Inspection on 26/01/06 for Amerind Grove

This inspection was carried out on 26th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Amerind Grove 07/01/09

Amerind Grove 17/06/08

Amerind Grove 28/08/07

Amerind Grove 06/12/06

Amerind Grove 01/08/06

Amerind Grove 04/07/05

Amerind Grove 25/01/05

Amerind Grove 09/08/04

Amerind Grove 23/03/04

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 Amerind Grove Picador, Regal, Embassy, Capstan & Kingsway 124-132 Raleigh Road Ashton Bristol BS3 1QN Lead Inspector Vanessa Carter Unannounced Inspection 09:30 26 and 27 January 2006 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 Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 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. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Amerind Grove Address Picador, Regal, Embassy, Capstan & Kingsway 124-132 Raleigh Road Ashton Bristol BS3 1QN 0117 9533323 0117 9533406 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) BUPA Care Homes Limited Veronica Marsh Care Home 150 Category(ies) of Dementia (60), Dementia - over 65 years of age registration, with number (60), Old age, not falling within any other of places category (90) Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. Embassy House may accommodate up to 30 persons aged 65 years and over receiving residential care or nursing care. Staffing Notice dated 13/8/1998 applies Picador House may accommodate up to 30 persons with Dementia (DE or DE(E) aged 50 or over The Manager must be a Registered Nurse RN1 or RNA on the NMC register The Registered Nurse in charge of Picador Unit is appropriately qualified to meet the mental health needs of service users who reside there. Picador House may accommodate up to 30 persons aged 50 years and over with Dementia (DE or DE(E)) Capstan House may accommodate up to 30 persons with Dementia (DE or DE(E)) aged 50 or over The Registered Nurse in charge of Capstan Unit is appropriately qualified to meet the mental health needs of Service Users who reside there. 4th July 2005 Date of last inspection Brief Description of the Service: Amerind Grove is a 150-bedded BUPA care home, situated in the residential area of Ashton, approximately four miles from the city centre of Bristol. The home is situated within walking distance from the local shops, and is on a local bus route. The home is a purpose built care home, designed specifically to meet the needs of elderly and disabled residents. The home is split up into five houses, each with 30 beds and their own character. The five houses are each of bungalow design with level access, via their own entrance. The home manager, administrative and ancillary staff, all work from the main part of the home. Car parking for visitors is available in front of all houses. Three of the houses are registered for nursing care and two for EMI nursing care. All bedrooms are for single occupancy. The manager has been in post since May 2005, having previously been the registered manager of a smaller, BUPA care home in the Bath area. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two days. This was a focussed inspection and only a small number of standards were assessed. This brief report should be read in conjunction with the report of 4 – 8 July 2005, when a full announced inspection was undertaken, and the majority of standards were assessed. Evidence was gained from touring all five houses, speaking with a number of the residents, the registered home manager and clinical manager, the five house managers and in brief, some of the staff. What the service does well: What has improved since the last inspection? Five requirements issued following the last inspection have been complied with. • Pre-admission assessments are comprehensive, signed and dated • The complaints procedure is robustly followed • The standard of cleanliness throughout the whole home has improved • Fire training has been undertaken by all day and night staff. • Risk assessments and consent is obtained where bed rails are necessary. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 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. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 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 Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 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 The home’s pre-admission assessment process as been improved, to ensure that placement is only offered to those residents whose needs they can meet EVIDENCE: Improvements have been made to the homes processes in assessing and arranging admission of residents into the home. The home now ensures that social services care assessments are always obtained as part of the information gathering process. A pre-admission assessment tool is used and this is comprehensive, ensuring that a full understanding of each person’s needs is determined. The standard of recording on the assessments had improved from the last inspection, evidencing how the assessor had made the decision that the home could meet the person’s needs. These improvements will reduce the potential that placement is offered in an inappropriate environment. The assessments were signed and dated. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 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 and 8 The care planning system needs some minor improvements to ensure each persons needs are set out in a comprehensive plan of care. This shortfall could potentially mean that residents may not have some of their needs met. Despite this, it is evident that residents are well cared and have their health and personal care needs met. EVIDENCE: Seven sets of care planning documentation were inspected from the five houses. The plans were generally recorded on standardised BUPA paperwork, were well set out, and were supported with risk assessments in respect of pressure sore development, falls, nutrition and manual handling. A ‘Map of Life’ plan had been completed for each person, but the quality of these varied between the different houses. The maps gave details of the residents past life and gave an insight into social activities they might enjoy. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 10 Minor amendments were needed for each of the seven plans. One person on the dementia care unit did not have a care plan detailing their specific mental health needs, detailing the best approach for the care staff to take. Another person, who was identified as being at high risk of developing pressure sores, did not have a preventative plan of action in place. These shortfalls mean there is the potential that some care needs may not be met. Residents spoken to were very complimentary about the way in which they are cared for. One person said that she had been cared for very well when she had recently been unwell, and that the carers were kind and compassionate. Another resident said that the staff “always do their very best”. Reviewing of the plans is generally undertaken on a monthly basis, but there were some examples where changes to a persons needs had been detailed in the review but the plan had not been updated to reflect the changes. This has the potential to cause confusion. Effective reviewing and updating of a person’s care needs, and the actions required of the care staff, is essential to ensure that all needs are met. Care planning documentation records all contacts with other healthcare professionals, including the GP, chiropody, dentist and optician. Where items of equipment are needed to maintain the residents comfort (for example specialist air mattress), these are in place and appropriately used. Wound care plans were detailed and recorded all necessary instructions for the staff to follow. There was evidence of progress monitoring, with photography, and wound measurements. House managers and staff spoken with during the inspection showed a good understanding of the residents needs. