Inspection on 02/10/06 for Amicus Care Home

This inspection was carried out on 2nd October 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 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

Amicus Care Home 20/02/06

Amicus Care Home 04/10/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Amicus Care Home 5 Hillside Avenue Frindsbury Strood, Rochester Kent ME2 3DB Lead Inspector Sue McGrath Unannounced Inspection 2nd October 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Amicus Care Home DS0000064892.V314353.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. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amicus Care Home Address 5 Hillside Avenue Frindsbury Strood, Rochester Kent ME2 3DB 01634 718386 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 Brenda Iona Slattery Mrs Brenda Iona Slattery Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration is restricted to one service user who has a diagnosis of Dementia whose date of birth is 18 March 1913. 20th February 2006 Date of last inspection Brief Description of the Service: The home cares for 18 older people, in a warm and friendly environment. The accommodation consists of 16 single rooms, 12 of which have en-suite facilities. Stairs or a chair lift can access the upper floor. The home has three bathrooms; the lower floor bathroom has an assisted hoist. The day areas are comfortable and homely. The home is situated in the residential area of Strood. Bus and train services are available nearby and there is good access to the local shops and amenities, although the surrounding area is a little ‘hilly’. The home is surrounded by very pleasant and well-maintained gardens, which has easy access for service users. There is some parking on site. The home is not registered for nursing care. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place over the course of a day and a half. The key inspections for care home services are part of the new methodology for The Commission For Social Care Inspection, whereby the home provides information through a questionnaire process and further feedback is gained through surveys sent to service users and relatives and information provided from professionals associated with the home, wherever possible. The actual date of the site visit is unannounced. At the site visit, service users and staff were spoken with, records were viewed and a tour of the environment was undertaken. Some judgements have been made through observation only. Amicus Residential Home offered a caring and homely environment in which to live. It had recently increased the number of bedrooms, all of which were tastefully decorated. The living areas looked comfortable with one large lounge, one smaller quiet lounge, a conservatory and a separate dining room. All of the service users spoken with were very happy with their private rooms and had been encouraged to bring in their personal items to enhance their rooms. All bedroom doors were lockable and each room had a lockable drawer for private items. All of those spoken with were very happy with the level of care and support offered. Excellent interaction was seen between staff and service users. Families spoken with said that staff were always caring and friendly and treated their loved ones with dignity and respect. The home had an open policy on visiting times and visitors said they were always made welcomed. Service users enjoy a good level of activities and have regular spiritual support. All agreed that the food was of a high standard and that drinks were freely available at all times. Menus seen indicated that a variety of food was on offer and that a choice was given. Specialist diets could be catered for. The home currently does have some vacancies. Staffing levels were adequate and 90 of care staff had achieved NVQ level two in care, some were currently working towards level three. Some mandatory training needed to be refreshed but the manager had recently employed a training consultant to ensure these courses were brought up to date. Staff were supervised by senior staff. The service users enjoyed the home’s gardens and one in particular took great pleasure in assisting the gardener, particularly in planning the flowerbeds. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 6 Some parking was available to the front of the building or on the road outside. The building was well maintained. On the day of the inspection the majority of the service users were spoken with. One visiting family member was also spoken with. Phone conversation also took place with three other families and the exercise therapist the following day. One care manager was also contacted and confirmed that she had no complaints about the home and was happy to place clients there. Information was also taken from the pre inspection questionnaire completed by the owner. Fees: £320-£400 per week. Two requirements have been made regarding staff training. The inspector on leaving the home was satisfied that service users were both safe and well cared for. What the service does well: What has improved since the last inspection? Four of the bedrooms and the lounge have been decorated as part of the rolling maintenance plan. Care planning had improved from the last inspection and continues to be developed. The hairdressing room is now fully operational and enjoyed by the service users. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 7 Access to the garden had been improved and a new rockery had been built. 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. