Inspection on 17/01/06 for Ampersand House

This inspection was carried out on 17th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Ampersand House 17/07/07

Ampersand House 31/08/06

Ampersand House 22/07/05

Ampersand House 19/01/05

Ampersand House 30/09/04

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 Ampersand House 164/166 Frindsbury Road Frindsbury Rochester Kent ME2 4HP Lead Inspector Sally Hall Unannounced Inspection 17th January 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 Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ampersand House Address 164/166 Frindsbury Road Frindsbury Rochester Kent ME2 4HP 01634 724113 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) Mr Thuraisamy Ravichandran Mr Nallanathan Suganthakumaran, Mrs Radha Ravichandran, Mrs Suganthini Suganthakumaran Antionette Lawrence Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate a service user who has a diagnosis of dementia and whose date of birth is 5.11.1914. 22nd July 2005 Date of last inspection Brief Description of the Service: Ampersand House is a care home registered to provide residential care and accommodation for a maximum of thirty-one older people. The home is a large detached property set in pleasant grounds. It is situated in a residential area of Frindsbury and is approximately one mile from Strood town centre. Motorway links are close by. The home is near a bus route and Strood mainline railway station is approximately one mile away. The accommodation is set out over three floors and has a passenger lift serving the upper floors. There are two lounges, one of which is a designated no smoking area, there is also a conservatory and dining room for use by service users. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection at Ampersand House took place on 17 January 2006 between 9.30am to 2pm The Inspector agreed and explained the inspection process with the Registered Manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A full tour of premises was not undertaken, but areas identified in the last report as needing attention were checked. The focus of the inspection was to assess Ampersand House in accordance to the National Minimum Standards for Older People, particularly focusing on standards not met or inspected during the last inspection. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with or observation of care practice. What the service does well: What has improved since the last inspection? The manager has reviewed the adult protection policy and ensured that the home has and follows the local authority adult protection protocols. The manager through constant monitoring has ensured that the medication is administered and recorded correctly. Service users confirmed that they get a choice of meals on a daily basis. Service users all agreed that the meals offered are well cooked and there is plenty of it. The menu each day can be seen displayed on the notice board out side the dinning room. Although staff supervision is not on tract to be completed six times per year, the recording Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 6 and content of that supervision has improved and it hoping that starting in March 06 supervision will occur on a regular basis. 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. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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 Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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): 3,4,5, Prospective residents have the benefit from having the their care needs assessed and the offer of a trial period at the home to assess whether the home can or cannot meet their needs before they decide to stay on a permanent basis. EVIDENCE: The home is using new assessments that are simpler to complete and cover all aspects detailed in the standard. The assessment is completed for all new service users coming in to the home and six monthly thereafter for existing service users. The manager and/a senior visits the service users at home or in hospital and start to complete the assessment. The assessment is completed when the service users visits or comes in to the home for the trial period. The home also ensures that the home receives the care manager’s assessment / care plan before assessing if they can meet the service users needs. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 9 The home develops a plan of care from the assessments in order to ensure that the service users need’s will be met. The home has recently achieved the Investors in People award, and the manager confirmed that 75 of the care staff team now have gained a NVQ level 2 or above in care award. Prospective service users are encouraged to spend at least a day at the home prior to becoming a resident at the home. The families are also encouraged to visit and ask questions before the service user is admitted. The service users is then admitted for a 28 day trial period, only if the service user is happy and the home can meet the needs will the arrangement become permanent. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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, Service users can be confident that their care needs will be catered for as agreed in the care plan. However the details of the care delivered to individuals needs to be improved. The health of service users is protected by the home’s health monitoring procedures. The residents can feel confident that they will receive the medication prescribed for them. EVIDENCE: Service users files sampled contained the new care plans, which are based on the needs assessment. Some of the plans seen required more specific information to instruct staff as to the action they are required to take to ensure the needs of the service user are met. Staff will need to ensure that they review the plan each month and record outcomes. There was no evidence seen that service users are involved in the formation of these plans and this was discussed with the manager. The inspector also discussed the content of the new daily reporting system, which did not detail all the care and input service user received through the course of the day, this system rather than improving Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 11 the information recorded has reduced it still further. The entries do now contain the times that significant events happen, but little else. This was discussed with the manager and owners. The moving and handling risk assessment do need to be revised to ensure all the risk factor are considered for all moves and the action for staff to follow needs to be detailed also. The manager was also advised that the moving and handling policy is also not now sufficient, advice was given as to where the information can be found. Health problems were seen recorded in the daily report. The home facilitates visits from the optician, dentist and the chiropodist as required if service users are not able to visit them. The Manager monitors any accidents and takes action where Service users are at risk. The manager understood the need to inform RIDDOR for certain injuries etc. There was also evidence seen of the pressure area care as directed by the district nurse. The home always tries to provide an escort for planned hospital visits, if the family are not available. The medication storage, administration and recording of medication was sampled. There have in the past been problems and the manager has put in systems to ensure these have been addressed. The Medication Record Sheet are now fully completed. Medication amounts checked against the sheets were found to be correct. Staff were reminded to show what stock is remaining in stock at the beginning of a new Medication Record Sheet. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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, 14, 15 Service users benefit from a range of activities arranged by the staff at the home. Residents maintain their independence and exercise their right to choice and control and are encouraged to maintain contact with their family and friends. The dietary needs of residents are well catered for in pleasing surroundings at convenient times. EVIDENCE: Service users spoken to enthused about the activities arranged in the home that they can choice to take part in. The home also has entertainers coming into the home, which the service users spoken to said they enjoyed. The service users also said that they now have a lady who visits the home every week and sewing with them, the explained that they have made lots of nice things and look forward to the sessions. They said they also have keep fit and things like bingo. The staff offer choices to the service users throughout the day and this was observed during the inspection process. With the advent of the new daily reporting system no choices were seen documented. Service users spoken to Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 13 said that they are always asked what they want to do, i.e. time for getting up/going to bed etc. Service users stated that the food served at the home is very nice and there is always plenty of it. They said that they do get a choice and they will make something different if asked. Each day’s menu is recorded on the information board out side the dinning room. The manager confirmed that staff record what meal each service users choose. The amount eaten needs to be recorded if service users have nutrition problems Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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): 18 Service users can feel confident that they are protected from the risks of abuse the home follows the local authority adult protection protocols and staff have had training. EVIDENCE: The manager has now received a copy of the new adult protection protocols from the local authority and confirmed that this is the policy and procedure they are following. Staff have now had adult protection training. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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): 26 Whilst service users benefit from living in a clean, safe and well maintained and well equipped environment suited to the needs of service users, the home’s laundry urgently needs cleaning, de-cluttering and redecorating. EVIDENCE: During the last inspection in July 05 requirements and recommendations were made re the Laundry. However the laundry facilities were found again to be dirty and very congested. The new washing machine with a sluicing facility has now been moved to a better position and this has given room for a sink to be installed, however this has not yet been done. The home is now using the red sack system in the sluicing machine reducing the amount staff need to handle foul linen. The laundry need not only to be cleaned it also needs to be decluttered, decorated and a sink needs to be fitted. A cabinet used by staff for storage of items not used in the laundry needs to be moved and consideration needs to be given to increasing the size of the laundry to give space for folding Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 16 and storing clean laundry prior to it being put away. It was noted that the handyperson at the home was making shelves into cupboards that can be lock to store clean materials, however this was not the cause of the laundry being unclean and congested. The owners have been advised to ask for advice form the Infection Control team at Preston Hall. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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): 29,30 Service users are supported and protected by the home’s recruitment policies however these need to be followed religiously in practice. Service users can feel confident that the staff are well trained. EVIDENCE: The staff files sampled did contain the ID required. The files however did not contain the other information required, i.e. not all had two references, the interview notes, offer letter etc. It was evident that the recruitment procedure is being followed interviews took place during the inspection, however care needs to be taken to ensure that staff are not employed until the necessary checks have taken place. This was discussed with the manager. The manager stated that staff receive the required training. A training matrix seen showed that staff were being trained to look after the needs of the residents they currently care for. This training is ongoing and the matrix clearly showed when courses needed to be repeated. The manager explained that 75 of the care staff at the home have an NVQ level 2 or above. The home has recently achieved the Investors in People award, this has supported the home to improve the training standards in the home. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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): 36,38 Service users are beginning to benefit from staff who are being supervised and appraised. The service users are not fully protected by the health and safety measures in place in the home. EVIDENCE: Although appropriate staff supervision was started in September/ October 05, it has not been continued and the home is not on line to ensure staff have the required supervision six times a year. The manager said she is considering training for her senior carers to do this as at this time she is trying to cover all staff her self. The manager was not able to provide the required gas, electrical, and LOLER certificates. The owners explained that the test had been done, they were advised to keep then certificates or a copy of them in the home. Copies of the certificates are to be forwarded to the Commission for Social Care Inspection. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 19 Staff at the home have had health and safety, moving and handling, basic food hygiene, first aid and fire training. However staff that were observed during the day of inspection were seen using inappropriate lifting techniques, the manager was informed and asked to monitor, retraining any staff who is not following good practice. The home has a COSHH file and the manager confirmed that it does cover all the chemicals used in the home. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 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 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X 1 STAFFING Standard No Score 27 X 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 2 X 2 Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 21 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 Sch 3.1(b) Requirement Timescale for action 31/03/06 2. OP26 13,16,23 3. OP36 18(2) 4. OP38 23 A service user plan of care generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. ensure entries and events in the daily log contains detail of the care delivered. The premises including the 28/01/06 laundry are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. The registered person ensures 31/03/06 that supervision arrangements are put into practice, recorded and happening six times per year from the -The registered manager ensures 31/03/06 so far as is reasonably practicable the health, safety and welfare of service users and staff. monitor staff use the techniques taught during moving and handling training on an DS0000055868.V275381.R01.S.doc Version 5.1 Ampersand House Page 22 5 6 OP38 OP38 12, 13 16 ongoing basis. Review the moving and handling policy. Review the moving and handling risk assessment to include all the required information to protect staff and service users. Complete a building risk 28/02/06 assessment Ensure that all the electric, gas 28/02/06 and LOLER certificates are available for inspection in the home. 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 OP29 Good Practice Recommendations Check all files to ensure they contain all the required information. Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 23 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 Ampersand House DS0000055868.V275381.R01.S.doc Version 5.1 Page 24 - 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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