Inspection on 27/02/07 for Amblecote House

This inspection was carried out on 27th February 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

Amblecote House 07/01/09

Amblecote House 11/01/06

Amblecote House 15/06/05

Amblecote House 20/01/05

Amblecote House 26/08/04

Amblecote House 15/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Amblecote House King William Street Amblecote Nr Stourbridge West Midlands DY8 4ES Lead Inspector Ms Linda Elsaleh Key Unannounced Inspection 27th February 2007 10:00 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 Amblecote House DS0000041946.V323660.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. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amblecote House Address King William Street Amblecote Nr Stourbridge West Midlands DY8 4ES 01384 813285 01384 813516 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) N/K Dudley Metropolitan Borough Council Mercedes Holness Care Home 36 Category(ies) of Dementia (11), Old age, not falling within any registration, with number other category (25) of places Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2006 Brief Description of the Service: Amblecote House is owned by Dudley Local Authority and managed by their Social Services Department. Registered to provide residential care services for 36 people over the age of 65, it is situated within the local community, close to the Brierley Hill and Stourbridge shopping centres and is accessible by public transport. The building provides single bedroom accommodation, on one floor, and is shaped in a square providing two small inner garden areas, one of which is lain to lawn, the other with shrubs and flowerbeds. The home no longer provides a day care provision for non-residents. The current weekly charge for this service is £355.00. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 27th February 2007. The purpose was to assess the home’s performance against the key standards in the National Minimum Standards for Care Homes for Older People and report on the progress made to address previous requirements. The inspector’s findings are based on the information received by the Commission for Social Care Inspection, examination of relevant records and documents kept at the home, discussions with the manager, staff and service users and a tour of the premises. The home has fully met the two requirements made at previous inspection. Ten requirements were identified during this visit. The atmosphere within the home was relaxed and friendly and service users expressed satisfaction with the care being provided. What the service does well: The home continues to carry out assessments to identify the needs of prospective service users. Suitable arrangements are made for them to visit the home prior to admission. The home’s ‘open’ policy enables service users to receive visitors any time during the day. Good arrangements are in place to ensure service users live in a comfortable and well-maintained home. Aids and adaptations are available to enable service users to navigate around the home safely and support staff assisting with personal care. Care is provided by a stable staff team, who are familiar with individual service users routines, likes and dislikes and provides care accordingly. Health care needs are met and regular arrangements are made for service users to consult with relevant health care professionals. Service users enjoy well-balanced and nutritious meals and suitable arrangements are in place for providing drinks and snacks throughout the day. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 6 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. Amblecote House DS0000041946.V323660.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 Amblecote House DS0000041946.V323660.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): 3 Quality in this outcome area is good. Prospective service users needs are assessed by the home and written confirmation is provided to each service user confirming their health and welfare needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A comprehensive assessments is carried out on all prospective service users needs prior to admission. The home confirms in writing to the service user (or her/his representative) that it is able to meet their health and welfare needs. The home consults with members of the service users family, where applicable, and one file examined contained detailed information about a service user’s life history, personality and likes and dislikes. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 9 Prospective service users are also provided with the opportunity to visit the home prior to admission. A stable staff team, 78 of whom have achieved Level 2 National Vocational Qualification, are employed to meet the needs of the service users. The records show the home regular consults with health care professionals, where applicable. The home also provides a respite service. Several permanent service users chose Amblecote House after being provided with periods of respite care. Appropriate assessments are carried out prior to these placements being agreed. Amblecote House DS0000041946.V323660.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 Quality in this outcome area is good. The care needs of service users are set out in their individual plans and reviewed on a regular basis. Staff would benefit from written guidance on the review process and regular monitoring would provide staff with support to ensure an effective review on care needs is carried out. The home operates safe systems for the management and administering of medication. However, this needs to be evidenced more fully on the records kept by the home. Service users are treated with respect and their right to privacy is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 11 Care plans and risk assessments are produced for each service user. The service user’s key worker reviews the care plan each month. However, there are some inconsistencies in the application of this process. For example some service users care plans have not been updated to include the outcome of reassessments. A number of risk assessments have not been reviewed/updated in conjunction with the care plan. A system for monitoring the quality of the reviews by key workers needs to be implemented to ensure the changing needs of service users are being fully met. Written guidance on the carrying out of reviews may be beneficial to staff. Staff are familiar with service users individual needs and preferences. The inspector observed good practice in the delivery of care. A record is kept of all health care appointments and regular consultations take place with relevant health care specialists. The home has suitable facilities for the safe storage of medication. The inspector was informed that senior staff are trained in the safe management and administration of medication. This training has not been included in the records kept by the home. The application of creams and ointments (prescribed and/or shop bought) is delegated to care staff. This task is carried out in the privacy of the service user’s bedroom. The arrangements for carrying out these duties and monitoring practice must be detailed in the home’s procedures. Service users’ who spoke with the inspector commented positively about the care being provided. They confirmed personal care is provided in a sensitive manner, in accordance with their individual wishes, and in the privacy of their bedroom. Rotas indicate staffing levels are appropriate to meet the current service users needs. Amblecote House DS0000041946.V323660.