Inspection on 24/08/05 for Amberley Nursing Home

This inspection was carried out on 24th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Nursing Home 11/09/08

Amberley Nursing Home 11/09/07

Amberley Nursing Home 07/11/06

Amberley Nursing Home 09/01/06

Amberley Nursing Home 10/02/05

Amberley Nursing Home 27/09/04

Amberley Nursing Home 02/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Amberley Nursing Home Off Cedar Close Eckington Sheffield Derbyshire, S21 4BA` Lead Inspector Ray Coonan Coonan Unannounced 24 August 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 Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Amberley Nursing Home Address Off Cedar Close, Eckington, Sheffield, Derbyshire, S21 4BA 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) 01246 436850 Derbyshire Care & Home Support Limited Mrs Angela Newall Care Home with nursing 15 Category(ies) of Learning disability over 65 years of age (15) registration, with number of places Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 10/2/05 Brief Description of the Service: Amberley House Nursing Home provides nursing and personal care for up to fifteen older persons with learning disabilities – aged over 65 years. It is situated on the edge of the north-east Derbyshire boundary within the village of Eckington. It is close to shops, a post office and all local amenities and near to direct bus routes to both Chesterfield and Sheffield. The home aims to provide a holistic approach to care and to promote individual’s dignity, choice and a good quality of life for service users within a friendly and homely environment. The home provides single bedroom accommodation and this is all on ground floor level. There is one large lounge/dining room, although there are plans to build additional lounge space. There is adequate toilet and bathing provision, with suitable adaptations and equipment provided and there is access to a garden/patio area with seating provided for service users. Nurse cover is provided at all times by Registered Nurses (Learning Disabilities) and there is a team of care and domestic services support staff. The Registered Manager is also a Registered Nurse Learning Disabilities. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of just over five hours on the 24th August. The Home is currently 4 places under full occupancy and some residents were out on a day trip at the time of the visit. However, several residents were seen and there was also the opportunity to speak with a number of staff. The Home’s manager, Angela Newall, was present throughout the inspection. A tour of the premises was undertaken and sample of bedrooms were viewed as well as communal areas. A range of documentation was also examined during the visit including care plans, policies and procedures, staff rotas and training records. What the service does well: What has improved since the last inspection? What they could do better: Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 6 The Home needs to further promote opportunities for care staff to undertake NVQ training. 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 Nursing Home C52 C02 S2035 Amberley House V241902 240805 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 Nursing Home C52 C02 S2035 Amberley House V241902 240805 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) 2 Residents were provided with appropriate terms and conditions, which satisfactorily detailed the costs for their care. EVIDENCE: Clear terms and conditions had now been developed for each resident. These contained details of the amount and method of payment of fees and detailed a breakdown of these fees, including the free nursing care element of the fee. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 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 and 8 Service users benefit from an organised and thorough approach to assessing and meeting overall care needs, with specific health needs closely monitored and actively promoted. EVIDENCE: A small sample of care plans was examined. These were generally in good order with comprehensive assessments of needs evident, which were based around activities of daily living. A range of relevant risk assessment information had been developed in such areas as mobility, skin integrity and nutrition, as well as in other specialised areas related to specific individual needs. The plans also included information on social needs and preferences, communication and included assessments as to the individual resident’s ability to access care records. Clear and detailed guidance for staff was laid out in the actual care plans. Staff spoken to felt the plans were generally informative, useful and accessible. Copies of annual reviews were kept on files and these included residents and family in the process. However, some risk assessments had not been updated for a considerable period of time and there was not always evidence of the ongoing monitoring of plans. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 10 Care plans evidenced that the health needs of residents were suitably assessed and monitored closely. There was a recognised approach to the prevention of pressure ulcer development, with monthly risk assessments documented for each service users. Regular weight records were maintained and a range of pressure relieving equipment was provided in accordance with the identified needs of individual service users. There was access to advice regarding continence promotion and relevant aids and equipment were provided in accordance with individual’s needs assessments. Nutritional risk screening was also undertaken and documented with monthly reviews. Care plans detailed the dietary requirements of service users. All service users are registered with a named GP and there was evidence of regular access to outside health care professionals for the purposes of routine health care screening. Staff had undertaken specific training in respect of one service user’s health care needs and care staff said they were provided with appropriate information on any specialised needs and were given good guidance by qualified nursing staff. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 11 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 and 15 Residents are provided with a suitable range of recreational opportunities that are in line with their preferences and needs. Contacts with families and friends are facilitated appropriately. Meals at the Home were of a satisfactory nutritional standard and planned with resident preferences or dietary needs in mind. EVIDENCE: The Home employed a member of staff whose primary role was to coordinate leisure activities, though she also did some care assistant hours each week. Residents’ social interests and preferences were detailed on care plans. A range of activities was arranged within the Home, with a variety of games, reading and musical materials available. Regular day trips were arranged either using community transport or the Home’s own minibus. It was stated that holidays were getting harder to arrange through lack of disabled facilities, though one resident was going for a stay in Blackpool shortly. Individual records regarding participation in leisure activities were maintained at the Home. Care plans maintained records of communication with relatives, though the manager stated that this was quite variable given the age of some residents. However, several residents had well - established friends who visited on a regular basis. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 12 The menu for the day was displayed and menus run on a 3 weekly cycle. These were seen to be of a good overall nutritional standard and quite traditional. The cook stated that menus are regularly reviewed with residents, and being a small group, individual preferences are well known. She also confirmed that information on any specific dietary needs was communicated to her effectively. Whilst it was stated that alternatives to the main meal were available no records of these were kept. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 13 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 and 18 There was a good overall awareness of residents’ rights and potential vulnerability at the Home, though there were some aspects of resident protection that could be further developed. EVIDENCE: The Home had satisfactory procedures for dealing with complaints and for keeping records of any issues that might be raised. However, the complaints policy was not immediately available and was not displayed. It was said that no formal complaints had been received since the last inspection and none have been made direct to The Commission. The Home had relevant information and documentation accessible to staff regarding the protection of vulnerable adults, together with policies and procedures. The provider organisation has developed a training course on abuse and protection and provides staff with an information booklet. Staff confirmed that they had been provided with a good basic awareness in this area, though one experienced member of staff had not received any specific training but did have the relevant booklet. It was noted that the manager had not accessed the local multi agency training on the protection of vulnerable adults. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 14 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, 24, 25 and 26. The Home was generally well maintained and residents had an overall safe and comfortable environment. However, there remained several areas for significant improvement and the process of upgrading the premises was underway. EVIDENCE: A tour of the premises was undertaken and the Home was generally clean and hygienic. There was no written maintenance programme though a considerable amount of work on upgrading the environment had taken place since the last inspection. Bedrooms had been redecorated as well as corridor areas. Several bedrooms were viewed and these were of a good size, comfortable, satisfactorily furnished and personalised by residents. Bathroom areas were also of a good size, well decorated and maintained. Two new specialist baths had been recently purchased and fitted. One bathroom had the option of a wheel-in shower. The Home was suitably resourced with toilets. The toilets adjacent to the lounge area had paint and plasterwork Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 15 damaged due to long standing problems with damp in this area. The laundry area had been extended since the last inspection. Water supplies, heating arrangements and ventilation were satisfactory throughout the Home, though it was felt that ventilation in the kitchen could be improved by providing screening for the back door. The large lounge area was satisfactorily furnished though remained in need of repainting. It was said that this area would be looked at once the major work on building the new lounge extension had been completed. This work was in process during the inspection visit and as a consequence the garden areas outside the front entrance had been affected. There had been no progress in fitting a gate to provide access to the small lane near the front of the building. Residents had use of a sitting area at the back of the building. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 16 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, and 30. Residents’ care was enhanced through the maintenance of appropriate numbers of staff, who received a wide range of relevant training input. However, there was a shortfall in the promotion of NVQ training for care staff. EVIDENCE: There were no staffing vacancies, though in the past few months there had been a degree of staff turnover. Staffing levels were satisfactory, though there were pressures on the qualified nurse group in covering night shifts. This on occasions led to some nursing staff working long consecutive shifts. General staff cover was usually provided in-house and several care staff were working regular overtime. Deployment of staff was generally satisfactory and several staff were with residents on the day trip at the time of the inspection visit. Staff spoken to confirmed that there was a good range of training opportunities provided including all basic mandatory care courses and impressed as committed to their work with residents. Individual training records were maintained. It was noted that only one member of care staff had completed NVQ training. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 17 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) 32, 33, 35, 36 and 38. The Home is run in an effective manner with residents’ interests and personal safety suitably safeguarded. EVIDENCE: The Home had a welcoming atmosphere and staff stated that they generally felt very well supported by their manager and received regular individual supervision and appraisals. Regular staff meetings took place. There were established structures for assessing the quality of services, including questionnaires to relatives, though not recently with staff. It was said that the provider organisation had a system for home audits though these had not taken place for some time. Regular visits to the Home were made by the Provider’s representative under Regulation 26 and these were recorded appropriately. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 18 Arrangements for the handling of residents’ personal monies were looked at and these were satisfactory with appropriate ledger accounts and balance books suitably maintained. Residents had individual deposit accounts and any cash on the premises was securely stored. There were relevant Health and Safety policies and procedures in place. A range of hazard assessments were made in relation to the premises, including a fire risk assessment, an internal safe environment audit and a risk assessment for legionella and water storage. Fire safety records were examined and these were kept up to date with regular fire drills taking place. Staff confirmed that they received regular fire safety training. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 19 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 3 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 1 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x 3 3 x 3 3 x 3 Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 20 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. 2. 3. 4. Standard 16 19 19 19 Regulation 22 23 23 23 Requirement A full complaints policy must be available in the Home and displayed appropriately. The main lounge areas must be repainted when current building work has been completed. The toilet areas adjacent to the lounge must have the paint and plasterwork made good. The garden areas at the front must be landscaped when current building work has been completed NVQ training for care staff must be more rigourously promoted in order to meet required quotas. Timescale for action 30 September 2005 31 December 2005 31 October 2005 31 December 2005 31 December 2005 5. 28 18 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. 2. Refer to Standard 19 7 Good Practice Recommendations Consideration should be given to the provision of a gate (as was previously in place) to enable service users access to the lane to the rear of the property. The manager should ensure that care plans are regularly monitored and that all risk assessments are updated. C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 21 Amberley Nursing Home 3. 4. 5. 6. 15 18 25 27 Records of alternatives provided to the main menu should be kept. The Home should ensure that all staff receive appropriate training regarding the protection of vulnerable adults. Ventilation in the kitchen area should be reviewed. Arrangement for the covering of night shifts by qualified nursing staff should be kept under review. Amberley Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT 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 Nursing Home C52 C02 S2035 Amberley House V241902 240805 Stage 4.doc Version 1.40 Page 23 - 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. 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