Inspection on 08/05/07 for Anchor House

This inspection was carried out on 8th May 2007.

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

Anchor House 06/05/09

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

CARE HOMES FOR OLDER PEOPLE Anchor House 11 Avenue Road Wheatley Doncaster DN2 4AH Lead Inspector Andrea Leverett Key Unannounced Inspection 8th May 2007 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 Amphion House DS0000068533.V334785.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. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Anchor House Address 11 Avenue Road Wheatley Doncaster DN2 4AH 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) 01302 327004 01302 327008 jas_toor@ntlworld.com Authentic Care Services Ltd Acting manager Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New service Brief Description of the Service: Amphion House is registered as a care Home for up to 23 persons who require residential care. All bedrooms are single occupancy and located at ground and first floor levels. A chair lift and stairs access the first floor. There is a lounge and dining room with communal areas on the ground floor. The registered provider is Authentic Care Services Ltd and the Home has a new manager in place. The Home is located in a residential area approximately one mile from Doncaster town centre. It is easy to access with a regular bus service. There is on street parking. There is a small garden to the front of the property and a larger garden to the rear. The registered person makes information about the service available to residents and their families via the homes Statement of Purpose and Service User Guide, which are presented in a Service Users handbook. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection of this newly registered service, which took place on the 8th of May 2007. A CSCI pharmacy inspector who undertook a key inspection of the homes medication administration, storage and recording systems accompanied the lead inspector. 6 residents were spoken with as well as 4 staff members, 2 relatives, the manager and the owner. Feedback from service user questionnaires has also been reflected in this report. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections for some of the residents in the report. Some judgements about quality of life and choices were taken from direct discussions with and observations of residents on the day, followed by discussion with support staff and evidencing records held at the home. The inspector concluded that on the whole residents are given a good service at Amphion House, although the pharmacy inspection evidenced that improvements are needed in medication administration. The Home provides a good standard of direct personal and social care and access to health services. The Home is clean and homely and residents are benefiting from a programme of refurbishment and decoration. Lowest fee £ 375.00 Highest fee £ 375.00 Cost of item (£) Items not covered by fee Hairdressing Chiropody £20.00 perm £5.00 set £8.00 What the service does well: Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 6 The Home has an activities co-ordinator and residents confirmed that individual and group activities are consistently provided. Good staffing levels and well-trained staff enable the Home to provide a high standard of consistent care. The MAR chart dividers contain a photograph and a full medication and allergy history for each person. This is an example of good practice as it helps care staff to administer the correct amount of the medicine to the correct person. Additional information is recorded on the MAR chart to help staff know when it is safe to give medicines. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 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 Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3, People who use the service experience good quality outcomes in this area. Some resident’s rights could be undermined by not having contracts in place. Residents can be confident that their needs will be assessed before they move into the Home and that these will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of resident’s files seen and discussion with the manager evidenced that not all residents had up to date contracts in place and a requirement has been made regarding this. The manager informed the inspector that the homes contracts were in the process of being reviewed by the social service contracts manager. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 9 Three residents assessments and care plans were inspected as part of a case tracking process. Residents have their needs comprehensively assessed prior to moving into the Home. Assessments included mobility, personal care incontinence, Nutrition and eating and drinking including likes and dislikes, Breathing, Communication and general likes and dislikes sheet. Risk assessments were also in place for all key areas of need including a general environment risk assessment. Assessments also included aims and objectives and care assistance required and this information was reflected in the residents care plans. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People who use the service experience good quality outcomes in this area. Residents benefit from having comprehensive health, personal and social care needs set out in an individual plan of care, which are followed. The home has a medication policy and medication records are generally up to date. Medication systems do not always follow good practice. No competency assessments have been carried out and no management checks of compliance with medication procedures are recorded. Residents feel they are treated with dignity and respect and their right to privacy is upheld. This judgement has been made using available evidence including a visit to this service. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 11 EVIDENCE: Residents care plans were detailed and comprehensive and included all needs as detailed in their assessments. Records also showed that these were being regularly reviewed. Health records show that access to routine health services are provided and residents and relatives spoken to confirmed this. The deputy manager administered medicines at 10:00am and the pharmacist inspector observed the process. It was clear that the home’s procedures were being followed accurately. People living in the home were routinely asked whether they wanted to be given medicines prescribed ‘as required’. Some people were given their medicines in private as they had previously stated their preference for this. No one in the home managed his or her own medicines at the time of the visit but it is clear that the home would support someone who wished to do this. The home has a risk assessment procedure and a consent form in place, and secure bedroom storage facilities are available. Dividers containing the name and a photograph of each person separate the MAR charts. The divider also lists the medicines on admission, details of all subsequent medication changes and an allergy history for that person. This is an example of very good practice in support of safe medicines administration. There were no significant gaps on the MAR charts and some useful extra information was routinely recorded e.g. the daily pulse of a person taking digoxin. The use of the ‘O’ (other) code was used by staff without an explanation or follow-up when used for a period of several days. This led to confusion in the case of one person as it was unclear from the MAR chart and care plan whether this person should be receiving prescribed 60mg of furosemide instead of the 40mg dose actually given each day. The ‘O’ code had been used for nearly three weeks as no 20mg tablets were in stock. On pointing this out, the deputy manager took immediate action and contacted the prescriber to clarify the situation. Failure explain or investigate recurrent use of the ‘O’ code on the MAR chart could lead to some people not being given medicines the way the prescriber intended. At the time of the visit, building work was in progress to create a new medical room, which would in future securely store all medicines held in the home. The pharmacist inspector offered advice on the need to regularly monitor the temperature in the new room and in the medicines fridge. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 12 A medication audit tool was in place but was not in use. The manager plans to carry out regular medication checks as part of a quality monitoring process as soon as possible. Feedback from residents and observation by the inspectors at the site visit showed that residents are treated with dignity and their choices are respected. Staff interacted sensitively and responsively to residents and it was clear that residents felt able to ask for support as needed. Some typical responses included: “It is very nice here, staff are always kind and do every thing for you.” “ Staff are marvellous I like it here very much.” Amphion House DS0000068533.V334785.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People who use the service experience good quality outcomes in this area. Resident’s experiences match their expectations and preferences in terms of social, cultural, religious and recreational needs. Residents are supported to maintain contact with family and friends and are supported to exercise choice and control over their lives. Residents receive a wholesome and appealing diet in pleasing surroundings and at times convenient to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home has an activities co coordinator and records seen and discussions with residents evidenced that a range of appropriate activities are provided. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 14 It was clear that the activities co coordinator took time to get to know residents and explore their needs and wishes in terms of activities. Resident’s files included “Getting to know you” document, which included detailed histories and interests of residents. The activities co coordinator made good use of this information to plan both 1:1 and group activities which included a weekly art class, exercise classes, card games, reminiscence and nail care. The Home also makes use of a hire bus to provide community trips. The activities coordinator had also undergone training in dementia care, which specifically looked at social and recreational needs of residents with dementia. Records were kept to evidence resident’s participation in activities. The inspector was able to observe the lunchtime meal being served, which was varied, healthy and nicely presented. The dining room is nicely presented and tables are laid with linen table clothes and napkins. Residents were observed being supported with their lunch in a sensitive and respectful manner and it was clear that residents felt able to ask for what ever they liked. Residents can choose when and were to eat including in their own room if they wish. Feedback from residents was positive regarding the food and all residents spoken to say they could have snacks and drinks whenever they wished. Menu’s seen are varied and nutritious and nutritional assessments are undertaken at the point of admission to the Home. An inspection of the homes kitchens and food stocks showed that a varied range of foods is purchased. Visitors are welcome at any time and are offered drinks and can have a meal if invited to do so by the resident. Feedback from relatives suggested that they have good relations with staff at the Home and examples were given of the Home maintaining contact with relatives in the best interests of the residents. Some typical responses included: “ The food is very good, I’m always hungry and glad to eat it.” “I can have a cooked breakfast with bacon, I get a choice, I have a cup of tea in bed in the mornings.” “It is marvellous here, I keep trying new things and I’ve just had my nails done.” “ It couldn’t be better here, they do everything for mum, she had a fantastic party, that was all down to them.” “ They are ever so good, absolutely brilliant staff, it’s like Home from Home, if I phone in the morning they tell me how mum is and contact me if there are any problems. The food is brilliant, they can ask for what ever they want. “ Amphion House DS0000068533.V334785.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use the service experience good quality outcomes in this area. On the whole residents are aware of their rights with regard to making a complaint and can be confident that their concerns and complaints will be listened to. Residents are protected from the risk of abuse by the home’s Adult Protection policy and procedures. This judgement has been made using available evidence including a visit to this service. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 16 EVIDENCE: The Home has a complaints procedure that includes all the information required by this standard and discussion with residents evidenced that on the whole they were aware of their right to make a complaint and would be comfortable doing so. However some comments made on service user questionnaires suggest that not all residents would know how to make a complaint and a recommendation has been made that the Home promote the use of the complaints procedure in the Home. The Home has had no complaints in the last Twelve months. Discussions with staff evidenced that they understood their role and procedures for the reporting of suspicion or evidence of abuse. Staff spoken to and records seen also confirmed that they had undertaken adult protection training and the manager informed the inspector that this training is ongoing. The manager was also able to give good examples of how the Home had taken prompt action to safe guard residents in the past. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 People who use the service experience good quality outcomes in this area. Resident’s benefit from living in a Homely environment, which is well maintained and clean. This judgement has been made using available evidence including a visit to this service. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 18 EVIDENCE: A tour of the premises was undertaken and the Home was clean, well presented and odour free. Resident’s bedrooms were pleasantly furnished and it was clear that residents are encouraged to furnish their rooms with personal items. Residents are benefiting from a programme of refurbishment and decoration and residents spoken to say they liked the Home. A tour of the Home and information taken from the homes pre inspection questionnaire evidenced that the homes equipment and facilities are serviced and maintained appropriately. The manager also informed the inspector that plans are in place to have the garden area landscaped and made more pleasing and accessible to residents in the summer months. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. People who use the service experience good quality outcomes in this area. Residents can be confident that their needs will be met by sufficient number of staff that is trained and competent to carry out their role. Residents are always protected by the recruitment procedures within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An inspection of the homes staffing rota’s and discussions with residents, relatives and staff showed that residents at Amphion benefit from good staffing levels at all times. The Home has two night staff, two staff on the morning and afternoon shift with one floating staff member from 11am to 6pm each day. In addition to this residents benefit from an activities co coordinator for 20hours a week plus a cleaner, a cook and the manager. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 20 Feedback from residents and their relatives evidenced that the Home had sufficient staff to meet their personal, health and social care needs and feedback from staff and staff files inspected showed that they were appropriately trained to carry out their roles. Training in the Home is ongoing with staff having undertaken a range of core training, including medication, H&S, M&H, First Aid and Adult Protection. Over 50 of staff is trained at level 2 NVQ or above. A sample of staff files were inspected and these evidenced that all appropriate recruitment checks were being undertaken including. Staff files included Criminal Record Bureau checks, 2 written references, application forms dates of employment. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 People who use the service experience good quality outcomes in this area. On the whole the Home is managed well but some improvements are needed in the area of medication administration. The health safety and welfare of residents and staff are promoted and protected and on the Home is run in the best interests of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Feedback from residents and staff showed that they felt supported by the manager and owner and generally the needs of residents and the management of the environment were maintained appropriately. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 22 The new manager has 27 years experience of working in social care settings and has NVQ 2 and 3 in care. In addition they have undertaken the registered managers award and the D32 and D33 NVQ assessors award. The manager informed the inspector that they are still in the process of transferring some of the resident’s personal finances from the old provider and will be setting up individual interest earning bank accounts. General day to day spending is appropriately recorded and money is kept securely. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 23 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 2 3 X X x 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 24 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 Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP2 OP9 Regulation 5 13 Requirement Timescale for action 08/07/07 Residents must be provided with contracts which details the terms and conditions of their residency. The registered person must 08/06/07 ensure that all prescribed medicines are available in stock and are administered as the prescriber intended so that the health and wellbeing of people living in the home is protected. This must be adhered to on receipt of this report and there after. The registered person must ensure that all staff authorized to administer medicines have been appropriately trained and assessed as competent so that they can handle medicines safely. 08/09/07 3 OP9 13 4 OP9 13 The registered person must 08/07/07 ensure regular checks (audits) on medicines and record-keeping are carried out to make sure that medicines are given correctly and to identify any weaknesses in the medicines handling DS0000068533.V334785.R01.S.doc Version 5.2 Page 25 Amphion House systems that need to be improved on. 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 OP16 Good Practice Recommendations It is recommended that the Home promote the complaints procedure to ensure that all residents know how to make a complaint if they wish to do so. Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Amphion House DS0000068533.V334785.R01.S.doc Version 5.2 Page 27 - 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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