Inspection on 24/10/07 for Ambleside

This inspection was carried out on 24th October 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

Ambleside 04/01/07

Ambleside 05/09/06

Ambleside 13/02/06

Ambleside 24/10/05

Ambleside 10/03/05

Ambleside 13/09/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Ambleside 6 Southside Weston Super Mare North Somerset BS23 2QT Lead Inspector Melanie Edwards Key Unannounced Inspection 24th October 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ambleside DS0000020268.V348657.R02.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. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ambleside Address 6 Southside Weston Super Mare North Somerset BS23 2QT 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) 01934 642172 F/P 01934 642172 Mrs Helen Humphreys Mrs Elaine Charlesworth Mrs Elaine Charlesworth Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (3) of places Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. May accommodate 20 residents aged 65 years and over who require nursing care. May accommodate up to 3 persons aged 65 years and over in need of personal care only. Manager must be a RN on Parts 1 or 12 of the NMC register. Staffing notice dated 24/05/2001 applies May accommodate up to 3 persons between 18 - 64 years of age, with Physical disabilities. 4th January 2007 Date of last inspection Brief Description of the Service: Ambleside provides personal care and nursing for up to 20 people aged 50 years and over who are elderly and in need of general nursing care. The home aims to provide a warm, friendly and homely environment. Visitors are welcome at any time and are encouraged to be actively involved in many aspects of the homes life. The home is set close to the town centre and is not far from the seafront. Local shops and other amenities are nearby. The home is on four floors and has a passenger lift accessing all areas. The current fee for the home is £537.37 per week. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector met nine of the nineteen residents at the Home. A number of visitors were also consulted. The owner Mrs Humphreys, the new manager Mrs Brown, two care staff, and a cook, were also consulted about their roles and responsibilities, their training needs, and how they assist and support residents. Staff were observed helping residents with their needs. A range of records relating to the day-to-day running and management of the Home were inspected. A selection of resident’s care records and care plans were reviewed. The majority of the environment was seen with the only areas not viewed being a small number of bedrooms. The ‘AQAA’ (an annual quality assessment document that all Homes are required to complete) has been used to help form the judgments in the report. The Home was operating within the required conditions of registration set down by The Commission. The conditions of registration set out the type of care of residents, and the numbers of residents who may stay at the Home. What the service does well: Residents are provided with a caring service centred on meeting their needs and wishes. Residents are looked after by staff who are kind and caring. There is a good emphasis on making sure that staff are trained and competent to do the work they do. The environment is kept very clean and well-maintained .The environment is homely and welcoming and suitable for residents to live in Residents are provided with a nutritious well-cooked diet and a variety of lowkey social and therapeutic activities to take part in. One resident said of the service, `it’s excellent very very good indeed ’. Residents feel very satisfied by how the staff are supporting them. Ambleside DS0000020268.V348657.R02.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. Ambleside DS0000020268.V348657.R02.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 Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6. Quality in this outcome area is good. Residents’ needs are being properly assessed by the Home. Residents and other representatives have the information they need to make a choice about whether to live at the Home. The Home does not provide intermediate care for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the service users guide and statement of purpose were read. Residents are given their own copy of the guide so they have the information they need about life in the Home. There is information about the service provided, the qualifications of the staff employed, and the accommodation. The way the service aim to meet resident’s needs is written about, as well as the philosophy of care. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 9 There were many comments of satisfaction expressed by residents about the care and overall service that the Home provides. Examples of comments made by residents included, ‘ the staff are very good, the service is very good’, and, ‘I think the staff are doing well’. These comments were reflective of all the comments made by residents. Two residents nursing assessment booklets were read to find out how well nursing needs are assessed, (each resident has there own assessment booklet). The assessments were informative, and showed the residents had been consulted about their range of physical, mental and social needs. There were assessments in place for each resident, that showed the Home had assessed the persons skin vulnerability and the risk of them developing pressure sores There were also moving and handling assessments that set out how best to support the resident safely with their mobility needs. The care plans were up to date and had been written based directly on the information in the assessment records, (see next section of report). Ambleside DS0000020268.V348657.R02.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. Residents’ are well cared for and care plans show how to support residents with their range of needs. The practises and procedures for handling residents’ medication are safe. Residents are treated with respect by staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were read to find out how residents are supported by staff to meet their nursing needs. The care plans were reasonably informative and detailed how to meet the care needs of the person. The care plans stated what actions staff must follow to assist the resident to meet their needs. They had been written from an initial assessment of what the person’s needs were and what support and help they need. This assessment process helps ensure residents’ needs are clearly identified. