Inspection on 04/08/05 for Ancona

This inspection was carried out on 4th August 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

Ancona 11/09/07

Ancona 06/12/06

Ancona 24/01/06

Ancona 28/10/04

Ancona 14/04/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Ancona The Square Freshwater Bay Isle of Wight PO40 9QG Lead Inspector Richard Slimm Unannounced 4 August 2005 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. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ancona Address The Square Freshwater Bay Isle of Wight PO40 9QG 01983 761787 01983 753284 kingbrooke@yahoo.co Mrs Carole Mary Brooke 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) Mrs Patricia Susan Ann White Care Home 18 Category(ies) of Dementia - over 65 years of age (5) registration, with number Old age, not falling within any other category of places (18) Physical disability over 65 years of age (6) Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28 October 2005 Brief Description of the Service: Ancona is a registered care home, which provides care/support and accommodation for people who may have dementia over the age of sixty five years. Six residents may be accommodated by reason of age related physical disability over 65 years. The home is situated in a quiet residential area of Freshwater close to the centre of of the village. The home has benefitted from significant building works, upkeep and maintenance programs including the development of improved access to the extensive rear gardens, and an ongoing refurbishment plan is in place to continue the improvement of the physical environment. Accommodation is organised over 2 floors across 2 houses that are linked on the ground floor, with access to all floors via the two shaft lifts. There are large gardens to the rear of the home, which are enclosed and fully accessible to residents. The ground floor has some bedrooms, but also provides communal space, including a large lounge split into two areas, a dining area, communal bath/toilet facilities, the kitchen a utility room and staff WC. All bedrooms are single and 13 have been provided with en suite facilities. Each floor has access to communal bathing/shower and WC facilities. The home also has staff accommodation in the attic area. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between the hours of 10 am and 4 pm on the 4/8/05. The day was spent visiting service users in their own rooms, and communal areas of the home and interviewing them in order to establish their views of the quality of service provided by the home, the inspector also joined the residents for lunch and met two other visitors to the home. The administration of medication for residents was inspected. The inspector checked records and other relevant documentation, interviewing care, management staff/owners. Both residents, staff and visitors spoken to, made positive comments about the home. This report will make a number of recommendations. What the service does well: What has improved since the last inspection? Action had been taken to implement the four recommendations made in the last inspection report. There is a 3-year plan to maintain and continue the improvements to the environment, and the home was well presented and clean, providing a valuing environment to residents. All WCs including en suites have been replaced with high-level units, four bedrooms have been fully upgraded, and a number of windows and doors have been replaced with UPVC units, a number of new carpets and furnishings have been provided, and a new car park area to the front of the home has been provided, a new terrace and improved garden access has been put in place, a new alarm call system has been provided, and new fencing to some areas of the boundary. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 6 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. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 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 Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 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) 3 Residents have their needs assessed prior to admission. Residents’ are assured that their needs will be met at the home. EVIDENCE: The home does not provide intermediate care services. Consequently standard 6 was not assessed. A sample of care assessments, planning and review systems were inspected. The provision of personal profiles as part of assessment has enhanced the quality of information about residents’ lives prior to entering the home. Care assessments continue to develop, and appeared to provide the information needed to develop clear plans of care. Where necessary the home will seek additional input from residents’ advocates/relatives, wherever possible with the consent of the resident. Residents were found to be contented, but given the degree of confusion of some residents they were not all fully aware of care records held about them. Staff members were able to demonstrate an awareness of residents’ needs and the importance of care planning systems in regard to promoting consistency and accountability. Staff may benefit from some training in the ongoing development and completion of care records at the home. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 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) 7-8-9-10 Residents had individual plans of care. Care plan records were specific. Daily monitoring care records are not kept appropriately. Care plans, and management systems, did ensure residents health care needs were identified and met. Arrangements for the administration of medications were found to be appropriate to the needs of the residents who needed support. Arrangements for residents who self-administer medications were appropriate. Changes to medication dosages where not signed by the external professional making these changes. EVIDENCE: Each Resident has a plan of care. Monitoring notes of care plans were not being maintained on an individual basis, or providing a clear chronology of the care provided or issues arising. Currently there is a separate log in which personal records are being maintained about all residents. Care plan systems appeared to cover mostly practical aspects of daily living, and plans could now be further developed to provide increased insight into the mental