CARE HOMES FOR OLDER PEOPLE
Amberley House 171-175 Ridgeway Plympton Plymouth PL7 2HY Lead Inspector
Jane Gurnell Unannounced 29 September 2005 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 V241947 290905 Stage 4.doc Version 1.40 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 39 Category(ies) of Mental Disorder - over 65 years (37), Old age, registration, with number not falling within any other category (37), of places Dementia - over 65 years of age (37), Physical Disability - over 65 years of age (32) Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14.04.05 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 39 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 39 single rooms with the majority being greater that 12sq.m. and with en suite facilities. The Home has 4 lounge rooms 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 respite facilities . The home has a garden and parking. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on 29th September 2005 in response to an anonymous complaint received by the Commission regarding the effect the building work was having on the care of the residents. Therefore the focus of the inspection was to consult with residents and care staff to identify if there were any issues of concern. Mrs Webb, the owner was present and she and her staff team assisted the inspector throughout the inspection. The inspector spoke to 25 residents, one visitor, 4 care staff and one domestic staff and made a tour of the building. The inspector found no evidence that the care of the residents was being unduly affected and the complaint was not upheld. What the service does well: What has improved since the last inspection? What they could do better:
Those residents consulted by the inspector said that their care had not been affected in any way by the on going building work and they had no concerns. Care staff said that they felt well supported by the owners. Therefore the inspector found no evidence to uphold the complaint. No requirements for improvement have been made at this inspection. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 Page 6 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. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 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 V241947 290905 Stage 4.doc Version 1.40 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, 5 Thorough and comprehensive systems for admission allow service users and their relatives to be confident that their needs can be met. EVIDENCE: A newly admitted resident described how she had been able to visit Amberley House on 3 occasions before making a decision to move in. She had been invited to spend as long as she wished at these visits and to share a meal with the other residents. She confirmed that Mrs Webb, the owner, had undertaken an assessment and had asked her about her care needs before she had been admitted. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 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, 10 Residents’ health, personal and social care needs are being met and residents are treated respectfully. EVIDENCE: Residents said they could not be treated better and described living in the home as like “living in a hotel”, saying nothing was too much trouble for the staff. Care plans detailed residents’ care needs: these plans were reviewed regularly. The District Nurse, Community Mental Health Nurse and the Continence Advisor provided specialist advice and support. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 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) 15 Meals are nutritious, plentiful and varied. EVIDENCE: Residents described the meals as very good with a wide variety of choice. The lunchtime meals presented at the time of the inspection were well-balanced, well presented and plentiful. Residents said that the building work had not disrupted the quality of the meals and that drinks and snacks were available at all times. Those resident who said they rose early in the mornings described having plenty of drinks as the care staff provided additional drinks for them and they could have hot and cold drinks upon request. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 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 Complaints and suggestions from residents, relatives or other visitors to the home are treated seriously. Residents are listened to and issues resolved promptly. EVIDENCE: Twenty-five residents were spoken to by the inspector and were specifically asked about whether they felt confident in raising concerns over their care, the accommodation or services. Residents said that the owners were very approachable and they were confident that any issues of concern would be listened to and dealt with. None of the residents had any complaints regarding the effects of the building work. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 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, 24, 25, 26 The residents live in a pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: The home was found to be clean and residents said that it is always clean despite the building work. A large extension and internal alterations are 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 first floor. Residents said that on 2 or 3 occasions the hot water to a small number of bedrooms had been disrupted but this had not caused any difficulties as the staff had provided hot water for them. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 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 Residents are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. EVIDENCE: Residents described the staff as very kind and caring and confirmed they responded promptly to requests for assistance. Five members of staff were interviewed individually by the inspector: all said they were confident that they could discuss any concerns with the owners Mr and Mrs Webb and that they felt very well supported. Care staff said that there were sufficient staff to meet the needs of those currently living in the home. Care staff are supported by catering, laundry and domestic staff. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 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, 38 Residents live in a well managed home. The owners and their staff team strive to provide a stimulating, safe environment that respects and protects residents’ rights. EVIDENCE: Residents said that they feel safe and secure in their home and that the home was well managed. The owners, Mr and Mrs Webb, are available each day during the week and meet with residents and staff on a daily basis. A tour of the building showed the home to be well maintained and the health and safety of the residents and staff is being safeguarded whilst the building work is being undertaken. Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 Page 15 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 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x x x x 3 Amberley House D52-D04 S41242 Amberley House V241947 290905 Stage 4.doc Version 1.40 Page 16 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 V241947 290905 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon, TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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