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 11 Care plans had been reviewed and updated regularly by registered nurses. This demonstrates residents’ health needs are being monitored and kept under review. All of the residents consulted said that staff are helpful, kind and caring, when they help them with their needs. The residents also spoke very positively about the respectful and very polite attitude of the staff who help them. All of the staff on duty were helping residents in a polite and respectful way. The procedures for the administration, storage and disposal of medication were reviewed . Medication to be dispensed is stored in a locked wall mounted cabinet. The medication administration charts of five residents were checked. There was a photograph of the resident maintained with each record. The charts were up to date, legible and contained the signature of the registered nurse giving out the medication, as well as the reasons for any omissions. The controlled drug record was in order, and one resident’s supply of controlled drugs was randomly checked .The records were correct. This helps to show residents medication stock is well organised. Ambleside DS0000020268.V348657.R02.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): 12,13.15.Quality in this outcome area is good. Residents are provided with a nutritious well-cooked diet and a variety of social and therapeutic activities that are suitable for their needs. Residents are supported to receive visits from family and friends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a social activities calendar on display in the hallway letting residents know about activities and events that are going to take place. There are a variety of low-key social activities in the Home. There is a weekly gentle exercise group that takes place. There is also a weekly musical afternoon with a local entertainer. A number of residents said they enjoyed these afternoons. An aroma therapist visits the Home on a regular basis. The aroma therapist came to the Home during the inspection and a group of residents had hand massages, and looked very relaxed. There is a hairdressing service provided during the week, and a number of residents have their hair attended to on a regular basis. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 13 A sample of the lunchtime meal was tasted .The choices were either baked ham in a cheese sauce with mashed and boiled potatoes, fresh cooked cabbage, and mashed swede or roast lamb with the same vegetables. The meal was tasty, and satisfactorily cooked. There were also several choices of dessert. Staff worked hard to ensure residents were served their meals promptly and politely. Residents’ meals are served to them either in their rooms or in the dining room. At meal times dining tables are covered with tablecloths and there are table settings and condiments at each table. Residents were observed receiving visits from their family and friends. Visitors said that the staff are welcoming and friendly .The Home has a relaxed and flexible visiting policy this benefits residents as this means they can keep in contact with family and friends. Ambleside DS0000020268.V348657.R02.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. Residents’ are protected from abuse, and they can be confident that complaints are taken very seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In the Home there is a copy of the complaints procedure on display on each floor. The procedure has our name and address for anyone who wishes to contact us to make a complaint. The contact details of the owners are also available if people need to make a complaint to them. The residents who were asked said that they would feel able to speak to the manager or any of the staff if they had a concern or a complaint. This helps to demonstrate the Home is receptive and `open’ to receiving complaints. The complaints record was looked at to find out how well complaints are dealt with. There had been no complaints received since before the last inspection. Staff go to training run by the Local Council to make sure they are up to date in their understanding of the principle of the protection of vulnerable adults from abuse. The care staff also undertake training on the subject of how to protect residents from abuse as part of the National Vocational Qualification in care award. There is an up to date policy in place relating to the issue of protection of vulnerable adults from abuse. Staff were aware of the policy and the actions they must take to protect residents. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,22,23,25,26.Quality in this outcome area is good. Residents live in an environment that is satisfactorily clean and well maintained. The Home is suitable for residents to live in and has the necessary adaptations and equipment in place to meet residents’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ambleside Care Home is an older Victorian property. The Home is built over three floors, and there are stairs and a lift to each floor. The building is over one hundred years old. It is located in a central residential area of Weston Super Mare. It is near local shops, a church, and local bus routes. Specialist equipment and adaptations are in place throughout the Home, to assist residents and visitors who may have reduced mobility. