Inspection on 09/01/06 for Amberley Nursing Home

This inspection was carried out on 9th January 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 Nursing Home 11/09/08

Amberley Nursing Home 11/09/07

Amberley Nursing Home 07/11/06

Amberley Nursing Home 24/08/05

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 Unannounced Inspection 9th January 2006 2:00 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 Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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 Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Amberley Nursing Home Address Off Cedar Close Eckington Sheffield Derbyshire S21 4BA 01246 436850 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) Derbyshire Care & Home Support Limited Mrs Angela Newall Care Home 15 Category(ies) of Learning disability over 65 years of age (15) registration, with number of places Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 1. Two LD places, on a named basis for the persons named in the Notice Of Proposal letter dated 16 September 2005. 1 LD place for the Service User named in the notice of proposal letter dated 29 November 2005. 24th August 2005 Date of last inspection 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 individuals 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 DS0000002035.V279524.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of three hours on the 9th January. The Home’s manager, Angela Newall, was present throughout the visit and there were also discussions with several staff on duty at the time. There was also the opportunity to meet most of the residents. A variety of documentation was viewed such as individual care plans and staff records. A full inspection of the premises did not take place on this occasion. What the service does well: What has improved since the last inspection? What they could do better: Improved opportunities for staff to access NVQ training need to be developed. Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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 Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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 Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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 and 5. Prospective residents have their abilities and needs fully assessed and are given suitable opportunities to view the resources and services provided by the Home. EVIDENCE: The individual care plans of 2 residents, who had come to live at the Home in the past few months, were examined. These demonstrated that full assessment information from a range of relevant sources is obtained by the Home, prior to any final decision made about a long-term placement. It was also clear that there was a defined transition process enabling the prospective resident sample life at Amberley House and form their own views. In the case of one resident, who was moving from another service establishment placement run by the provider organisation, a member of staff accompanied the resident to the new placement for a period of time. Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 9 Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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 and 9. 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: Each resident had an individual care plan and a sample of these was viewed. These were generally well structured and informative with a comprehensive assessment of needs evident. 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. Risk assessments were now being updated more regularly and plans were being monitored appropriately. Plans included information on social needs and preferences, communication and also 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 Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 11 and accessible. Copies of annual and post placement reviews were kept on files and these included residents and family in the process. Care plans also demonstrated that the health needs of residents were suitably assessed and monitored closely. There was a clear 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 and specialist health care screening. The Home has a treatment room, which is used for the storage of medication. This was kept secure with separate arrangements for the storage of controlled drugs. Oxygen cylinders were checked on a daily basis and temperatures for the small drugs fridge were also maintained. Records for ‘returns’ were kept and the Home has an established contract for the disposal of clinical waste. Records for the administration of medication were viewed and were in good order. There was also a home remedy policy. Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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 and 14. Residents are provided with a range of recreational opportunities that are in line with their preferences, interests and needs. Contacts with families and friends are appropriately encouraged. 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. Discussions with staff indicated that they get involved in organising recreational activities and are aware of the differing needs of those younger residents at the Home and are attempting to develop relevant recreational opportunities in this respect. Individual records regarding participation in leisure activities were maintained at the Home. Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 13 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 DS0000002035.V279524.R01.S.doc Version 5.1 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): Standards in this section were not fully assessed on this occasion. EVIDENCE: Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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): 20 Residents have satisfactory communal living space, which the owners have upgraded, though there remains some areas in need of attention. EVIDENCE: A full tour of the premises was not undertaken on this occasion, however, communal and lounge areas were viewed. The building of the new conservatory was completed just before Christmas and is being made ready for full use by residents. Other lounge and dining areas were satisfactorily furnished and furbished though the main lounge remains in need of redecoration and the adjacent toilet area still has damaged paint and plasterwork. The external garden at the front is in the process of being renewed following the recent building work. Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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 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 and 30. Care to residents is provided through a staff group who receive a wide range of relevant training, though there remains a shortfall in staff going onto NVQ courses. Whilst staffing levels remain constant they are in need of ongoing review in line with the needs of the resident group. The interests of residents are suitably served through the maintenance of satisfactory recruitment procedures. EVIDENCE: There had not been any staff changes at the Home’s since the last inspection, though the staff group were covering 30 hours staff time due to long-term sickness. There was a feeling amongst staff spoken to that they were stretched due to this factor and also because the dependency levels of residents, particularly those recently admitted to the Home, had significantly increased. It was also said that this was affecting the Home’s ability to progress NVQ training for staff and there remained only one member of the care staff with this qualification. However, staff were satisfied with the overall level of training opportunities provided, including the provision of mandatory care courses, though it was noted the manager has not been able to access local multi agency training on the protection of vulnerable adults. A sample of staff files was examined. These contained full interview records with written references obtained and checks on any employment gaps also undertaken. There was no evidence of CRB checks and it was explained that Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 17 these were kept centrally by the Provider organisation. One staff file did not have a photograph. Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 18 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): Standards in this section were not assessed on this occasion. EVIDENCE: Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 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 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X 2 X X X X X X STAFFING Standard No Score 27 3 28 1 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 20 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 OP19 Regulation 23 Requirement The main lounge areas must be repainted when current building work has been completed. (Previous timescale of 31/12/05 not met). The toilet areas adjacent to the lounge must have the paint and plasterwork made good. (Previous timescale of 31/12/05 not met) The manager must attend relevant local interagency training in the Protection of Vulnerable Adults. NVQ training for care staff must be more rigorously promoted in order to meet required quotas. (Previous timescale of 31/12/05 not met) Timescale for action 31/03/06 2. OP19 23 31/03/06 3. OP18 12 30/04/06 4. OP28 18 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 21 No. 1. 2. 3. Refer to Standard OP19 OP27 OP29 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. Overall staffing levels, including arrangement for the covering of night shifts by qualified nursing staff, should be actively reviewed. Evidence of appropriate CRB checks on staff should be kept at the Home and be available for inspection. Amberley Nursing Home DS0000002035.V279524.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Derbyshire Area Office 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 DS0000002035.V279524.R01.S.doc Version 5.1 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. 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!