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Inspection on 08/04/05 for Ancaster Court

Also see our care home review for Ancaster Court for more information

This inspection was carried out on 8th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

All residents have a full assessment prior to their admission and every effort is made to ensure the move into the home is in the residents best interest and that they can have all their care needs met at the home. Care documentation is clear and used to give guidelines to care staff on how to care for an individual. Feedback from residents and visitors confirmed that staff were `kind` `friendly` and `attentive` and the Inspector felt that staff were caring in their approach to residents. Although the home is large the individual and communal space provided is homely and well maintained. Residents and relatives are encouraged to air their views and feedback on issues raised is shared. One resident has her cat with her in the home and the staff support her in caring for him this gives her a great deal of pleasure.

What has improved since the last inspection?

The care documentation has improved since the last inspection and provides clear guidance to care staff. This needs to be maintained to ensure continuity of care and clear evaluation of care. Further resources have been provided to promote resident`s recreation and social activity and this has been well received by residents and visitors. Staff training is being recorded more accurately and is being co-ordinated by an identified staff member. Ongoing redecoration and up grading is evident and ensures that this Victorian building is well maintained.

What the care home could do better:

Systems need to be adopted to ensure that the resident or their representative are involved in the planning of the residents care and that they are fully updated on changes in care needs. All areas of the home must be cleaned routinely and resident`s personal laundry needs to be returned to their rooms in a condition ready for use. Although progress is being made on staff training all staff must receive training so they can do their jobs.

