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Inspection on 29/09/05 for Amethyst House Care Centre

Also see our care home review for Amethyst House Care Centre for more information

This inspection was carried out on 29th September 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a very homely atmosphere created where the residents were able to make friends in a clean environment offering a good range of communal lounges. The residents were very complementary about the choice of meals, both the way they are prepared and served. Service users were also complementary about the activities that are offered on a regular basis. When service users need personal care this is provided in private and in a way that does not draw attention to them.

What has improved since the last inspection?

There has been a laundry shoot installed to minimise possible injury to staff who had to carry laundry down steep steps. The way that complaints are recorded and followed up has improved.

What the care home could do better:

The program of training for care staff to National Vocational Qualification level 2 will not result in 50% of staff being trained to this level by 1st January 2006.

CARE HOMES FOR OLDER PEOPLE AMETHYST HOUSE CARE CENTRE Sheepbridge Lane Rossington Doncaster DN11 0EZ Lead Inspector Alan Bartrop Unannounced 29 September 2005 :09:00 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 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. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Amethyst House Care Centre Address Amethyst House, Sheepbridge Lane, Rossington, Doncaster, South Yorkshire, DN11 0EZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01302 866226 01302 865415 Ashbourne Homes Limited Mrs Susan Seale Care home only 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: . One specific service user under/over the age of 65, named on variation dated 23rd August 2004, may reside at the home. Date of last inspection 9-May-2005 Brief Description of the Service: Amethyst House is a care home for older people providing personal and nursing care, registered for 39 service users.The accommodation is a converted older building with a new extension.The home is situated in the village of Rossington, near Doncaster.The home has well maintained gardens that are level, save and accessible to people who use wheelchairs or have mobility problems.The home is owned by Ashbourne Homes. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that started at 09:00 and finished at 15:00. The inspection included speaking to service users, reading records and case files, a tour of the home, talking to staff and the care manager, and sampling a lunch. The general manager was on holiday and the service was represented by Jill Huthings on the day. What the service does well: What has improved since the last inspection? There has been a laundry shoot installed to minimise possible injury to staff who had to carry laundry down steep steps. The way that complaints are recorded and followed up has improved. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 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. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 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 standard(s) 3,6 Service users were assessed by the manager prior to being admitted to the home. The home does not admit residents who are classed as needing Intermediate Care. EVIDENCE: The home is not registered for Intermediate Care residents and there are no dedicated facilities for such a group. Records are kept of assessments of need carried out by the manager prior to the residents being admitted. Should a resident being considered be outside of the Registration Category for the home, Commission for Social Care Inspection are contacted to discuss the case so that only appropriate care is offered. Very few residents are admitted without the involvement of Local Authority social workers to help ensure that the home can provide appropriate care for the individual. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 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 standard(s) 7,8,9 All service users have a care plan and records are kept of the care they received on a day-to-day basis. Health issues are included in the care plans and medication is administered appropriately by trained nurses. EVIDENCE: Care plans were inspected, these included details of the care to be offered and the way it should be done. Changes to the care plan are easy to see and draw the staff’s attention to the changes, so that care can be altered to meet the new need. Medication is recorded accurately on the medication administration record & request and any alterations to the medication regime are correctly written in. Controlled medication is appropriately stored and administered with records showing a running balance of what remains. Medications that need to be returned are taken back by the prescribing pharmacist or sent to a registered contractor. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 10 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 standard(s) 12,14 There is a good range of activities offered and these are published in a program that is given to each resident. The service users are encouraged to make their own decisions about their daily lives. EVIDENCE: Programs seen in different parts of the home that state the planned activities for the month. Activities organiser was very involved in giving residents choices about what they wanted to do, and encouraging people to join in with craftwork. Day trips and half day trips are organised to give residents who find a full day too much to go out for shorter periods. Staff were heard giving the residents choices and giving them time to reply without being rushed so that the residents who could not respond quickly were still able to offer an opinion. The residents confirmed that there was always a choice of meal offered and that if they didn’t want either choice they were provided with something different. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 11 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 standard(s) 16,18 The complaints procedure requires that all complaints are recorded and that a log is kept in the front of the file so that any trends can be identified. There is a comprehensive adult protection procedure that the home follows. EVIDENCE: The complaints log was inspected and found to be up to date with complaints logged chronologically. There is a complaints procedure that identifies the Commission for Social Care Inspection as a body to contact directly if the complainant wishes. The complaints were recorded in detail and all of them recorded an output from the investigation and that the complainant was notified. The complaints inspected had been handled promptly and the investigations carried out competently. The adult protection procedure is based on the Department of Health Practice Guide. This is available in the office for all staff to follow if they have any suspicions that things are not right. Should an allegation be made a report is made to Doncaster Metropolitan Borough Council Adult Protection as part of the procedure. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 12 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 standard(s) 26 The home is kept clean and free from unnecessary obstructions. EVIDENCE: A tour of the building indicated that the cleaning regime covered all the resident’s areas with sufficient frequency so that the home was kept clean with minimum disruptions to the service users. The corridors were kept clear of stored items which meant that the service users who used wheelchairs were able to travel around the home with the minimum of assistance by the staff thus maintaining their independence. Bathrooms ant toilets were clean and pleasant to use. All the chemicals seen were stored and/or used appropriately. Staff confirm that they have training on the use of chemicals so that they and residents are not put at risk. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29,30 The home follows a company wide recruitment policy that meets the requirements of Commission for Social Care Inspection and there is a good training plan to ensure that the staff are able to meet the needs of the residents. EVIDENCE: Personnel files were inspected and they contained all the details necessary to ensure the member of staff met the National Minimum Standards. Criminal Records Bureau checks are carried out and these are renewable every 3 years. All staff receive induction training that covers the basic aspects of the type of care they should offer and the general running of the home. There is a comprehensive training register kept so that the member of staff can have their training planned systematically. Discussion indicated that each member of staff gets three paid days training each year. The home has a commitment to training care staff up to National Vocational Qualification level 2. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35,38 A laundry shoot has been fitted to reduce the risk of injury to staff taking dirty washing down the steep steps. Re resident’s money is held by the staff and records are kept to show where the money is deposited and how much is available to each person. EVIDENCE: The laundry shoot has been fitted since the last inspection and is working as designed. Resident’s money is recorded on a balance sheet that enables an audit trail to be carried out. Not all balance sheets were accurately kept, this was discussed and improvements to the records were suggested. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 15 The monies checked were accurate and cross referenced with the bank account. When a resident’s money builds up it is transferred to a communal bank account and records kept of this transaction. Where service users do not have enough money in their account to pay for a service their balance should be shown as a negative amount. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 17 no 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. 1. 2. Standard 28 35 Regulation 18 20 Requirement 50 of care staff are trained to level 2 When an error is made on financial accounts, it is crossed through with a single line and not obliterated Timescale for action 31st December 2005 20th October 2005 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 33 35 35 Good Practice Recommendations Minutes of the resident/relative team meetings are produced promptly and made available for inspection. Where residnets are able and willing to hold their own personal allowance, or part of it, they do so. When services are paid for and the resident does not have enough money in their account, this is shown as a negative balance. AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 18 Commission for Social Care Inspection First Floor Barclay Court Heavens Walk Doncaster South Yorkshire DN4 5HZ 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 AMETHYST HOUSE CARE CENTRE 20050929 Amethyst House X00015 UI Stage 4 S15849 V214591 J55.doc Version 1.40 Page 19 - 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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