looked forward to enjoying the same this year. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. Residents benefit from a staff team who have the skills and training to meet their needs. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. Evidence: Staff were observed to interact and communicate well with residents. Current staffing levels are three carers, manager, domestic staff and the cook in the morning and three carers in the evening. There is one staff awake at night and another asleep on call within the home. Examination of the rota for the week of the inspection reflected the above staffing level. There are 7 full time care staff and 8 part time care staff. The rota showed that there were sufficient care staff on duty to meet the gender needs of residents. Three residents interviewed stated that there were enough staff on duty. The training records for three care staff were inspected. Staff had attended training in the mandatory topics of first Aid, fire safety, food hygiene, health and safety, administration of medication, dementia and NVQ 2. 10 staff members have followed the Mental Capacity Act Training 2005. Care Homes for Older People Page 19 of 25 Evidence: The three staff files examined showed that the organisation has a thorough recruitment procedure with adequate checks to ensure the protection of service users. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The deputy manager demonstrated sound managerial abilities and residents benefit as the home is run in their best interests. The responsible individual visits daily and takes an active part in the running of the home. he liaises with the Deputy manager to ensure a good quality service for residents. Evidence: The responsible individual was present when the inspector arrived and available during the inspection process. The registered manager was on long term sick leave and the Deputy, Mr Ashok Bhagbut was the acting Care Manager. Mr Bhagut provided much of the information for this inspection. He possesses NVQ level 2 and has enrolled on the leadership in Management & Care Services, due to start on 17th March 2009. He has followed training in the mandatory topics of First Aid, Fire Safety, food Hygiene, Health and Safety, administration of medication, dementia and the Mental Capacity Act 2005. Mr Bhagut started employment at the home as a care worker on the 28th September Care Homes for Older People Page 21 of 25 Evidence: 2005 and was appointed deputy manager on 1.6.07. Mr Dhunnoo stated that the Registered manager had decided to retire and would not be returning to work. Mr Dhunnoo stated that he was in the process of applying for the registration of a new care manager. The home has an annual development plan. Quality assurance surveys are sent out and there was evidence of responses from residents and their representatives. The general outcome of surveys was that people were satisfied with the service provided. A change that was implemented as a result of feedback from surveys relates to the introduction of individual shopping trips. This was appreciated by residents in their comments to us. Interviews with residents showed that they had confidence in management. One resident stated: The owner is very attentive to my needs and will always oblige if I ask for something. I can now enjoy meals in my bedroom. The owner reported that none of the residents manage their own money and that the home manages none either. He reported that all residents have their finances managed by relatives or care managers and that he receives no cash at all in respect of any resident. The owner said that personal allowance is paid separately to relatives in all cases who use it to buy what the resident requests. A sample of health and safety records were inspected. The owner has employer liability insurance for the home which is covered until August 2009. The fire book showed that fire drills are carried out every 2 months. The last recorded fire drill was on the 9.3.09. Fire alarm tests had been carried out and recorded. The responsible individual comes to the home on a daily basis. He discusses with the Deputy any matter that needs addressing. He supervises the Deputy every 3 months and the last recorded supervision was on the 20.1.09. It is recommended that supervision is given every 2 months in order to promote best practice. The three care staff files inspected showed that supervision was given on a 2 monthly basis and this was recorded. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 15 It is recommended that fruit be cut in small portions or a fruit salad be offered to residents to ensure that they take advantage of the fruits on offer. It is recommended that all staff follow training in safeguarding vulnerable adults to maximise the safety of residents. It is recommended that the seat to the bath in the first floor bathroom be replaced and the toilet sink stain be removed. It is recommended that facilities including signs are provided to assist the needs of all service users, taking account of the needs, for example, of those with hearing impairment, visual impairment or dementia or other cognitive impairment. It is recommended that supervision is given every two months in order to promote the best outcomes for residents. 2 18 3 19 4 22 5 31 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!