Inspection on 04/10/05 for Amicus Care Home

This inspection was carried out on 4th October 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.

Other inspections for this house

Amicus Care Home 02/10/06

Amicus Care Home 20/02/06

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 Announced Inspection 4th October 2005 10:00 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.V250575.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. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 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 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration is restricted to two service users who have a diagnosis of Dementia whose dates of birth are: 12 November 1914 and 18 March 1913. First inspection under new ownership Date of last inspection Brief Description of the Service: The home cares for 13 older people, in a warm and friendly environment. The accommodation consists of 13 single rooms, 7 of which have en-suite facilities. Stairs or a chair lift can access the upper floor. The home has a bathroom on each floor; 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. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first announced inspection of the home since new owners were registered. All previous requirements and recommendations were not taken into account. The inspection took place on the 7th October 2005 between 10.00 and 15.30. One inspector was in the home and the main focus of the inspection was on assessing the new owner and offering advise and support where needed, the general environment and the well being of the residents. During the inspection documentation and records were read, including care plans and assessments. A tour of the building was undertaken and many of the residents were spoken with. Time was also spent talking to staff and members of the management team. The outcome was that the clients were being well cared for and were safe and secure. What the service does well: What has improved since the last inspection? What they could do better: Staff supervision needs to be implemented but the owners are aware of this and have plans in place. The purchase of a hoist needs to be considered and advice should be sought from an Occupational Therapist. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 6 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.V250575.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 Amicus Care Home DS0000064892.V250575.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): 1, 2, 3, 4, 5, and 6 Prospective clients are provided with the information they need to make an informed choice about moving into the home. Clients benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Clients 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 home’s Statement of Purpose was seen during the registration process and covered all the necessary information to enable prospective clients to make an informed choice over the suitability of the home. The Service Users Guide was in the process of being updated to ensure all information was completely accurate. The document was almost complete. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 9 New contracts were discussed and the owner was advised to read the Office of Fair Trading’s guidance on terms in care home contracts. The owner had admitted one new client since buying the home and a full assessment was undertaken prior to his admission. This resident had visited twice before admission and senior staff had undertaken a comprehensive assessment of his needs. The care plan had been drawn up following the assessment and the client had signed to say he agreed with the level of care being offered. Relatives were also involved with the admission to the home to ensure they had the opportunity to assess the homes quality and suitability. The home does not provide intermediate care. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Clients can be confident that their health needs will be met and that they will have full access to all professional health care services as required. Clients are put at risk by the home’s poor practice with regard to the administration and handling of medication though the new owners of the home have recognised the need for staff to receive training in this area. Clients can be confident they will be treated with respect and that their privacy will be respected. EVIDENCE: The home had inherited care plans from the previous owners, but was finding them cumbersome and was developing more person centered care plans for future use. These will be assessed at the next inspection. All clients were registered with a local GP and had full access to other health care professional as needed. The process of medication administration was being changed from the Nomad system to a MAR system in the near future. Some discrepancies were noted mainly around the paperwork. The owner is advised to obtain a copy of the Royal Pharmaceutical Society of Great Britain guidelines and to produce written Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 11 protocols for PRN medication. The owner is also advised to purchase a designated lockable medical fridge. Copies of signatories for the administration of medication must also be recorded. The controlled drugs were audited and found to be correct. The manager was also advised not to allow staff to handwrite any changes to dosage or new medications. Printed labels should be obtained from the pharmacist if the GP could not write the changes directly onto the MAR sheets. Discussion also took place around the signing of the prescriptions prior to being dispensed. A responsible person from the home should complete this. Several clients were spoken to and all confirmed that they felt happy and secure. Staff were seen to treat the clients with respect and used their preferred terms of address. The clients also confirmed that when personal care was being delivered the staff were very kind to them. The clients seemed very relaxed and were very happy with the change of ownership. The clients had been offered personal keys to their rooms. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The clients can be confident that they will be supported to maintain contact with their family and friends, which will ensure that they will continue to receive stimulation and emotional support. The clients benefit from the appetising meals and balanced diet offered by the home and those clients requiring specialist diets are well catered for. EVIDENCE: The home was run on a fairly flexible basis with minimal rules and regulations. The atmosphere was relaxed and peaceful. Several clients stated they were very happy and that there was more freedom of choice over various routines and activities. Client meetings are being held and minutes kept. Where possible actions had been taken to reflect client’s wishes. One client was enabled to attend church daily and others could take Holy Communion twice a week in the home. The owners are trying to bring representatives from the Church of England into the home as well. A range of activities is offered to the clients to participate in if they wish. Relatives can visit at any times and are always made to fell very welcomed. One comment from a relatives comment card indicated that better care and Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 13 communication was now being offered. Also improvements in the presentation food had been noted. The food was discussed with several clients and all confirmed it had improved. Comments like ‘the desserts are much better and I was offered lasagne last week’ were made. Other comments like ‘ we now have home made cakes and have more choice’ were also made. The kitchen was visited and discussion took place with the cook who confirmed that more choices were being offered. Copies of the menus were viewed and appeared nutritious and varied. Fridge and freezers temperatures were recorded daily and cleaning schedules were in place. A new fly screen had been recently fitted and a first aid box had been supplied. Hand towels and liquid soap were also available. New colour-coordinated chopping blocks were also available. Specialist diets were well presented and appropriate. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The clients are protected by a robust complaints system and service users and their relatives feel their views are listened to and acted upon. Clients are protected from abuse by the home’s robust adult protection policies and procedures. EVIDENCE: The home has a robust complaints procedure in place and has adopted the Kent and Medway’s Adult Protection procedures. Staff are to be trained in the new procedures in the near future. Staff spoken with had a good understanding of Adult Abuse. There had been no complaints since the new owners had been registered. The owner was familiar with the POVA register. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Residents benefit from living in a clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. EVIDENCE: A new chair hoist had been installed since the new owner was registered and new curtains had been fitted to the lounge. The lounge had also been redecorated. The home was decorated to a high standard and was well maintained. The gardens were also well maintained and easily accessible. One client stated that ‘she was really happy to potter around in the garden’. The bathrooms and toilets were clean and tidy and met the needs of the clients. One of the clients was very keen to show her room, which was spotlessly clean. She stated that she liked to keep her room clean herself. She clearly was very happy with her room. Other rooms seen were personalised and comfortable. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 16 The owner intends to purchase a new hoist in the near future. One client remained in bed and appropriate pressure relieving equipment was being used. All of the client spoken with were happy with their rooms and said they were comfortable. Extra domestic staff means that care staff are spending more time caring for the clients and they have appreciated that fact. The home was very clean and fresh. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 17 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 and 29 The residents benefit from being cared for by staff who have a good understanding of their needs. EVIDENCE: More staff have been employed including extra night staff. A new Assistant Manager has improved various area of care including some better infection control measures. Soiled washing is now collected in billies when taken to the laundry. Several staff commented that they now had more time to spend with the clients and that this was much better. The new owners are currently gathering information on staff training and are in the process of drawing up a staff training matrix. This will be assessed at the next inspection. A new staff member’s personnel file was viewed and found to contain only one reference. The owner is advised to ensure that in future two references are obtained. CRB details were seen. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,and 36 The clients benefit from living in a home where the manager is competent, enthusiastic and very experienced with the care of older people and has a clear vision for the home. EVIDENCE: The new owner had only been at the home for a few weeks but had made several improvements already. It was very evident that she was very focussed on a high standard of personal care and consideration for the clients. It was very pleasing to hear laughter in the home. The owner is also the registered manager and has completed her NVQ 4 in Management and Care and is currently nearly finished the Registered Manager Award. She also owns a small home in another area so has the experience in the management of this type of service. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 19 As in most changes of ownership there have been as few staffing issues but these appear to be settling down and both staff and the new owner are committed to providing a high level of care to the clients in the home. Staff supervision was discussed with the owner and plans are about to be put in place to ensure all staff receive regular supervision. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 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 3 3 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 2 X X Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 OP36 Regulation 18(2) Requirement Timescale for action 30/11/05 2 OP29 19(1) The registered person shall ensure that persons working at the care home are appropriately supervised. The registered person operates a 08/10/05 thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. Immediate 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 Refer to Standard OP22 Good Practice Recommendations It is recommended that an assessment be carried out by a qualified person to determine if a hoist is required in the home. Amicus Care Home DS0000064892.V250575.R01.S.doc Version 5.0 Page 22 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.V250575.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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