Inspection on 03/07/06 for Amberley Lodge

This inspection was carried out on 3rd July 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Amberley Lodge 27/11/08

Amberley Lodge 10/11/05

Amberley Lodge 09/12/04

Amberley Lodge 12/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

Tudor Lodge

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

CARE HOMES FOR OLDER PEOPLE Amberley Lodge Amberley Lodge Nursing Home 86 -94 Downlands Road Purley Surrey CR8 4JF Lead Inspector Michael Williams Key Unannounced Inspection 3rd July 2006 10:00a 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 Lodge DS0000019020.V298566.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 Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amberley Lodge Address Amberley Lodge Nursing Home 86 -94 Downlands Road Purley Surrey CR8 4JF 020 8668 0999 020 8668 0378 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) manager.burroughs@careuk.com Care UK Community Partnerships Limited Mr Osborne Acquaye Care Home 60 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (0), Old age, not falling within any other category (0) Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 23 residential service users A maximum of 10 service users aged between 55 and 65 years Date of last inspection 10th November 2005 Brief Description of the Service: Amberley Lodge is a large purpose built Care Home registered to provide care for up to 60 service users. On the ground and first floors it provides personal and nursing care for people over 60 years of age and who have dementia. The second (top) floor provides personal (residential) care, but not nursing care, for up to 23 people 60 years and above, and who have past or present mental disorder including PTSD (Post-Traumatic Stress Disorder) or who have dementia. The home has a single Manager with team leaders on each floor. Whilst the home is not registered to cater for service users with physical disabilities the home is adapted to meet the needs of service users who may have mobility problems; this includes assisted baths, ramps, grab rails and similar aids. Laundry and catering services are provided centrally with lounge and dining areas on each floor. The home’s Statement of Purpose states that the single bedrooms are at least 12 square metres and have ensuite toilets. The home itself is located in Purley to the South of the main A22/A23 Purley junction and is therefore close to shops and transport. Fees range from £515 for residential to £750 Nursing depending upon arrangements at time of admission plus extras for personal items and extra fees for extra care may also be negotiated with the fee payers if the need arises. Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A site visit took place on 3rd July 2006 In addition to this inspection visit, which latest approximately 4 hours, a number of questionnaires were distributed to interested parties; residents, relatives/friends, care managers, health professionals and to all staff. In compiling this inspection report the CSCI also noted information received into the commission including details of complaints, untoward incidents and general correspondence. During the course of the inspection visit as many residents who wished to meet with the inspector were given the opportunity to do so but many residents no longer have the capacity to express anything other than an immediate response to simple questions given the level of their dependency in many cases. Several staff were interviewed by the inspector. The premises were toured and documentation, including records, checked. All sections were as assessed as good and this will be reflected in the overall judgement of the home. What the service does well: What has improved since the last inspection? What they could do better: One requirement remains outstanding; that is, to ensure staff application forms request a full employment history and not just current ‘7 years’. One of the showers was excessively hot at 54oC and therefore needs to have its thermostatic valves checked. Minor damage noted to the environment such as bathroom with broken tiles and some walls such as in toilet was dirtier that might be expected, especially above a radiator. Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 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 Lodge DS0000019020.V298566.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 Lodge DS0000019020.V298566.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New service users are being admitted only on the basis of a full assessment undertaken by people trained to do so and this involves the service user or, in some cases, their representative so residents know that their needs have been fully assessed and can be met in this home. EVIDENCE: This standard, about assessment prior to admission, was assessed by speaking to residents and where possible their visitors to evaluated information given to them prior to, or at the point of admission. A sample of residents’ case was examined to check these assessments were in place and being used to compile the plans of care. The Statement of Purpose and Service User Guide have previously been checked by the Commission and found acceptable. In summary, the home is undertaking adequate assessments of prospective service users and they confirm they were told about the home and what Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 9 services, including for example nursing care, would be available to them when they enter the home. Areas of strength in this home are ‘welcome packs’ that include the service user guide another area of strength is the assessment carried out prior to admission. No matters requiring improvement were identified in this section, so this section, about information gathering prior to or at the time of admission, is assessed as good. Amberley Lodge DS0000019020.V298566.