Inspection on 31/05/07 for Amberley House Plympton

This inspection was carried out on 31st May 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

Amberley House Plympton 29/09/05

Amberley House Plympton 14/04/05

Amberley House Plympton 16/11/04

Amberley House Plympton 06/05/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Amberley House 171 - 175 Ridgeway Plympton Plymouth Devon PL7 2HY Lead Inspector Jane Gurnell Unannounced Inspection 31st May 2007 09:30 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 Amberley House DS0000041242.V320472.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. Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amberley House Address 171 - 175 Ridgeway Plympton Plymouth Devon PL7 2HY 01752 336960 01752 343118 andyhwebb@aol.com 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) A & L Care Homes Ltd Mrs Lisa Jane Webb Care Home 39 Category(ies) of Dementia - over 65 years of age (39), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (39), Old age, not falling within any other category (39), Physical disability over 65 years of age (39) Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2005 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 respite care for up to 3 people at anyone time. 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. The home has a very pleasant landscaped garden and a parking area. The current weekly fees range from £278.40 to £375. Items not included in the weekly fee are chiropody treatment, hairdressing, newspapers and magazines and personal toiletries. Information regarding the services provided at Amberley House can be obtained directly from the home. Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and undertaken between 9.30am and 3.30pm on 31st May 2007. Mr and Mrs Webb, the owners, were present throughout the inspection. Prior to the inspection, the Commission had sent surveys to a selection of relatives and staff to enable them to comment directly to the Commission about their experiences of the home: all those returned praised the home, the owners and the staff and confirmed that Amberley House continues to provide an excellent service to the people who live there. A GP who was visiting at the time of the inspection confirmed that the health care of those living at Amberley House was met by competent staff and that she had every confidence in the staff and the owners. The inspector made a tour of the building, spoke to the staff on duty and two visiting relatives and examined the records relating to the care of those living in the home, medication practices and the running of the home. Significant time was spent with the people who live at the home and observations were made of how people spend their day and their relationship with the care staff. What the service does well: People living in the home, their relatives and the staff all commented favourably about their experiences of living, visiting and working at Amberley House. The home was described as “excellent” by all. The people living at the home said they were well supported by kind and caring staff. They said the home was very comfortable and they appreciated the variety of lounge and dining rooms that giving a “home-like” impression and the sense of living in a much smaller home. Staff confirmed they are well trained and supported to undertake their role. In addition to the support provided to staff and those living in the home by the District Nursing Service and the Community Mental Health Care Team, the owners consult with a Social Worker who has specialist knowledge of the support needs of people with dementia and mental health conditions to ensure high quality care is provided to all of those living in the home regardless of their level of confusion or anxiety. Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 6 A planned programme of daily activities provides interest and stimulation. A Residents’ Committee ensures those living in the home and their relatives can be involved in the day-to-day management of the home and influence the services being provided. 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. 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. Amberley House DS0000041242.V320472.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 Amberley House DS0000041242.V320472.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): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thorough and comprehensive pre-admission assessments and visits to the home enable people to have confidence that their personal care needs can be met at Amberley House. EVIDENCE: A Service User Guide, the document that describes the services provided at the home, was available for people considering moving to Amberley House and provided the information required to allow people to make a choice over the suitability of the home. The inspector spoke to a newly admitted person: he described how he and his family had been able to visit before making a decision to move in. He said he felt he was being fully supported and was pleased he had chosen to move into Amberley House. Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 9 The owners had written to this gentleman following his visit to the home and after undertaking an assessment of his care needs confirming that his needs could be met at Amberley House. This demonstrates very good practice as both the home and the prospective resident can be clear about the nature and extent of the needs that have been identified. Amberley House DS0000041242.V320472.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 and 11. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of people living at Amberley House are being met and people are treated respectfully. The home’s practices relating to medication administration are safe. EVIDENCE: Many of the people living at Amberley House were, due to their level of confusion, unable to comment directly about the quality of the care and support they receive. The time spent observing the daily life in the home and care staff practices found the staff were very patient and the inspector witnessed those people with confusion being treated gently and with respect by the owners and the care staff. Those who were able to comment, including the newly admitted gentleman, said that they are well supported by kind and competent staff. Several people described the home as “excellent” and “marvellous”. One lady said that she would rather be at Amberley House than in her own home. Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 11 One relative said “I have only praise for Amberley – my mother is a different person since her arrival last year. She has gained wait and her mental state has improved due to the care and stimulation she receives”. The inspector spoke to two visiting relatives and they confirmed they are very satisfied with the care their relative receives. They said they had every confidence in the staff and were kept fully informed. Twenty-two surveys were returned to the Commission by relatives: all praised the quality of the care provided at the home. Comments included “my mother feels comfortable there and is always praising the staff”; “my mother is happy in the home as the staff find time for her and she has the comforts she needs”; “in my opinion this is an excellent care home. All the staff are kind, caring efficient and friendly. My aunt is well looked after, and I am kept informed of her condition. It is always a pleasure to visit Amberley House” and “my brother and I are really very happy that we found such a lovely happy home for mum. The owners and staff are really very helpful, nothing is too much trouble”. Both the owners and the staff were knowledgeable about the care needs of the people living in the home and demonstrated a clear understanding of the needs of those with confusion and anxiety. The care plans for 4 people who the inspector had spoken to and spent time with were examined. These provided clear descriptions of each person’s care needs and the action required by staff to meet those needs. Any risks associated with mobility, pressure area care, nutritional intake or relating to the person’s anxiety or confusion were identified and instructions provided to reduce the risk of deteriorating health. Staff were supported by specialist health care professionals such as the Community Mental Health Care Team as well as an independent Social Worker who has specialist knowledge of the support needs of people with dementia and mental health conditions to ensure high quality care that promotes independence is provided to all of those living in the home regardless of their level of confusion or anxiety. Mr and Mrs Webb are commended for continuing to invest in this specialist support for their staff. The District Nursing Service visits Amberley House to support the care staff with meeting people’s health care needs. People with terminal illnesses may remain at the home if the staff team and the District Nursing Service can continue to meet their needs. Medication was stored safely and the records, including those for controlled drugs, were accurate. The owners confirmed that people could retain the responsibility for their own medication if they wished and were able to do so. Amberley House DS0000041242.V320472.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 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social activities are managed well and provide daily interest for the people living at Amberley House. Meals are nutritious and varied. EVIDENCE: Daily activities are organised to provide interest and stimulation. Each person had been given a copy of the monthly timetable and activities included singers and musicians, quizzes, Bingo, slide shows, reminiscence sessions as well as coach trips to local places of interest. Religious services are held once a month. A number of people also choose to become involved in the activities organised in the Day Centre. At the time of the inspection, a singer was entertaining people in one of the lounge rooms: people were seen to be singing along and dancing to the “rock and roll” music. Once the singer had finished he moved to the Day Centre and several people moved with him to hear him again, saying how much they enjoyed this particular singer. As noted in the previous outcome group for Health and Personal Care relatives were very pleased with the services provided at Amberley House. Other Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 13 comments include, “I am very happy with the standard of care at Amberley. I never say when I am going to turn up and the standard is always the same”; “as relatives we are welcome at any time and are always consulted over my mother’s care. Since she has been there her overall health has improved” and “I visit several times a week and am fully satisfied with the care and attention she is getting”. The food was described as “excellent” and with plenty of choice. Three dining rooms ensure that meals are taken in pleasant and homely surroundings; meals can also be taken in people’s own rooms if wished. Amberley House DS0000041242.V320472.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, 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and suggestions from residents, relatives or other visitors to the home are treated seriously. Residents are listened to and issues resolved promptly. EVIDENCE: Those people who were able to comment directly about making known any concerns said that they had confidence in the owners and the staff to deal with these promptly and to their satisfaction. Relatives also had the same confidence. The owners have an “open door” policy and throughout the inspection the inspector observed people meeting with them on numerous occasions. Neither the owners nor the Commission had received any complaints about the services provided at Amberley House prior to this inspection. Care staff had received training in the protection of vulnerable adults ensuring they are aware of their responsibilities should they suspect a person is at risk of abuse. Amberley House DS0000041242.V320472.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, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents live in a very pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: The extension work to provide a new day care centre, 3 additional respite bedrooms, a new laundry room, the widening of hallways and a new passenger lift has been completed to a very high standard. Bedrooms, some of which were of generous proportions, were very pleasantly decorated and personalised; all but 2 bedrooms provide en suite facilities, seven have en suite baths. Doors have been fitted with locks providing people with privacy as well as security for their belongings when not in their room. Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 16 Additional alterations have been commenced to provide an “aromatherapy” bathroom with scented hot air blowers, piped music and a bath with an integrated seat that raises and lowers for ease of use by people with restricted mobility. The owners also plan to create a fully functioning hairdressing salon to give the people living at the home, and who are unable to attend a salon in the community, the experience of attending a hairdresser’s rather than having their hair done in their own rooms. The home provides 4 lounge rooms and 3 dining rooms which gives the impression of living in a much smaller home. The alterations to be building have been undertaken in such a way that the people enjoy a “home-like” environment which they said they found particularly pleasing. Radiators are covered to protect people from burns should they come into contact with them when on. The hot water temperature to the baths is controlled to prevent the risk of scalding as well as to a number of the bedroom hand washbasins that have been identified as posing a risk to people should they be used without the assistance of a staff member. The garden has been very pleasantly landscaped and provided safe and attractive seating areas. Amberley House DS0000041242.V320472.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 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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: People who live in the home as well as those relatives consulted said that staff assisted promptly indicating that there are sufficient care staff on duty each day. Seven care staff are on duty each morning and early afternoon, 6 during the later afternoon and 3 from 6pm: 2 waking staff are on duty during the night. These numbers do not include the owners who both work 5 days a week. Care staff are supported by catering and domestic staff each day. The owners confirmed that staffing levels are increased when necessary to ensure the quality of the care provided remains high. The home has an “on-call” system that operates during the evenings and night-time during the week and 24 hours a day at the weekend which provides staff with additional support from the owners or a senior member of staff should, for example, a person living at the home be taken ill. Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 18 The owners have a strong commitment to training. Training records indicated there is an ongoing training programme ensuring care staff remain up to date in fire safety, first aid, infection control, health and safety and manual handling providing them with the knowledge and skills necessary to deal with emergencies. Over half the care staff have obtained a National Vocational Qualification in Care, (a nationally recognised qualification awarded by an external training provider that assesses the knowledge and skills of staff with regard to caring for older people). As noted in the outcome group for Health and Person Care, a Social Worker provided training specifically tailored to support people with mental health conditions and dementia to remain as independent as possible and to overcome their anxieties associated with confusion. One-to-one supervision for the senior care staff is also provided. This consultation and supervision is independent from the owners and allows staff to speak in confidence about the standards of care in the home and their personal development and training needs. Newly employed staff undertake the “Skills for Care” induction training programme (a nationally recognised induction programme for new staff) that ensures staff are given information regarding the principles and values of care practice, the rights of the residents and their responsibilities towards provided a high standard of care. Staff responded positively to the survey sent by the Commission, comments included, “I feel Amberley House is an excellent home”; “we are lucky to have such understanding bosses who are not afraid to be hands on”; “there is good support for staff from the managers” and “I feel very happy and fulfilled in my work. I feel I am given encouragement from the managers to use my previous experiences.” . Amberley House DS0000041242.V320472.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, 32, 33, 35, 36, 37 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Amberley House is a well managed home. The owners and their staff team strive to provide a stimulating, safe environment that respects and protects peoples’ rights. EVIDENCE: Those people spoken to and who could comment directly about the management of the home said that they feel safe and secure in their home and that the home was well managed. One relative said Amberley House was “a very, very good residential home, very well managed with excellent level of care.” Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 20 Mr and Mrs Webb are available each day during the week and meet with the people living in the home and staff on a daily basis. People are encouraged to become involved with the Residents’ Committee, the chairperson of which is a resident. The Committee meets regularly with Mr and Mrs Webb, the owners, to consult on the running of the home and the quality of the services provided: relatives are also welcome to join the Committee. In November 2006, a written survey had been sent by the owners to each person living in the home and/or their relatives to ask them their views about the services provided. The results of which were available and indicated a high level of satisfaction. Staff receive both formal and informal supervision from Mrs Webb as well as an annual appraisal to ensure their work performance reflects the high standards of the home and that they have the support and training to be able to undertake their role and develop their own skills. People are encouraged to maintain responsibility for their own finances if they are able to do so and are provided with lockable storage space for money and other valuables. The owners do provide safe storage should anyone wish to use this facility: all transactions are recorded for each person and receipts obtained for their records. Amberley House DS0000041242.V320472.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 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 Standard No Score 16 3 17 3 18 3 3 3 4 3 4 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 3 3 Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Amberley House DS0000041242.V320472.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Amberley House DS0000041242.V320472.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. 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!