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 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): 13 and 14 Residents are enabled to choose how they spend their time and visitors can visit the home at any reasonable time. EVIDENCE: A relative said the home always involves the family in the care of their relative. As part of the care planning documents, one “care plan” is named Friends and Family. The home maintains a record of all communication with family members. This is good practice however the format of the form should be changed as it is a family communication sheet, and not a care plan detailing actions that the care staff must take. Residents are able to choose what time to get up, go to bed and where they want to have their meals served. One resident had stated they wished to be assisted to get up and be ready for the day by 7.30am and this had been incorporated into their plan of care. Some residents choose to remain in their own rooms, preferring the quieter life. Residents were heard being asked where they wanted to go and what they wanted to do. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 12 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 Improvements have been made to the way in which any complaints are handled, meaning that residents concerns will be listened to and acted upon. EVIDENCE: The complaints procedure for the home is well displayed throughout the main reception area and all five of the houses. It is also included in the Service Users Guide supplied to all residents. Residents and relatives spoken with were aware of how to go about raising concerns. Since the last inspection CSCI have received one complaint, where the complainant did not feel their concerns were being properly addressed. As a result of this the home manager has ensured that the organisations complaints policy has been strictly adhered to. An examination of the complaints log evidenced that good records are maintained and the complainant is kept informed at all times during the process of investigation. The complainant is always advised of the outcome of their complaint and the actions the home proposes to take. On a monthly basis, the manager completes an audit of complaints to identify trends and areas where improvement can be made Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 13 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): Residents are cared for in a comfortable and safe environment. It is well equipped to meet the needs of the residents. The standards of hygiene are satisfactory but in some parts of the home, improvements must be made in providing a fresh smelling environment. EVIDENCE: Amerind Grove is a purpose built care home and is arranged as five separate single storey houses for 30 people each. The service facilities are all located in a sixth building. The grounds are surrounded by walled gardens, and the entrance has large steel gates that are locked over night. Fencing surrounds both dementia care units, enabling the residents to walk out in the gardens, without risk of straying too far. The houses are well maintained throughout and regular maintenance audits are undertaken. The home has an ongoing programme of redecoration and since the last inspection Regal house has been upgraded. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 14 The front doors to each of the homes are secured with a keypad door entry system, and all fire exits are linked into the call bell system. This creates a very secure environment for the residents. Each house has a large communal area consisting of a lounge and dining area. Furniture and furnishings throughout the home are of a homely nature and in good condition. The home is well equipped with a range of equipment to enable the care staff to undertake their duties and to move residents safely in line with good manual handling techniques. Residents each have a single bedroom, with fitted wardrobes and a wash hand basin. Improvements have been made with the standard of cleaning throughout the five homes however Picador house was malodorous in some parts. Some of the comfy chairs in the lounge area were offensive despite appearing to be clean. The home must address this to ensure that the environment remains fresh, clean and pleasant for the residents, their visitors and the staff. The housekeeping team has been enhanced by the employment of a senior team member whose role involves greater supervision of the housekeepers. The cleaning schedules have been revamped. Each house has 10 hours allocated housekeeping each day. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 15 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): The standards in this section were not assessed on this inspection. EVIDENCE: At the inspection in July 2005, the home scored 3 for all four standards. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 16 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): 37 and 38 Improvements must be made to some of the records kept to ensure they meet good record keeping guidelines. EVIDENCE: In general the standard of record keeping was good. However some of the entries made in resident’s notes were not easy to read. All records must be legible, and where required, must have a full signature and not just be initialled. When making entries about visits of other healthcare professionals, the person’s title should be used, not just their first name. A number of comments made in residents daily notes were written in a manner which could be misinterpreted – the nature of the recordings were discussed with the manager and do not need to be detailed in this report. All staff must bear in mind that residents can request to see their records, so entries must be accurate and appropriate. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 17 At the last inspection, two requirements were made in respects of health and safety and both have been met. Risk assessments are undertaken and consent obtained prior to the use of bed rails, and the fire training records evidenced that the staff team have received fire training. Staff spoken to also verified they had had training. Three senior personnel have attended a fire course that will enable them to instruct staff with regard to fire safety. Some items of electrical equipment throughout the home need to be ‘PAT’ tested – the maintenance person has recently undertaken the appropriate training and will be addressing this shortfall. Sluice room doors all display signage stating that the door must be kept locked, however were found open in two of the houses. Although no chemicals and cleaning products are stored in these rooms, it is good practice for them to be locked. Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 18 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 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 2 3 Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Each resident must have a comprehensive care plan, covering all identified need, detailing what actions the care staff need to take (Previous timescale of 08/10/05 not met) Timescale for action 26/02/06 2. 3. OP26 OP37 23(2)d 17(1)a The home must address the problems of malodour in some parts of the home. Residents records must be accurately and appropriately kept 26/02/06 26/02/06 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. 2. 3. Refer to Standard OP37 OP38 OP38 Good Practice Recommendations The home should rename the friends and family care plan to reflect the purpose of the recordings. All electrical equipment in the home should be ‘PAT’ tested to ensure its safety. Alternative means for securing sluice rooms doors should be explored DS0000020371.V271599.R01.S.doc Version 5.0 Page 20 Amerind Grove Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Amerind Grove DS0000020371.V271599.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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