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for care planning, the provision of health care and the procedures for dealing with medication are all satisfactory so as to ensure the social, and health care of service users can be met. EVIDENCE: To assess this standard a sample of residents’ case files was examined, these are now computerised (and there was some delay in accessing them); residents were given the opportunity to comment if they wished to do so but few were able to reflect upon the care they receive with any great clarity given the degree of memory loss they now have. Relatives also contributed to the assessment of this standard and confirmed that they are involved in the assessments and review of residents’ care needs and health problems. Nurses are employed to provide support to service users and they were also interviewed to ensure they were aware of the specific needs of each resident in their care; they appeared well informed and were complimented by relatives for their caring approach. A Doctor (G.P.) was on site and confirmed a doctor from the surgery visits weekly and she confirmed she has had no complaints Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 11 about the service or the manner in which she is able to examine and treat her patient. A visitor advised the inspector how well her very sick relative is being cared for when his life expectancy is now very limited. Final wishes have been noted and the local doctor has agreed to support the patient for as long as is possible within the home rather than send to hospital. Areas of strength are new computerised record of care and the well managed nursing of very dependent residents and matters requiring improvement are the need to ensure that all residents and their visitors have access to a printed copy of their care plans for them to sign and have ready access to; so this section, about health and social care, is assessed as good. Amberley Lodge DS0000019020.V298566.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily routines in this home are reasonably flexible, within the constraints of a large service. Service users are being supported and encouraged to maintain links with family, friends and to exercise choice and control over their lives in so far as they wish and are able to do so. Service users are receiving a wholesome, appealing and well balanced diet in a congenial setting in accordance with their recorded requirements and preferences. EVIDENCE: Each service has a care plan, now computerised but staff are in the process of printing a copy of each service user so that they or their representative can sign a copy to be held in their room of case folder for ready access. The care plans follow a typical pattern with assessments care plans or goals and systems for monitoring and updating plans. General risk and health assessments are in place but there was some delay in gaining access to the computerised system to see the records. Visitors were on site to confirm that they are welcomed into the home and information is shared with them as the need arises. In some instances residents are still able to visit their family for short breaks away from the home. Representatives from the community including church people were also on site to confirm they visit regularly and Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 13 their visits are clearly appreciated by residents. The more able residents are free to exercise choice over the lives and this includes regular access to the community, they are free to smoke, they can pass the day in the manner they choose and so forth. Other more dependent residents need considerable support from staff and their visitors to make even simple choices about daily living, choice of clothing, meals and activities for example. The cooks were complimented for providing nice food, two curry dishes on the day of inspection, a very hot day, so two types of curry seemed an odd choice but other options were made available - residents and relatives said the food is always very good in this home. Areas of strength were summed up by a relative who said the home is providing care tailored to her relative’s very specific needs and matters requiring improvement are limited to making a copy of care plans accessible to residents and their visitors; so this section, about daily life, is assessed as good. Amberley Lodge DS0000019020.V298566.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear and simple procedure for dealing with complaints so service users’ are confident their concerns will be dealt with promptly and effectively and that they are safeguarded from abuse. EVIDENCE: The record of complaints is in place. About five complaints were recorded since the previous inspection and the correspondence shows that the matters have been dealt with professional and promptly as they arose. No matters are being dealt with dealt with under the procedures for dealing with the protection of vulnerable adults from abuse. No complaints were made by service users, or their relatives, during the course of this inspection. In contrast several compliments were paid to the home and the staff team by appreciative relatives. Staff confirmed that they have been told how they must conduct themselves, that is, with respect for service users and that they have received instructions about how to deal with allegations of abuse – by reporting it without delay. The home has a copy of the local authority’s procedures for dealing with allegations of abuse. The coordinator for Protection of Vulnerable Adults (London Borough Croydon) has visited the home and giving presentations to staff on the local procedures. Areas of strength are the professional manner in which complaints are handled and no matters requiring improvement are identified so this section, about complaints and protection, is assessed as good. Amberley Lodge DS0000019020.V298566.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The layout of the home and the manner in which it is being maintained is generally satisfactory ensuring the home is a clean, safe and comfortable environment for the service users. EVIDENCE: The inspector toured the premises observing matters such as fire doors, fire extinguishers, escape routes and general fire-safety matters; the use of cleaning materials and how they are stored, the quality of floor coverings, furnishings and fittings and the general décor of the home. The inspector also checked a number of bedrooms and communal areas such as the lounges and dining rooms plus facilities such as bathrooms and toilets to confirm they are in good decorative order and at a comfortable temperature and that they have suitable fixtures and fittings for the service users. The home is in a good state of repair and furniture and equipment is well maintained and the home was clean and tidy and free of offensive odours. A Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 16 small number of minor points were noted such as a dirty wall in a toilet, a dirty shower curtain, broken tiles in bathroom and a call bell in bedroom also needed to be repaired but otherwise standards are good and it is noted that new floor coverings are being fitted. Areas of strength are generally very well maintained environment and matter requiring improvement are limited to minor matters of décor; so this section, about the premises, is assessed as good. Amberley Lodge DS0000019020.V298566.