Inspection on 16/05/06 for Amelia House

This inspection was carried out on 16th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Amelia House 06/07/07

Amelia House 11/11/05

Amelia House 17/05/05

Amelia House 30/11/04

Amelia House 11/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Amelia House Amelia House Pocombe Bridge Exeter Devon EX2 9SX Lead Inspector Mark Sharman Unannounced Inspection 16th May 2006 09:45a 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 Amelia House DS0000003640.V289396.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. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Amelia House Address Amelia House Pocombe Bridge Exeter Devon EX2 9SX 01392 213631 01392 213631 AmeliaHouseRes@aol.com 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) Mrs Nuala Baxendale Mr Alan Baxendale Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to accommodate 18 service users (male or female) in the categories of old age, not falling within any other category (OP) and/ or Dementia - over 65 years of age (DE (E)). Date of last inspection 11/11/05 Brief Description of the Service: Amelia House is registered to accommodate up to 18 people aged 65 and over, including people with dementia (but not other forms of mental disorder). The home is near the A30 on the edge of Exeter, in a rural location with attractive views. It is a detached house approached via a steep drive and has a car parking area. There are level terraces at the front and back and an attractive (but steep) garden. There are residents bedrooms on the ground and first floors, and also a dining room and a lounge on each floor. Three of the bedrooms are double rooms but they are normally occupied singly. There is level access outside on to the terraces from both floors. The owners accommodation directly adjoins the home. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A pre-inspection questionnaire was completed by the home owners and sent to the Commission for Social Care Inspection before this inspection. Also received were six comment forms completed by residents and four forms completed by relatives. Any other information received from the home since the last inspection was also considered. About eight and a half hours were spent in the home at the inspection visit, and time was spent with the home owners. Several of the staff and most of the residents were spoken with, although some residents were unable to express an opinion due to their level of confusion. A sample of care records was examined. A tour of the building included all of the communal areas and several of the bedrooms. What the service does well: What has improved since the last inspection? Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 6 The one requirement made at the last inspection has been met. This related to the security of one of the bedroom windows, which has been further improved in order to prevent a fall from the window. The residents’ care plans are in the process of being rewritten to be more “user-friendly” to the care staff, for whom they are of course primarily intended. The terrace area at the back of the home has been made more secure, and therefore safer for confused residents to use when they wish to be outdoors. 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. Amelia House DS0000003640.V289396.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 Amelia House DS0000003640.V289396.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. Standard 6 is inapplicable. Quality in this outcome area is good. Prospective residents’ needs are assessed prior to admission to the home. EVIDENCE: All of the residents’ files examined contained an assessment of needs carried out prior to their admission to the home. These included assessments by local authority care managers and by hospital nursing staff (in cases where the resident was admitted to the home from hospital). Unless it is impracticable the home owners see any prospective new resident themselves, whether it be in hospital, at home or in another care home. Several recent examples of this taking place were discussed, and the inspector was involved in the case of two clients admitted a few weeks ago for respite care. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 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 the following standard(s): 7,8, 9 and 10. Quality in this outcome area is generally good. There is a care planning system which is being revised at present, which should be satisfactory when the revision is completed. Residents’ health care needs are well met and there is a safe system for administering medication to them. EVIDENCE: A sample of individual plans of care was inspected. They are in the process of being rewritten to be more “user-friendly” to the care staff, for whom they are of course primarily intended. They set out actions to be taken by staff to ensure that the residents’ health, personal and social care needs are met as far as possible. They now include an informative summary of the particular resident’s preferred daily routine, which is especially useful in the case of those residents who have difficulty communicating due to their confusion. The files examined included a risk assessment and a mobility assessment. The staff on duty who were consulted said they were able to access the care plans when they needed to. All residents are registered with general practitioners, and regular services are provided by a visiting optician, dentist, chiropodist and the district nursing service. There was evidence of this in the residents’ care records which were Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 10 seen. There was also evidence of involvement by members of the specialist mental health team with certain residents when requested. A concern was expressed recently by relatives of a previous resident that her health needs had not been adequately attended to during her stay in the home. This was considered during this inspection and subsequently, and the inspector has concluded that she was appropriately referred by the home to health care professionals for advice and treatment. The home’s disability equipment includes a stair lift, assisted bath, call system, mobile hoist and other equipment. For pressure area care there are several special mattresses and cushions, including some of the airflow type. An assessment (some were seen) is made as to the residents’ ability to manage their own medication. Current residents are unable to do this safely. Medication was locked away securely, and a sample of the medication administration recording sheets was examined. Medication training is provided to staff by the home’s supplying pharmacist, and two of the staff said they received this training in February this year. The last pharmacist’s report (9/1/06) was available. Residents spoken with were complimentary about the attitude of the staff, and indeed the staff on duty treated them respectfully. There are three bedrooms which can be used as double rooms, although they are used as single rooms. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is generally good. There is a range of activities available to the residents appropriate to their interests and abilities, and they are helped to follow their own preferred routines. The standard of catering is commendable. EVIDENCE: The Commission for Social Care Inspection survey forms completed by residents demonstrated reasonable satisfaction with the activities arranged for them. These include regular professional musical entertainment by two different entertainers, fortnightly exercise sessions run by an external trainer, music and story tapes, games and quizzes with staff. Mobile clothing shops hold a display and sale in the home from time to time, and one had been held very recently (some residents had made purchases). There are two cars available to transport residents. There was some discussion with Mr Baxendale about the difficulty of finding activities which hold the residents’ interest, and it was suggested that one person from among the staff should be designated as an activities co-ordinator. Several residents said that their relatives visit them in the home, and Mr Baxendale will transport residents as required. One resident said that he takes him to see his wife who lives in another care home. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 12 The residents’ survey forms demonstrated a high degree of satisfaction with the meals provided, which was confirmed by discussion with residents on the day. The cook is aware of their likes and dislikes, and one resident said that she is diabetic and her diet is planned for accordingly. The menus inspected showed a good variety. There is normally something cooked at tea time as well as at midday, which was the case on the day of the inspection. A bowl of fruit and a chilled water dispenser were available for residents in the hall. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18. Quality in this outcome area is good. The home has a complaints system and residents and relatives are confident that complaints will be taken seriously. There are satisfactory arrangements for protecting the residents from abuse. EVIDENCE: There is a complaints procedure which complies with the Standard, a copy of which was displayed on the notice board. The survey of residents and relatives demonstrated that they are aware of the procedure. The residents who were asked said they were confident that any complaint they might have would be dealt with by the home owners. In fact none of the residents expressed any complaint during the inspection. The home has a number of policies in place including whistle blowing, physical restraint and dealing with abuse, and staff spoken with were aware of their responsibilities. There are also policies in respect of residents’ finances, and precluding staff from receiving gifts and legacies from residents. Professional training for as many staff as possible on the protection of vulnerable adults has been booked in July, and the home also has its own training material. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 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 the following standard(s): 19, 20 and 26. Quality in this outcome area is good. The home is spacious and generally well maintained, and was clean. There are several communal areas, giving residents various options of where they can spend their time. EVIDENCE: The owners have consistently responded to requirements and recommendations relating to environmental matters, and there was evidence of ongoing maintenance taking place. In response to a recent health and safety audit of the building new fire signs have been installed, and improvements have been made to fire doors (a carpenter was working on this on the day of the inspection). Some of the residents’ bedroom windows have been made more secure since the last inspection of the home. There is a dining room and a lounge on both floors of the house, with level access outside from both floors enabling residents to go outside. The home was reasonably clean (including bathrooms and WCs), and residents (the more able) said that this is normally the case. There is a spacious laundry room. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 15 Amelia House DS0000003640.V289396.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. Quality in this outcome area is generally good. The staffing arrangements meet the residents’ needs, and the staff receive appropriate training for the work they do. Recruitment practice for new staff was satisfactory. EVIDENCE: This was an unannounced inspection and there was an adequate number of staff on duty to meet the residents’ needs. The staff rota was inspected. The cook was unable to be at work that day and so one of the carers had stepped into that role. The staff who were consulted said they felt that normally sufficient staff are on duty, which was confirmed by most of the responses in the survey forms received before the inspection. However it was noted that recently there have been only two carers on duty over the tea-time/early evening period for some days each week, and it was acknowledged that there has been some shortage since the departure of two staff. Mr Baxendale said that this would be improved by the arrival of two new carers later in the week, plus the return of one staff member who has been on maternity leave. The residents were complimentary about the staff at the home, and indeed the staff on duty during this inspection were observed to be competent and caring. Three staff files were examined and they contained two written references and Criminal Records Bureau disclosures. A disclosure was still awaited for one person who is a foreign national, although a police check had been done in his country of origin as part of the agency’s vetting procedure. In fact several of the staff are foreign nationals who are qualified nurses in their country of origin, and thus should be regarded as trained under Standard Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 17 28. Accordingly this Standard is met. The staff training file was examined, containing numerous certificates in respect of core training such as moving and handling, food hygiene, medication and fire training. Two of the staff on duty said that they had received moving and handling and medication training in the last few weeks. There was evidence of professional training having been booked in respect of dementia awareness and the protection of vulnerable adults in the next few weeks. The care manager said that new staff receive induction training. This was recorded for staff who had been employed for some time, but had not been recorded for the two newest staff members. Amelia House DS0000003640.V289396.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): 31, 33, 35 and 38. Quality in this outcome area is good. The home is closely managed by the resident owners, who are keen to keep improving the service. Health and safety arrangements are satisfactory. EVIDENCE: The owners have now had about 7 years experience of running the home. Mrs Baxendale is undertaking NVQ level 4 in management and care, and Standard 31 should be fully met when she has completed this. The owners live in adjoining premises and provide the sleeping-in cover at night. They are thus in regular contact with the residents and their relatives and thus able to receive feedback about the service provided. They have regular meetings with the senior care staff. A satisfaction survey has been conducted with residents and relatives in respect of the services provided, and the responses were analysed and collated. Mr Baxendale said this will be repeated in the near future. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 19 A sample of the records (including receipts) kept by Mr Baxendale in respect of personal money administered by him for residents was inspected, and was found to be satisfactory. With regard to health and safety matters, an annual health and safety audit was carried out by a business services consultancy in December. Their subsequent recommendations are being carried out, such as the replacement of strips in fire doors (being done on the day of the inspection) and the fixing of fire signs. The home’s fire log was inspected at this inspection and was found to be satisfactory. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 4 x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 21 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 OP27 Regulation 18 Requirement There must be a third staff member on duty on every day of the week during the tea-time and early evening period. Timescale for action 30/06/06 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 OP30 Good Practice Recommendations The induction training for all new staff should be recorded to provide evidence that appropriate training has been given. Amelia House DS0000003640.V289396.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Amelia House DS0000003640.V289396.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. 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