Inspection on 06/07/07 for Amelia House

This inspection was carried out on 6th July 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

Amelia House 16/05/06

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 Stella Lindsay Key Unannounced Inspection 6th July 2007 10:00 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.V335019.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. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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 Mrs Nuala 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.V335019.R01.S.doc Version 5.2 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)). To accommodate a named person out of category 2. Date of last inspection 16th May 2006 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 beside 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, and level access via the back door. There are level terraces at the front and back where residents may sit, and a pleasant (but steep) garden leading down to the road. There are residents bedrooms on the ground and first floors, and also a dining room and a lounge on each floor. All bedrooms are for single occupation. There is a stair lift. Current fees range from £369 to £420 depending on care needs as well as facilities provided. An inspection report is available from the office on request. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days in July 2007. It involved a tour of the premises, and discussion with the home owners, four staff on duty and discussion or observation with ten residents. Care records, staff files, and health and safety records were examined as well as the medication system. The Home owner had supplied additional information prior to the inspection, and surveys had been received from residents’ relatives and a random sample of staff. Their views are represented in the text. The inspector shared a meal with residents and spent some time in the lounge, as well as visiting some residents in their private accommodation. All required core standards were inspected during the course of this inspection. What the service does well: What has improved since the last inspection? A major building programme has taken place, providing four fine new rooms. All bedrooms are now considered to be for single occupation, including those large enough to have been used as double rooms in the past. This is a great advance in meeting the needs of residents for privacy and dignity. The staff group has been very stable, with few changes, which is very important for the residents. Staff had evidently developed good understanding with residents. A requirement was made at the last inspection for a third carer to be on duty during the tea-time and early evening period, and this had been met, with three carers on duty at all times from 8am till 8 pm to ensure that care needs are met. Induction training had been improved, to ensure that staff are competent and well prepared to fulfil their roles. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 Page 6 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. Amelia House DS0000003640.V335019.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 Amelia House DS0000003640.V335019.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): 1,3 Quality in this outcome area is good. Clear information about the home is produced, and prospective residents’ needs are assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Amelia House has a clearly written Statement of Purpose which is very informative about the service provided. It supplied to prospective residents and their representatives, and a copy is available on request from the office. The Manager always meets prospective residents and their relatives as part of the assessment process, even if this entails a considerable journey. Accommodation is offered only if the Manager is confident of the home’s suitability to meet the person’s needs. This agreement has been made in writing when the person or family are acting independently without support from Social Services. Trial periods are offered. When people move in they have one month built into their occupancy agreement to decide whether this is the right place for them. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Residents’ personal and health care needs are well met and there is a safe system for administering medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident had a care plan. A sample were examined and they were seen to have been checked regularly by care staff. They would benefit from having a summary of the daily routine as preferred by the resident, and to have some personal history, particularly for those residents who have difficulty communicating. The home was just about to take delivery of a new system of care recording which should be entirely suitable, and includes risk assessments and social assessments. Residents said they were happy with their care – ‘they look after us well’, and ‘they call a doctor when I need it’ were typical quotes. Staff were seen to be attentive and had a gentle approach to residents. There was much evidence of working in a collaborative way with health and social care professionals. Staff had been given specific training on the care of Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 Page 10 a resident with diabetes. Advice was being sought from the Community Mental Health Team at the time of this inspection. All residents are registered with general practitioners, and regular services are provided by a visiting optician, dentist, chiropodist and the district nursing service. The medication system was seen to be administered with care. It would help assure correct administration if the Medication Administration Record sheets were kept in a ring binder with dividers between each resident’s records, with a photo of the resident to assist identification. Variable dosage (PRN) tablets were being recorded in residents’ daily record sheets. They should be recorded with the other medication records, along with the reason for giving them and the dose given. A relative returning a survey said that the staff are very patient and caring, and treat residents with respect and as individuals. Residents were seen by the inspector to be treated with courtesy at all times. Their privacy and dignity have been promoted by the recent provision of four new bedrooms which resulted in the homeowners being able to offer all accommodation in single rooms. It would be good practice in the interests of privacy and dignity to provide the chiropodist with some place other than the lounge for giving treatment. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. The social life within this home is relaxed and pleasant, but would benefit from the promotion of individual activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The atmosphere within the home is relaxed and friendly and all the staff and management are commended for this. Some staff may need support to improve their provision of appropriate social and cultural support. Work on peoples’ life stories could produce ideas of interests to follow, and there is further potential for residents to be engaged in tasks in the home. There is a kitchenette on the first floor that could be used for domestic activities. Some residents appeared to be taking notice of the television in the lounge, but some objected to the argumentative voices of the chat show. Music of the ‘50’s and 60’s was seen to be well received. The home owners help celebrate special occasions including birthdays with a cake and a special tea, inviting relatives to join in and sometimes providing entertainment. Regular professional musical entertainment is provided by two different entertainers, and fortnightly exercise sessions are run by an external trainer. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 Page 12 Residents had bought clothes from mobile clothing shops that had held a display and sale in the home. The home has a vehicle for transporting residents, but at the time of this inspection only the home owner was able to drive it, so residents would be likely to need a taxi for outings of any sort if they had no family or friends to take them. A Church service is held in the home every month. Some residents chose to take their meals in their rooms, and two needed to be fed due to their disabilities. A group of men regularly dine in the upstairs dining room, while a relaxed group of about ten residents ate in the main dining room. The lunch served during this inspection was suitably soft and tasty food. Staff gently encouraged and helped people to eat. The home owners said that fresh vegetables are normally supplied. One resident had salad instead of the vegetables served, and two residents who had gone out had their meals saved for them. Residents who spoke to the inspector all said they were very happy with their meals. They did not know what they would be getting, but they were confident that they would enjoy it. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Residents feel that their voices are heard, and they are protected from harm by a qualified and caring staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure which is given to new residents and displayed in the entrance hall. One complaint was received during the past year, which was not found to be upheld. It was dealt with in a careful and professional manner. The residents who were asked said they were confident that any complaint they might have would be dealt with by the home owners. None of the residents expressed any complaint during the inspection. The home had a policy and procedure for the protection of residents from abuse. The section on what to do in the event of any allegation being made needed to be clarified, so that the correct action would be taken if ever it were necessary. The home also has policies in place including whistle blowing, physical restraint and policies in respect of residents’ finances, and precluding staff from receiving gifts and legacies from residents. Staff had been trained in awareness of abuse issues, and were seen to communicate with residents in a way that would promote their dignity. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,26 Quality in this outcome area is good. Residents’ private accommodation is attractive, safe and comfortable, and there is a choice of communal areas. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Amelia House is a detached house set on a hillside on the edge of Exeter. There is a car parking area beside the house. The most accessible entrance is via two shallow steps to the back door. The home owner has a continuing plan for improving the property and facilities. Maintenance is on-going, with necessary work on roof repairs planned. Smaller items tasks are dealt with immediately, as the home owners live next door and are on hand to deal with problems as they arise. There is a dining room and a lounge on both floors of the house, with level access to outdoor patios from both floors (because of the house being set on a Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 Page 15 hillside). Both patios are very pleasant, but the lower one needs either a gateway or partially resurfacing to assure the safety of residents using it. There are two bathrooms. The home owner had entered into discussions with builders for their refurbishment. A major building project had provided four fine new bedrooms. All bedrooms now are for single occupation. Many have large windows and good views. Suitable locks had been fitted, so residents can lock their own door from the inside for privacy by turning a knob, but may have a key to lock it from the outside if they are able to manage this. Lockable boxes are provided for any residents who are able to use them to secure any valuables. The laundry was large and well organised. Its walls, though not smooth, have a coating of washable paint. There is no handbasin, staff go to the kitchen to wash their hands if the nearby bathroom is occupied. Cleaning is done by two care staff in the mornings after personal care and breakfast, while the third attends to residents in the lounge. Some lounge furniture had been missed and was in need of cleaning. The home owners should consider how these had been missed. In general the house was clean and well presented. Staff training in Control of Infection had been provided. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 30 Quality in this outcome area is 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This was an unannounced inspection and it was seen that there were enough staff on duty to meet the residents’ needs. Three carers are on duty at all times from 8am to 8pm, although this includes cleaning duties. Two mornings per week there is an additional Senior to deal particularly with health and social care professionals and with ordering medication. The cook works 8 – 2pm every day, and the home owners are frequently on hand although their expected hours are not written. 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. At night there is one carer on duty, and the home owners are on call. If they are away, another carer is on sleeping-in duty on the lower ground floor. Staff all said that communication between staff and management is good, and that they are given the support they need to do their work. 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 28. One was undertaking NVQ3 in Care. Accordingly this Standard is met. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 Page 17 The staff group is settled, so there had been little need for recruitment recently, which is very good for consistency of care and for ability of staff to communicate with residents. The files of two fairly recently appointed staff were examined. References , proof of identity and Criminal Record Bureau clearances had been obtained, to assure the safety of residents from potential harm. New staff had completed an induction programme for this house, and enrolled on language courses where necessary. The Skills for Care Induction course was available. Other training recently provided for staff included First Aid, Moving and Handling, Control of infection, Adult Abuse awareness, and Dementia Care. Training needs were due to be reconsidered in individual supervision with the home owner. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Amelia House is well run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owners have now had about eight years experience of running the home. Mrs Baxendale has almost completed a City & Guilds qualification in management. 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 they receive continual feedback about the service provided. Formal staff meetings are not held, but the home owners speak with staff individually and in groups, and staff who spoke to the inspector and those who returned surveys considered that they are well managed and the home is well run. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 Page 19 The Home owners employ professional advisors in respect of employment matters. All policies are reviewed annually. A health and safety ‘Activity Matrix’ is maintained, to evidence weekly and annual checks that are carried out to assure the maintenance of safety within the home. Informal feedback is continual, and in May 2007 a questionnaire was circulated to gather systematic feedback. This showed that residents were either ‘very satisfied’ or quite satisfied’ on all counts, and 100 ‘very satisfied’ on many issues including staff’s attitude and the way they carry out their work and the owners’ efforts to create a good atmosphere and get things done when asked. A sample of the records (including receipts) kept by Mr Baxendale in respect of personal money administered by him for three residents was examined, and was found to be satisfactory and accurate. Other residents are billed for incidental expenditure such as hairdressing and chiropody. The arrangements with regard to fire safety were examined and found to be satisfactory. Accidents are reported and recorded, and medical advice sought as appropriate. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 X 4 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 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. 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. 1 2 3 4 5 6 Refer to Standard OP9 OP10 OP12 OP18 OP19 OP26 Good Practice Recommendations Administration of variable dosage medication should be recorded with the other medication records, along with the reason for giving them and the dose given. The chiropodist should be provided with a room other than the lounge for providing treatment to residents. Social activities in response to individual interests should be promoted. The home’s procedure on the Protection of Vulnerable Adults from abuse should include the local arrangements to inform the Social Services Adult Protection team. The front patio should be made safer for residents. The home owners should consider providing dedicated time for cleaning. Amelia House DS0000003640.V335019.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 - 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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