CARE HOMES FOR OLDER PEOPLE Ancaster Court 24 Hastings Road Bexhill on Sea East Sussex TN40 2HH Lead Inspector Melanie Freeman Unannounced 8 April 2005 11:00 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. Ancaster Court Version 1.10 Page 3 SERVICE INFORMATION Name of service Ancaster Court Address 24 Hastings Road Bexhill on Sea East Sussex TN40 2HH 01424 213532 01424 221925 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) BUPA Care Homes Ltd Alison Sowerby Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (OP) 51 of places Ancaster Court Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum service users to be accommodated is fifty one (51) 2. That the care home can provide nursing/residental care to older people aged sixty five (65) or over on admission 3. The service can provide upto fifty one (51) nursing places and three (3) social care places Date of last inspection 17 November 2004 Brief Description of the Service: Ancaster Court is a Victorian building that has been converted and adapted to its present use. It is located in a residential area approximately 1/2 mile from Bexhill town centre, seafront and mailine train station. The home has a garden to the rear of the property where residents can sit weather permitting. There is parking to the front of the home for approximately 15 vehicles. Ancaster Court has 51 registered beds that can be used to provide general nursing care and admits people who are privately funded and those who are funded by Social Services. The bedrooms are found on three floors and a passesnger lift provides level access throughout the home. 4 of the bedrooms can be used for sharing and 16 have en-suite facilities. Ancaster Court is owned and managed by BUPA Care Homes Ltd. Ancaster Court Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out between the hours of 11.00 and 17.00. The home manager was on duty and was able to contribute to the inspection process. The Inspector toured the home and was able to talk to 3 visitors along with a number of residents who were in their rooms, 6 of these residents were able to express their views on the care and services provided in the home. Staff members were observed while they were working and discussed resident care needs with the Inspector. The care documentation is retained on three separate floors and the Inspector reviewed 2 from each, along with staff training records. What the service does well: What has improved since the last inspection? The care documentation has improved since the last inspection and provides clear guidance to care staff. This needs to be maintained to ensure continuity of care and clear evaluation of care. Further resources have been provided to promote resident’s recreation and social activity and this has been well received by residents and visitors. Staff training is being recorded more accurately and is being co-ordinated by an identified staff member. Ongoing redecoration and up grading is evident and ensures that this Victorian building is well maintained. Ancaster Court Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ancaster Court Version 1.10 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 Ancaster Court Version 1.10 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) 2,3,4 and 6 The admission procedure ensures that there is a full assessment of people prior to their admission to the home and they or their representative are given clear information to inform their choice of home. EVIDENCE: The terms and conditions of residency have been updated since the last inspection and were noted to provide clear information to any service user or their representative on the facilities and service provided. All prospective service users are assessed by either the home manager, or the head of care and these assessments were available in the service user’s care records. Specific training has been provided to the care staff on caring for service users with a dementia type illness as required following the last inspection. This has provided care staff with further skills to ensure all the care needs of service users are met. Specialist advice and equipment is sought and resourced for service users prior to their admission as necessary. Ancaster Court Version 1.10 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 and 10 Individual plans of care recording the needs of service users are maintained and are up to date. The home was found to be meeting the health care needs of service users with the support of community health care support as necessary. The privacy of service users is well respected throughout daily interaction in the home. EVIDENCE: The care documentation reviewed was full and demonstrated that all service users have plans of care based on a needs assessment. These plans on the whole were up to date demonstrating at least a monthly review. A few shortfalls in the plans of care were noted and this was discussed with the registered nurses working and the home manager. The care documentation does not record the service users or their representatives involvement in the planning of care and the home manager has been developing systems to promote and record this since the last inspection. A recognised pressure sore assessment tool is used to identify service users at risk of pressure sore development and appropriate equipment was seen in response to this risk. Service users spoken to said that they felt that their health care needs were being responded to with input from GP’s. Ancaster Court Version 1.10 Page 10 The home is provided with furniture and fixtures that promote service users privacy and staff were noted to treat people in the home with courtesy. Ancaster Court Version 1.10 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 The home provides staff to promote individual social and recreational activities to meet the varied social and recreational needs of service users. The food provided is varied and on the whole provided to a satisfactory standard. EVIDENCE: The home provides staff specifically to promote service users activities and entertainment within the home and to enable outings and visits to local facilities. Service users spoken to said that they had enjoyed recent outings and one service user said that he had been accompanied to a local public house. Service users who are restricted to their rooms or do not wish to use the communal lounges are provided with individual time. The care documentation records service users life history and social care planning. The provision of food was discussed with service users and although they appreciated the choice and variety provided the standard of the food provided was not always well received. One service user said ‘the food could be better’ and one service user had not eaten his vegetables as they were ‘not cooked properly’. Most people said the food was of a satisfactory standard. The home manager had advised the inspector that the food provision was under review and that new menus were being used. Ancaster Court Version 1.10 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection EVIDENCE: These standard was not assessed at this inspection Ancaster Court Version 1.10 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The home provides service users with a comfortable environment that is well decorated. The cleaning standard in some areas is poor and personal laundry is not well managed in all cases. EVIDENCE: The tour completed by the inspector confirmed that the home continues to be subject to an on-going re-decoration and up grading programme. As a result the home provides a well-maintained environment that provides individual space and as the service are often involved in how rooms are redecorated one that they can identify with. The home was fairly clean and free from unpleasant odour, it was however noted that bed frames were not clean and a wheelchair looked like it needed cleaning. A cleaning schedule to ensure such areas are cleaned regularly was not in place. The laundry is well equipped and the home manager confirmed that staff are working in the laundry every day. A relative identified to the inspector that not all personal laundry is ironed and this matter was identified to the home manager. Ancaster Court Version 1.10 Page 14 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) 27 and 30 There are sufficient numbers of suitably qualified staff on duty to meet the needs of service users. Staff training is developing but does not fully demonstrate that staff are trained to do their jobs. EVIDENCE: There were 41 service users living in the home at the time of this inspection. The home is found on three floors and each is staffed separately with a registered nurse directing and overseeing the care provided. The home manager works in a purely management capacity and has a senior RGN who works as the head of care. The head of care does work some shifts in a supernummery capacity and this allows for regular supervision of less experienced nurses. In addition to the care staff appropriate kitchen and catering staff are employed. An administrator also works in the home on a full time basis. Service users and visitors spoken to said the staff were ‘kind’ ‘friendly’ and ‘attentive’ although one visitor and service user said that the call bell was not always answered quickly. The home manager confirmed that an audit of the call bells concluded that the bells were responded to within 3 minutes. The staff training records reviewed confirmed that the recording systems had improved and that statutory training had been progressed since the last inspection. Evidence that induction had been completed and that foundation training had been established were not full. Ancaster Court Version 1.10 Page 15 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) 33 Service users views on how the home is run are taken into account and reviewed in order to develop and change the provision to meet their needs and best interests. EVIDENCE: When speaking to service users and visitors it was clear that regular meetings are held where everyone is able to express their views on how the home is being run. These meetings are minuted and communication with everyone is maintained through a News-letter. Systems are in place for the review and audit of services and quality of care within the home and these are well documented and are monitored at a regional level. Leaflets inviting people’s comments are readily available in the home. Staff meetings are also held regularly. Ancaster Court Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x x x x x Ancaster Court Version 1.10 Page 17 yes 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. Standard 7 Regulation 15(1) Requirement Timescale for action 1 6 2005 2. 3. 4. 26 26 30 16(2)(e) 16(2)(j) 13(3) 18(1)(c That plans of care are written with the involvement of service users or their representatives (Requirement of the last 2 inspections). That all areas of the home are 1.6.05 cleaned routinely. That all clothing is returned to 1.6.04 service users rooms crease free and in a condition to be worn That all staff receive induction 1.7.05 and foundation training which meets National Training Organisation (NTO) specifications within the time limits specified in NMS 30.2 & 30.3 (Requirement of the last inspection). 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 22 Good Practice Recommendations That an assessment of the premises and facilities should be undertaken by a qualified Occupational Therapist, to advise on the suitability of disability equipment and environmental adaptations. Version 1.10 Page 18 Ancaster Court Ancaster Court Version 1.10 Page 19 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Ancaster Court Version 1.10 Page 20 - 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!