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 & 15 Quality in this outcome area is good. The home supports service users to continue with their chosen lifestyle, where possible. However, more detailed information needs to be kept where decisions are made on behalf of service users. Meals are well presented and served in a pleasant environment. Service users relatives and friends are welcome visitors to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Photographs are displayed around the home of service users enjoying various celebrations, activities and trips. Most service users who expressed a view stated they are satisfied with the activities provided by the home, bingo and mobility exercises set to music being among the most popular. Arrangements are also made for service users to go shopping and enjoy a pub lunch. The home operates an ‘open door’ policy for visitors. The inspector observed a Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 13 number of visitors arriving at various times throughout the day. The atmosphere in the home is relaxed and friendly. Bedrooms are individualised and service users are able to bring small pieces of furniture with them. Each bedroom has a lockable facility. The inspector was informed some service users manage their own finances and/or medication, but have not been provided with a key to this facility. The reasons for this needs to be detailed on their individual records. Information is appropriately stored to ensure confidentiality is maintained. The home has a policy on service users rights to access their personal records and information is available about how to access independent advocates. The home provides a printed menu, the contents of which appear well-balanced, nutritious and varied. Service users expressed satisfaction with the food provided. Main meals are prepared in the catering kitchen by appropriately trained staff who are aware of individual dietary needs, likes and dislikes. Regular servicing and safety checks are carried out on the appliances and equipment. Meals are served in the dining room located on each unit. Tables are pleasantly set and the inspector observed good interaction between staff and service users during the mid-day meal. The dining rooms have a kitchenette facility where care staff prepare light breakfasts, snacks and drinks. Service users are also able to use this facility, subject to a satisfactory risk assessment. The home’s records show 50 of the care team have completed Basic Food Hygiene training. Amblecote House DS0000041946.V323660.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 & 18 Quality in this outcome area is good. Service users are confident their complaints and concerns are listened to and acted upon appropriately by the home. The home has suitable procedures in place to protect service users from abuse. However, accurate records need to be kept to demonstrate staff are competent and confident in implementing these procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has policies and procedures for managing complaints and protection of vulnerable adults. The records show the manager and a senior member of staff have received training in managing and responding to complaints. One complaint has been received by the home since the last inspection. Evidence is available to demonstrate the complaint was dealt with appropriately and to the satisfaction of the complainant. There have been no reports of concerns in respect of the protection of service users. Information provided by the home states adult protection training has Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 15 been provided for staff. However, the records seen do not include reference to adult protection training. One member of staff confirmed she had attended training, another stated training was being arranged and certificates of attendance were seen for two other staff. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 16 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 & 26 Quality in this outcome area is good. Service users live in a comfortable, clean and hygienic home. A planned programme for the maintenance of the garden will further improve the environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Amblecote House is purpose built to provide residential care to service users aged over 65 years. Off-road parking is available for staff and visitors. The home has four separate units each has its own lounge, dining room and bathing facilities. There is an allocated staff team for each unit. Suitable adaptations are fitted, where applicable, such as handrails along corridors and Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 17 grab rails and assisted hoists in toilets and bathrooms. The home also has its own well-equipped salon that is used by the visiting hairdresser. The communal room is large enough to accommodate all service users. Various activities take place here and arrangements are made for service users to share a meal together on special occasions. Since the last inspection some environmental improvements have taken place. For example the majority of windows have been replaced and some bathrooms have been re-furbished. Safety closures were being fitted to the remaining doors during this visit and the manager stated arrangements were being for dining rooms to be re-decorated. The inspector was informed some service users enjoy spending time in the garden. However, no work has been carried out over the winter months. The flowerbeds and borders are in need of weeding and moss removed from paths and patio areas. The home must implement a planned programme for the regular maintenance of the garden. The premises are clean and odour free. Suitable infection control systems are in place for the protection of service users, staff and visitors. The laundry is appropriately equipped and there is a separate ironing area. Service users commented on the efficiency of this service. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 18 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 & 30 Quality in this outcome area is good. Appropriate recruitment procedures are followed to ensure service users welfare is safeguarded. The number and skill-mix of staff on duty are consistent with the rota and sufficient to meet the assessed needs of the current service users. Service users receive a good standard of care from a committed staff team, the majority of who have achieved a recognised qualification. A review of the induction programme for newly appointed staff and on-going training for established staff, will ensure service users are provided with care based on the most current guidance and practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A stable staff team with mixed experiences, skills and interests provide a consistent level of care to service users. The rotas reflect a good mix of seniors, care staff and domestic and catering support. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 19 The home is run by Dudley Social Services and the local authority’s procedures are followed for recruiting staff. Successful applicants are provided with a copy of their statement of terms and conditions and additional information. The staff files examined during this visit contained limited information about the induction of new staff. The manager needs to review the induction programme to ensure it meets with the National Training Organisation (NTO) targets. The notice board in the staff room contains information about forthcoming training courses provided by the local authority’s training section and the manager also provides in-house training for staff. Staff reported courses provided by the training section are often over subscribed or cancelled at short notice. There are omissions and inconsistencies in the home’s training records. However, the inspector is informed that 78 of the staff team hold the Level 2 National Vocational Qualification (NVQ) or equivalent. Whilst the home is to be commended for this, a more planned approach needs to be taken to meeting additional and future training needs for which accurate records must be kept. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 20 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, 33, 35, 36 & 38 Quality in this outcome area is good. Service users live in a home run by an experienced and competent manager. Improvements to arrangements for supervision and training will ensure staff are up to date with the most current guidance and best practice. A comprehensive quality assurance system needs to be implemented by the home to ensure the service being provided continues to be in the best interests of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 21 The registered manager has many years experience and is closely involved in day-to-day ‘hands-on’ management of the home. Responsibility for the supervision of care staff is shared between the senior staff team. The arrangements for planned supervision needs to be reviewed, as the records show staff receive less than six sessions per year. Staff meetings take place on a regular basis. Minutes are kept of each meeting and displayed on the staff notice board. The home’s quality assurance system needs to be reviewed to ensure the views of service users; their representatives, relevant stakeholders and staff are sought and an annual plan for the development of the service produced. The majority of service users personal allowances are managed on their behalf by the home. There are suitable administration systems in place and records are kept of all items purchased on their behalf. Appropriate safety checks and routine servicing is carried out on appliances and equipment. The most recent report from the West Midlands Fire Service show there are no outstanding issues. Various health & safety training courses are available to staff. The records show the majority have attended lifting and handling people, the use of hoisting equipment and fire safety training. However, provision must be made for staff to attend all relevant health & safety training. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 22 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 2 Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP7 Regulation 24 Requirement A system must be developed for monitoring the quality of reviews carried on by key workers on service user’s care plans and risk assessments. Accurate records must be kept of training in the safe handling and administration of medication provided to senior staff. Timescale for action 16/07/07 2. OP9 17(2) Sch 4, 13, 18 21/05/07 3. OP14 4. 5. 6. OP15 OP18 OP19 Arrangements for care staff to apply creams & ointments and systems for monitoring this practice must be included in the home’s medication procedures. 12 A record must be kept of any reason why a service user, who manages their own finances and/or medication, has not been issued with a key to the storage facility in her/his bedroom. 18 All staff must receive training in basic food hygiene. 17(2) Accurate records must be kept of Sch 4, 18 the training attended by staff in adult protection issues. 23 Arrangements must be made for the garden to be maintained on a regular basis throughout the DS0000041946.V323660.R01.S.doc 21/05/07 16/07/07 21/05/07 18/06/07 Amblecote House Version 5.2 Page 24 7. OP30 18 year. The induction programme and training provision for newly appointed staff must be reviewed. All staff must be provided with individual training and development profiles that meet the National Training Organisation (NTO) specifications. Accurate training records must be kept for all staff. A comprehensive quality assurance system must be carried out and a development plan for the service produced. Arrangements must be made for staff to receive a minimum of six planned supervisions each year. All staff must attend relevant health & safety training courses. 16/07/07 8. OP33 24 18/06/07 9. 10. OP36 OP38 18 18 18/06/07 16/07/07 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 OP7 Good Practice Recommendations The manager is advised to provide staff with written guidance on carrying out reviews on service users care plans and risk assessments. Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Amblecote House DS0000041946.V323660.R01.S.doc Version 5.2 Page 26 - 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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