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 16 Accessible toilets are located close to the dining rooms and lounges. The bathrooms and toilets were clean and well maintained and were free of any unpleasant odours. The majority of bedrooms are for single use. There is one double room that is currently used as a single room for one resident. Rooms were satisfactorily decorated and maintained. The environment was generally clean and tidy throughout. Bedrooms have been personalised to reflect the tastes of residents with photographs, mementos and small items of furniture. The standard of furniture and fittings is satisfactory and residents asked said they liked the environment and setting of the Home. There is a dining room, a spacious lounge with a library room attached to it and a lounge located on the top floor. There is also an arts and crafts room, where residents take part in pottery classes and painting sessions. Residents were observed sitting in communal areas looking very relaxed and comfortable in the surroundings. The environment was clean and satisfactorily maintained. The Home was well ventilated and warm with plenty of light. The radiators had been fitted with guards throughout helping maintain residents’ health and safety, so that they do not risk burning themselves. The residents and visitors reported that a very high standard of cleanliness is maintained. There was soap and hand-towels available in the toilets and bathrooms to minimise the risks of cross infection in the Home. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30.Quality in this outcome area is good. Residents are cared for by a sufficient number of competent trained staff. The Homes recruitment procedures are safe and protect residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff duty record for this month was checked to see how many staff are on duty to support residents with their needs. There is always one registered nurse on duty and at least three staff on duty during the core hours of the day including at least one senior member of staff. There are two members of staff on duty at night. There are also two chefs, laundry assistants, and domestic staff employed. All of the staff on duty communicated and supported residents in a warm and friendly manner. Extra staff are also on duty on regular occasions when required. Registered nurses and care staff are provided with regular training on a range of topics relevant to the needs of residents. Registered nurses also regularly attend clinical course run by the local Primary Care Trust. This helps them to keep their nursing knowledge up to date. Several care staff have now completed National Vocational Qualification in care award to Level 3.They are now being given more day to day responsibility in the Home and are also supervising other less senior care staff. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 18 In discussion with two care staff they were positive about the range of training and development opportunities that are provided for them to assist them in their work and practice. The staff employment files of the two most recently recruited registered nurses were checked to see if all staff have two written references and Criminal Records Bureau checks taken up before they start work. All the staff had had a Criminal Records Bureau Checks and ‘Protection of vulnerable adults from abuse first’ check carried out on them before they started work. This is to ensure staff are judged to be suitable to work with vulnerable people. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,36,37,38.Quality in this outcome area is good. Residents’ benefit from having experienced management running the Home in their best interests. Staff are regularly supervised in relation to the work they carry out in the home. This makes staff more skilled and knowledgeable in the work they do caring for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Brown is the new manager of the Home. She has previously been the Deputy manager for seven years. A number of residents spoke very positively about the previous manager, and about Mrs Brown who they said was ‘very kind’, and ‘very helpful’. Mrs Brown is a first level registered nurse, with many Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 20 years of experience in Care Home work .She is not yet registered with us as the manager, although she is in the process of sending us an application. Mrs Humphreys one of the owners of the Home takes a `hands on’ approach. She spends time on a regular basis in the Home .A number of residents know who she is, and said she was `very nice’. During the inspection Mrs. Humphreys spent time with residents talking with them and serving them drinks. The staff said they are provided with regular support and supervision of their work and practises. The staff supervision records of two staff were seen. These records showed that staff are supervised and supported in the work they do. The confidential records of residents are kept securely locked away in the Home’s office, and are available to staff if when needed. The records seen were legible, up-to-date and in satisfactory order. The staff do regular training in health and safety matters including first aid, food hygiene training and moving and handling practises. There is also a range of health and safety polices and procedures for staff to follow. These are to make sure staff keep themselves and residents safe while they carry out their duties. This will help protect residents’ health and safety if staff stay up to date and trained in health and safety principles and practices. The fire logbook records show that fire alarm tests are carried out regularly. There are also fire drills carried out on a regular basis to help protect the health and safety of residents and staff. The kitchen was tidy and organised when viewed .Up to date checks of kitchen fridges and freezers are maintained to ensure they operate within food safety guidance levels. The temperature records showed `high risk’ foods are temperature probed before serving to ensure the food has reached above minimum required temperature. Food that had been cooked, and stored in the fridge for use at a later date was being suitably covered and had the date recorded, when it was put there. This is required to ensure food is eaten in a safe timescale. Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 3 X 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 3 3 Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 22 N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Ambleside DS0000020268.V348657.R02.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!