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 8 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 Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4,5 Quality in this outcome area is good. Prospective service users are provided with the information they need to make an informed choice about moving into the home. Residents benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. EVIDENCE: The manager had updated the statement of purpose to reflect the recent changes in the home’s numbers. A service users guide was also available however these were not freely available. The majority of the families spoken with had not received a copy and consequently some helpful information had Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 10 not accessed. It is recommended that all service users be given the updated copy of the service users guide and the statement of purpose. It is also recommended that more use be made of the statement of purpose when new service users are admitted to the home. This would ensure that all information is given to all interested parties. The home carries out comprehensive assessments prior to admission to ensure they can meet the needs of any prospective service user. The manager is happy she obtains all of the relevant information required. All have the opportunity to visit the home prior to admission and have a minimum of one month’s trial to ensure they are happy to stay. Where possible families are encouraged to be involved with the admission process. Written contracts were seen for service users. The home does not offer recuperative care or nursing care. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10,11 Quality in this outcome area is good. Service users have choice over their personal care and are encouraged to be independent and responsible for their own personal hygiene where possible. The health and personal care offered is based on the individual needs and the principals of respect, dignity and privacy are well met. Spiritual needs are well met. The home administers medication efficiently. EVIDENCE: The owner has worked hard to develop new care plans. These were viewed and found to be comprehensive and to give good guidance to staff. Each individual area of care had been reviewed and action for staff detailed. The daily reports were kept separate and the one area of concern was that by keeping these separate, staff might not be as fully aware of the care plan as was expected. Consideration must be given to merging the two documents Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 12 thus enabling all information on one service user to be kept in one place. When spoken with none of the service users had any understanding or knowledge of these care plans and it will be recommended that where possible they are involved with the drawing up of the plans and where possible signed to say they agree the plan. Standard (7.6) It was evident from records and from talking to the staff that they had a good understanding of skin integrity and the prevention of pressure areas. Some pressure relieving equipment was available. No service user currently had any pressure areas. Service users were encouraged to maintain their mobility levels and were encouraged to participate in the regular exercise sessions that were carried out by qualified person. It will be recommended that nutritional risk assessments be carried out on the existing service users and for any new admission. (Standard 8.9). Information was left with the manager regarding this issue. It was evident that all of the service users had full access to medical, nursing, dental, optical, chiropody and care from hospital and community health services according to need. Records were kept of any G.P. or D.N. visit. The administration of medication was assessed and was found to follow the Guidelines of the Royal Pharmaceutical Society of Great Britain. No errors were found in the recording of the administration of the medication. Only nominated staff could administer medication and although two of these had completed an intensive course the others had only received a one day course. The manager was hoping that the remaining one would complete as soon as places were available. Both service users and families commented on how well staff respected their dignity and privacy. This was also observed throughout the inspection. The issue of care and comfort given to service users who were ill or dying was handled sensitively with dignity and propriety. Spiritual needs were also given a high priority and families were also offered support at these difficult times. Appropriate policies and procedures where in place. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15 Quality in this outcome area is excellent. Services users are able to choose their lifestyle, social activity and keep in contact with families and friends. Social, cultural and recreational activities meet service user’s expectations. Service users receive a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: Leisure activities were organised by the home for those who wished to participate. These included sing-a-longs, quizzes and exercises. The owner had recently employed a company who specialise in organising activities to help motivate the service users. A musical duo came once a month and a theatre company entertained three to four times a year. Some service users went out on local trips with the owner. Service users can entertain visitors in either the quiet lounge or their own personal rooms. Visitors stated that the owner and staff always made them very welcomed. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 14 Mealtimes were flexible within the restraints of living in a small community. The dining room was pleasant and comfortable. Service users confirmed the food was very good and one said ‘I have put on weight since coming here’. The menus were varied and specialist diets could be catered for. Service users said drinks were freely available at any time. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 15 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): 16,17,18 Quality in this outcome area is good. Service users benefit from a robust, effective complaints procedure, and are protected from abuse and have their legal rights protected. EVIDENCE: The home has a robust complaints procedure in place and has adopted the Kent and Medway’s Adult Protection procedures. Staff still require training in the new procedures. Staff spoken with had a good understanding of Adult Abuse. There had been no complaints in the last year. The home must ensure that both service users and their families are aware of the policies and procedures in place regarding complaints. This could be met by making the statement of purpose more available to all. The owner was familiar with the POVA register and the procedure for Criminal Records Bureau disclosures. Postal voting is arranged for the residents to enable them to participate in any election if wished. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. The physical design and layout of the home enables service users to live in a safe, well-maintained and comfortable environment. EVIDENCE: Four of the bedrooms and the lounge have recently been redecorated. This was part of a rolling programme of redecoration and refurbishment planned by the current owners. The new areas were now fully in use. The new hairdressing room is proving popular with the residents. The home has sufficient toilets and bathrooms to met the needs of the service users and all are kept clean and fresh. Twelve of the sixteen single rooms have en-suites. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 17 The home has one assisted bath and may need to consider the need for a mechanical hoist soon. Several service users are becoming very frail and care must e taken to ensure correct manual handling techniques are used. Staff are also reminded that wheelchairs must not be left in front of fire doors. The quality of the internal environment is good with quality carpets and fittings throughout. The premises were very clean and the laundry facilities were good. The home has a disinfector sluice and robust policies regarding infection control were in place. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is adequate. Staff are employed in sufficient number to meet the needs of service users but staff require contracts that reflect their working hours. The service recognises the importance of training and has a high level of NVQ trained staff. Mandatory training needs attention. Robust staff recruitment ensured service users are safe. EVIDENCE: Rotas seen on the day of the inspection indicated that sufficient staff were on duty to meet the needs of the service users, however staff do not hold contracts for these hours and this needs to be addressed by the owner. Ninety percent of staff have achieved NVQ level 2 or above and indicates a high level of commitment to training, however several of the mandatory courses including adult protection and moving and handling had not been updated recently. This was discussed with the manager who stated that she was in the process of employing a training consultant whose job would be to compile a training analysis and a programme of structured training sessions to ensure all mandatory training was updated. A requirement will be made. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 19 Induction training was also discussed and although the home had a basic induction course it was recommended that a more structured course be introduced. Advice was given regarding the ‘Skills for Care’ recommendations. Recruitment procedures had improved from the last inspection. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. The management and administration of the home is based on openness and respect. Effective quality assurance systems continue to be developed. The health, safety and welfare of service users and staff is promoted and protected. EVIDENCE: Throughout the inspection the manager displayed her knowledge and compassion towards the service users living at the home. She had made good progress in achieving a high standard of care in the home and had developed Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 21 her own personal management skills. She had a clear sense of direction relating to the aims and purpose of the home. Progress had been made regarding the quality assurance system discussed at the last inspection. Questionnaires had been sent to relatives and were currently being evaluated. The owner was advised to widen the range of people involved in the process to include GP’s DN’s Care Managers and anyone else involved with the home. These results should then be published and made available to current and prospective service users and their families and other interested parties including the Commission. Residents have hairdressers and chiropodist come to the home, which were initially paid for by the home. The resident’s families were then invoiced for the services. The records of the transactions were seen and were up to date and appropriately kept. Receipts were given and recorded for all transactions. The home does not normally hold residents monies for them and encourages families to deal with any financial interests. Staff supervision is now completed on a regular basis as required from previous inspections. Records were well maintained Full insurance cover was in place for contents and public liability as required by regulation. Records were inspected regarding the health, safety and welfare of the residents and were up to date. The Portable Appliance Testing (PAT) not completed at the last inspection has now been completed. The home now has a Health and Safety Statement in place as required from the last inspection. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 22 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 23 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 home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP30 Regulation 18(1)(c) Requirement A training matrix is completed and a programme of identified mandatory training be arranged. Copy to be sent to the Commission. Staff working at the home receive a structured induction programme. Action plan required Timescale for action 30/11/06 2. OP28 18(c)(i) 30/11/06 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. 4. Refer to Standard OP1 OP7 OP8 OP22 Good Practice Recommendations It is recommended that the home’s statement of purpose and service users guide is made more freely available. It is recommended that where possible residents and/or their representatives are included in the care planning process. It is recommended that nutritional screening is undertaken on admission and subsequently on a periodic basis. It is recommended that consideration be given to purchase DS0000064892.V314353.R01.S.doc Version 5.2 Page 24 Amicus Care Home 5. 6. OP9 OP27 a portable hoist. It is recommended that consideration be given to providing a dedicated medical room. It is recommended that staff be given contracts that reflect their actual working hours. Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Amicus Care Home DS0000064892.V314353.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!