health psychological needs of residents. More confused and frail residents have fluid/food intake records. There will be a recommendation made in order to ensure residents’ daily notes are kept on an individual basis. Some staff members training needs were identified in the area of maintaining accurate and relevant case records. Residents were able to confirm that they had access Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 10 to community health care support as required, and confirmed that they could see their GP on request. Some residents were under specialist health services, including consultants and community psychiatric nurses. The inspector spoke to 2 visitors who confirmed that they visited the home on a regular basis and always found the home to be welcoming, clean, and with a staff group who were interested in the residents. Residents spoken to confirmed that the staff members treat them with dignity and respect, and this was also observed throughout the visit. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 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) 12-13-14-15 Residents are provided with support to lead their own lives as far as possible. Contact from outside of the home is encouraged and supported. Residents are encouraged and supported to exercise choice and control, and the home provides a balanced diet with options to main menus based on the wishes/ needs of residents. Religious and recreational needs of residents’ are recognised and met. The opportunities available for residents to have outings from the home could be increased. EVIDENCE: Given the degree of vulnerability of some of the resident group, supervision is needed in most aspects of daily living. Most residents need support outside of the home, and the home strives to provide opportunities for residents to get out when possible. The owners stated that they intend to employ additional senior staff soon, in order to free themselves up to provide increase outings for residents. The needs of residents are known and the home ensures that more able residents rights to journey out alone are fully respected. Residents said that they felt that there were enough things going on at the home to meet their needs. Some residents have family support in the area of outings and several residents were observed going out for a drive with their relatives. Visitors to the home are welcomed and encouraged. Residents confirmed that they had visitors. The inspector spoke to two visitors and they confirmed that they were always made welcome at the home. Activities are arranged in the home relevant to the needs, wishes and abilities of the residents. There are Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 12 few restrictions in the home, with residents having full freedom of movement around communal areas and choice in such areas as where they sit, this was observed during the visit. Support is provided wherever needed by a patient, dedicated and well supported staff team. Residents spoke highly of the staff and good relations were evident. Residents confirmed that their religious needs are catered for at the home, and one resident received a visit from a local pastor during the visit. Routines appeared to be kept to a minimum, with the residents placed firmly at the centre of the running of the home. Residents choose where they eat their meals, and support is provided to maintain dignity and independence to more dependent residents. Residents spoken to were found to be happy with the quality and choice of food provided, and options are provided to main menus. Special diets are catered for where necessary. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 13 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) 16-18 Systems are in place to ensure any concerns or complaints are listened to, taken seriously and acted on. This includes information and systems to protect residents from potential abuse. EVIDENCE: The home has a clear and accessible complaints procedure. This is made available to residents and/or their representatives. Residents’ confirmed that they knew how to make any concerns known, and who to speak to. The manager has the role of investigating any concerns and full records would be maintained. There had been no complaints since the last inspection visit. There is an adult protection policy and procedure in place and this is available to staff members. Staff training in adult protection is provided in-house, with plans to access external courses in the future. A number of staff members have received adult protection training via their NVQ courses. The home reports all incidents affecting the wellbeing of residents to the CSCI as required. Residents confirmed that they felt safe living at Ancona. The home would benefit from accessing a copy of the department of health document “NO Secrets”. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 14 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) 19-24-26 The home was clean and well maintained, providing a valuing environment to residents. The home provides only single bedrooms. Bedrooms are not provided with appropriate locking arrangements for potential residents needs and wishes, in line with the standards. There is a clear commitment and written plans for the ongoing improvement and development of the home’s environment. EVIDENCE: The home is well presented and maintained, and there was clear evidence of the ongoing investment into the physical environment of the home. The home was cleaned to a good standard throughout at the time of the visit. Residents stated that they were happy living at the home, and confirmed their home was always kept clean and decoration is ongoing, and that they were involved in deciding colour schemes. Residents also confirmed that they accessed the garden frequently. The home has only single bedrooms, and thirteen have been provided with en suite facilities. No bedrooms have appropriate locking arrangements, however, existing residents were not concerned with this matter. The owners have agreed that they will consult with all residents about the provision of door locks to individual bedroom doors, and where necessary Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 15 provide appropriate locks. It was agreed that existing residents who choose not to have locks will have their wishes respected, however, as residents move on rooms will be provided with locks before new residents are admitted to the home in the future. The manager agreed to monitor this issue in consultation with the resident group. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 16 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) 27-29-30 Staffing levels were maintained to a good standard. Staff recruitment, selection, supervision and retention met the standards. Staff members may benefit from further training in care record maintenance. Records of checks on staff who are school leavers and who have not worked before need to be improved, and where necessary references from sources other than previous employers taken up. EVIDENCE: The home has clear staff rosters. Staffing levels were maintained to a good standard. The home does not employ agency staff, however, staffing does prove difficult at times. The home plans to take on additional senior staff in order to free up the owners to provide other service developments, in such areas as resident outings. Residents spoke highly of the staff team, and confirmed that they are always treated with dignity and respect. Staff members were observed interacting well with residents, and providing sensitive, discreet support. Staff may benefit from increased training in the development and maintenance of the homes’ care record systems. There is one waking and one sleep in staff member at night. In addition to care staff the home employs ancillary staff including a cook and domestic. The home uses a recruitment and selection system that meets the legal requirements and provides safeguards for residents, by ensuring staff receive appropriate checks. There are difficulties in accessing references for school leavers who have not had paid jobs before. However, the manager advised that she had known the staff concerned for many years. There is a clear commitment to the ongoing training and development of the staff team to NVQ levels 2 and 3. There are a number of highly dependent residents, however, staffing levels Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 17 were of a level that ensure their care needs did not detract staff time from other residents accommodated. The manager is qualified to NVQ 4 and is currently doing the registered managers’ award, and 70 of the staff team had been provided with training to NVQ 2 or above. Staff had also been provided with other specialist training relevant to the care needs of the resident group. There are regular staff meetings, and formal staff supervision is being provided. Staff spoken to confirmed that they were happy working at the home. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 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 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) 33-35-38 The home is run in the best interests of residents. The home has no input into the residents’ financial interests or affairs. The Health and safety of residents and staff, in the area of fire protection should be further promoted. Fridge freezers need to be defrosted. EVIDENCE: A sample of policies and procedures were inspected. Systems of quality assurance continue to develop at the home. The homes’ owners’ are a husband and wife team who employ a manager, and are keen to work with the CSCI in the ongoing development of the service. The home has decided to have no involvement in residents’ valuables, monies or financial interests. However, residents spoken to confirmed that they could have access to money if they needed it, the home providing this service and billing retrospectively. Staff members had received training in core training topics, including manual handling, fire safety, first aid, and food-hygiene and infection control. The manager and one of the owners make arrangements for the maintenance of health and safety at the home. However, at the time of the visit records of Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 19 staff fire training and drills were not available for inspection contrary to best practice and the recommendations of the chief fire officer. The owner/manager agreed that the relevant fire records would be kept in future. Service contracts are in place for the maintenance of the central heating, shaft lifts, and electrical items/systems and bath hoists/chair. Fire precaution maintenance is recorded, with copies of service visits maintained. Residents confirmed that the fire alarm system is tested regularly and that they felt safe living at the home. Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 2 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 21 No 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 Regulation Requirement Timescale for 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. 2. 3. 4. 5. Refer to Standard 7 9 12 18 24 Good Practice Recommendations The registered persons should ensure that daily care records are maintained individually, providing a chronological record of care provided and any other issues. The registered person should ensure that where external professionals make changes to prescribed medication they sign the relevant medication records. The registered persons should make increased opportunities available for residents to take outings from the home. The registered persons should obtain a copy of No Secrets from department of health. The registered persons should consult existing residents about providing the choice of having privacy locks fitted to their individual bedroom doors. Door locks will be provided to bedroom doors prior to any new admission to the home. The registered persons should make arrangements to defrost freezers where food is stored. The registered persons should ensure that there are clear and accurate records of all staff fire training and fire drills carried out in the home. H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 22 6. 38 Ancona Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 Page 23 Commission for Social Care Inspection Mill Court The Furrlongs Newport Isle of Wight PO30 2AA 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 Ancona H55-H03 S34735 Ancona V216922 040805.doc Version 1.40 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. 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!