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Inspection on 14/04/05 for Amberley House Plympton

Also see our care home review for Amberley House Plympton for more information

This inspection was carried out on 14th April 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 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 home has a well-trained and motivated staff team who the service users described as being very kind and caring. Members of the Residents` Committee described their relationship with the owners as being very good and that the home was "excellent". Staff work closely with other health care professionals. Service users described how much they enjoyed the daily activities and that they found the food very good with varied, well-balanced meals that were well presented.

What has improved since the last inspection?

The extension to the building and internal alterations will provide improvements to the home and day care centre and increase the number of respite beds available. An assessment of the building has been undertaken by an occupational therapist to ensure the facilities are suitable to meet the needs of service users with mobility difficulties and memory loss.

What the care home could do better:

The requirements and recommendation identified at the last inspection have been addressed and no further requirements have been identified on this occasion.

CARE HOMES FOR OLDER PEOPLE Amberley House 171 - 175 Ridgeway Plympton Plymouth PL7 2HY Lead Inspector Jane Gurnell Announced 14/04/05 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. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Amberley House Address 171 - 175 Ridgeway, Plympton, Plymouth, Devon, PL7 2HY 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) 01752 336960 01752 336960 amberleyhouse@plympton51.FSNET.co.uk A & L Care Homes Ltd Mrs Lisa Jane Webb Care Home 37 Category(ies) of Dementia - over 65 years of age (37), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (37), Old age, not falling within any other category (37), Physical disability over 65 years of age (32) Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2004 Brief Description of the Service: Amberley House is an established family run business, owned by A & L Care Homes Ltd, which comprises a limited company with Mr and Mrs Webb as Directors who manage the home on a day-to-day basis. The Home is situated close to Plympton Ridgeway shopping area and other local amenities and transport links. The Home is registered to provide accommodation with personal care for up to 37 people over the age of 65 of both sexes and for reason of old age, dementia, mental disorder and physical disability. The Home also offers limited respite care. Accommodation is provided over 3 floors and consists of 37 single rooms with the majority being greater that 12sq.m. and with en suite facilities. The Home has 4 lounges and 3 dining rooms. A shaft lift provides access to the first and second floors. A day centre is attached to the Home, having its own facilities and being run separately. An extension to the building is in progess to provide improvements to the main building and new day care and respsite facilities . The home has a garden and parking. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over 6 hours. The focus of the inspection was to consult with service users and review the home’s care planning processes and related documentation. Mr and Mrs Webb, the owners were present and they and their staff team assisted the inspector throughout the inspection. The inspector spoke to 33 service users as well as 3 visitors, toured the building and examined care records and other documents. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 6 The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 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 Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 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) 1, 2, 3, 4, and 5 Thorough and comprehensive systems for admission allow service users and their relatives to be confident that their needs can be met. EVIDENCE: A statement of Purpose and Service User Guide were available for prospective service users and provided a clear description of the services offered. Assessments were undertaken to identify service users’ needs prior to admission and letters to prospective service users confirmed that these needs could be met. The community psychiatric nurses provide specialist advise to the care staff for those service users with more severe memory loss. Service users said that they had been able to visit the home before making a decision to move in: many of the service users were familiar with the home as they had used the day centre and respite services. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 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, 8, 9, 10 and 11 Service users health, personal and social care needs are being met and service users are treated respectfully. The home’s practices relating to medication administration protect the service users from risk. EVIDENCE: Service users said they could not be treated better and described living in the home as like living in a hotel – nothing was too much trouble for the staff. Care plans detailed service users’ care needs: these plans were reviewed regularly and, where able, the service users had signed their plans. The District Nurse, Community Psychiatric Nurse and the Continence Advisor provided specialist advice. Service users with terminal illnesses could remain in the care home as long as their needs could continue to be met. Medication administration records, including the controlled drug register, were well maintained and medication was stored safely. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 10 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) 12, 13, 14 and 15 Social activities are managed well and provide daily interest for the service users. Meals are nutritious and varied. EVIDENCE: The service users described that activities are provided daily and that they can also attend the activities and trips organised by the day centre. A programme of monthly activities is provided for each service user. Service users said that the food was “excellent” and plentiful. Three dining rooms ensure that service users can take their meals in a pleasant and homely environment rather than a room large enough to accommodate 35 residents. Specialist diets were provided for. Three visitors said that they were very pleased with the care and support their relative received: they said that the home was friendly and they were always made welcome. A Residents’ Committee meets regularly with, Mr and Mrs Webb, the owners to consult on the running of the home and the needs of the service users. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 11 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) 16, 17 and 18 Complaints and suggestions from service users, relatives or other visitors to the home, are treated seriously. Service users are listened to and issues resolved promptly. EVIDENCE: Service users said that the owners were very approachable and they were confident that any issues of concern would be listened to and dealt with. The home has received no complaints since the last inspection. The complaint identified in the last inspection report as yet to be resolved proved to be unsubstantiated. A copy of the complaints procedure is available to all service users and visitors to the home and detailed in the home’s Statement of Purpose and Service User Guide. Staff have received training in issues relating to abuse and the protection of vulnerable adults and described the actions they would take should an issue of abuse be suspected. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 12 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) 19, 20, 21, 22, 23, 14, 15, and 26 The service users live in a pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: All communal rooms and bedrooms were pleasantly decorated and furnished and service users said that it is always very clean. A large extension and internal alterations were being undertaken to provide general improvements to the home, including a new laundry room and an extension to the kitchen, as well as to the day care and respite facilities. The number of rooms with en suite facilities will increase to 34, seven of these rooms have en suite baths, and a new bathroom with an assisted bath will be provided on the fist floor. A maintenance and refurbishment plan and a financial plan were available to identify the programme of work and investment. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 13 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) 27, 28, 29 and 30 Service users are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment processes protect vulnerable service users. EVIDENCE: Service users described the staff as very kind and caring and confirmed they responded promptly to requests for assistance. Care staff are supported by catering, laundry and domestic staff. A training programme detailed the ongoing training undertaken by staff ensuring that they have the skills to care for older people and those with dementia. A consultant social worker provides dementia care training. Staff files contained application forms, written references, Criminal Record Bureau disclosures, and photographic identification. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 14 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) 31, 32, 33, 34, 35, 36, 37 and 38 Service users live in a well managed home. The owners and their staff team strive to provide a stimulating, safe environment that respects and protects service users’ rights. EVIDENCE: Service users said that they feel safe and secure in their home and that the home was well managed. Mr and Mrs Webb are available each day during the week and meet with service users and staff on a daily basis. Meetings with the Residents’ Committee are arranged twice a year and minutes are recorded. A written survey has been sent to each service user to be completed by them or, if they are unable, their relatives, seeking their views about the home and the services it provides: some of these had been returned and praised the staff team and their care. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 15 The consultant social worker provides monthly supervision for the three matrons and Mrs Webb supervises the remainder of the staff team, although 2 matrons will be assisting now that they have received appropriate training. Records of staff performance monitoring were available to ensure that work performance meets the standards set by the owners and the needs of the service users. Written policies and environmental risk assessments addressed health and safety matters. The fire log detailed equipment testing and staff training. Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 4 3 3 4 3 3 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 Standard No 16 17 18 Score 3 3 3 3 4 3 3 3 3 3 3 Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 17 no 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 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. Refer to Standard Good Practice Recommendations Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 18 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Amberley House D52-D04 S41242 Amberley House V211041 140405 Stage 4.doc Version 1.20 Page 19 - 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!