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has adequate numbers of staff and the staff recruitment procedures, induction, training, support and supervision regime in place so this will ensure they are competent in their jobs ensuring service users are in safe hands at all times. EVIDENCE: As an existing care home staffing levels are to be no less that proscribed by the previous registering authority. On the day of inspection it was noted that for 58 service users there were 4 Nurses and 10 care staff plus the manager, who is also a qualified Nurse; ancillary staff were also on duty including cleaners, cook laundry staff and maintenance staff. This is within the minimum staffing levels required. The staff files in the home are methodically laid out with a checklist of some of the police check processes. The manager asserts that all staff have had a CRB (police check) and a sample of CRB checks were examined to confirm this. Other recruitment processes are in place including application forms, references, health and qualification checks and interviews. The overall process appears sound and so it is clear service users are in safe hands and certainly service users say they feel safe and cared for, but a requirement is made to ensure that the application forms of prospective employers have a detailed work history in chronological order without unexplained gaps. Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 18 In respect of equality issues, it is evident that an open and unbiased approach is taken when recruiting staff so that minority and other special needs groups are not disadvantaged by the recruitment process. The home employs a staff from a range of cultural and ethnic minority backgrounds and also employs a number of staff who reflect the culture and background of the service users. The staff files list the range of training taken up by staff and two new members of staff on duty at the time of the inspection confirmed that they are receiving induction training at the commencement of employment in the home. One requirement is repeated to ensure that the application forms issued by the home require a full employment history for all staff and not just seven years as at present. The staff training files are now computerised and a print was shown to the inspector to confirm that a wide range of training is offered and staff are required to attend a set number of safety related training course each year. Areas of strength are recruitment practices, training schedule and very positive attitude of staff confirmed by residents and visitors alike; and one matter requiring improvement is the need to ensure a full employment history is required for all new staff; so this section, about staffing, is assessed as good. Amberley Lodge DS0000019020.V298566.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 37 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is registered with the CSCI as a person competent to run this home in accordance with its stated aims and objectives and so in the best interests of the service users. The home is well managed, including finances, and is safe for service users. EVIDENCE: The registered manager is qualified, competent and experienced to run the home and to meet its stated purpose, aims and objectives. Quality monitoring is based upon the views of service users and their family as well as visiting professionals and those funding the placements. It is clear this home is being run in the best interests of the service users and this was reflected in the vary many compliments paid to the manager and his staff during the visit. Service user’s money was checked to confirm systems are in Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 20 place to ensure that the property and money of service users (held by the home) can be held securely and is safeguarded. Provision is also made for service users to control their own money. Health and safety in the home is well organised, ensuring that in so far as it is reasonably practical to do so, the health, safety and welfare of service users, and staff, is being promoted and protected but a number of matters of safety need to be addressed and they are listed in the requirements table below. This includes the need to ensure hot water is controlled to a safe temperature, 43oC, at all outlets to which the residents have access including baths and showers. Safety certificates for water, lifts and electrical equipment were checked to confirm these systems are being effectively managed and is periodically checked by an authorised person and competent person. Other records checked and found acceptable were complaints, staffing, resident case files, accidents and incidents; the maintenance person and staff also confirmed that regular fire safety checks are also made. Areas of strength are the competent way in which this home is being managed and matters requiring improvement are limited to a very small number of requirements, reflecting well run home, so this section about management and administration, is assessed as good. Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 2 Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP29 Regulation 19(1)bi Requirement Staff Recruitment: The registered person must ensure that the home has all the information listed in schedule 2 before employing staff; in particular a full employment history and not just 7 years as current application form. This remains outstanding from 30/12/05. Safety: hot water at baths and showers must not exceed 43oC Environment: the environment must be kept clean and be well maintained. Thorough cleaning must be undertaken peruidei9val to ensure walls are cleaned as well as upper surfaces and that minor damage such as bathroom tiles are replaced quickly. A call bell pint also need to be repaired. Timescale for action 30/09/06 2 3 OP38 OP19 13(4) 23(2)b 30/07/06 30/09/06 Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 23 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 OP37 Good Practice Recommendations Records: it is recommended that all staff be made aware that whilst records can be held on a computer they must be made accessible for inspection by the Commission and must, if requested be made available in a form which is legible and can be taken away (see Section 31(4)b Care Standards Act 200). Amberley Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Lodge DS0000019020.V298566.R01.S.doc Version 5.2 Page 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. 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