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Inspection on 02/02/06 for Angel Court Residential Home

Also see our care home review for Angel Court Residential Home for more information

This inspection was carried out on 2nd February 2006.

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.

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

The home provides residents with a good quality of life in an environment which is well maintained, comfortable and homely. There is a strong staff team in place who are well regarded by the service users and are competent in their roles. The staffing levels provided are appropriate to meet the assessed needs of residents and the home places a clear emphasis on offering residents meaningful and appropriate activity. The location of the home means that service users are easily able to access the local facilities and resources in the town centre.

What has improved since the last inspection?

Since the previous inspection and in response to a requirement made at that time, the home has purchased a fit for purpose medication trolley. Additionally all resident bedrooms have been fitted with a secure cupboard for the purposes of individual medication storage.

What the care home could do better:

The home continues to offer a good service to residents and to evidence good working practices. However, there should be clear guidelines in place for the management of hospital acquired infections to ensure that the health, welfare and quality of life of the sufferer are not compromised. Care staff at the home would benefit from training on this topic and can access advice, information and training via the local health authority infection control services.

CARE HOMES FOR OLDER PEOPLE Angel Court Residential Home Angel Street Hadleigh Ipswich Suffolk IP7 5HA Lead Inspector Jane Higham Unannounced Inspection 2nd February 2006 09.15 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 Angel Court Residential Home DS0000037158.V281096.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. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Angel Court Residential Home Address Angel Street Hadleigh Ipswich Suffolk IP7 5HA 01473 823147 01473 829157 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) Suffolk County Council Mrs Frances Mary Nunn Care Home 28 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (18) of places Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2005 Brief Description of the Service: Angel Court is a residential resource for older people situated in the heart of the market town of Hadleigh, close to local amenities and owned and administrated by Suffolk County Council. The home offers accommodation and care for up to 28 residents. 10 places are allocated for those with special needs (inclusive of one special needs respite bed), the remaining 18 places also include four respite beds. The home was initially opened in the mid 1960s and extensively refurbished between September 1996 and May 1997. Angel Court also operates a twelve place day centre for older people, having its own access and facilities. At the present time the day service is not subject to registration and inspection. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Inspection of Angel Court, a twenty-eight bedded residential care home for older people, owned and administered by Suffolk County Council. The accommodation includes a ten bedded special needs unit for people over the age of who have a diagnosis of dementia. This was the second inspection in the inspection year 2005/2006. The inspection took place on 02.02.06 over a period of two and three quarter hours. All core standards have been assessed over the two inspections and this document should be read in conjunction with the report of the Unannounced Inspection dated 31 August 2005. The home was inspected against the National Minimum Standards: Care Homes for Older People and the Care Standards Act 2000. The National Minimum Standards and Care Homes Regulations 2001 are referred to throughout this report and any non compliance identified. The Registered Manager was available at the time of the inspection and assisted with the inspection process. On this occasion, core standards not assessed as part of the previous inspection were examined and any requirements made at that time were re-assessed. During the course of the inspection, the inspector spoke to six residents and one district carer. Residents provided feedback in relation to the quality of the service and care provided. What the service does well: The home provides residents with a good quality of life in an environment which is well maintained, comfortable and homely. There is a strong staff team in place who are well regarded by the service users and are competent in their roles. The staffing levels provided are appropriate to meet the assessed needs of residents and the home places a clear emphasis on offering residents meaningful and appropriate activity. The location of the home means that service users are easily able to access the local facilities and resources in the town centre. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 6 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. Angel Court Residential Home DS0000037158.V281096.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 Angel Court Residential Home DS0000037158.V281096.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): 6 The home does not offer an intermediate care service. EVIDENCE: Standards 1,2 3 and 5 were assessed as part of the previous inspection which took place on 31 August 2005. On the day of the inspection the home was offering accommodation and care to three people on a short-term basis. Several residents spoken to during the inspection had moved into the home on a permanent basis after enjoying regular periods of short-term care. However the home does not offer an intermediate care service. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 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 the following standard(s): 7 and 10 Residents living at the home can expect to be provided with a plan of care which details their individual assessed care needs. The home places a high priority on ensuring that the privacy and dignity of residents is maintained. EVIDENCE: Standards 7, 8 and 9 were assessed as part of the previous inspection which took place on 31 August 2005. However, the care plan of one service user was examined in relation to the management of MRSA and did not evidence that a review of their individual care needs had taken place over the last two months. Standard 7.4 of the National Minimum Standards: Care Homes for Older People recommends that service user care plans are reviewed on a minimum monthly basis. The home was able to evidence that the care plans of residents provided information about their preferred from of address. The home was able to evidence that both the Induction training package and one of the NVQ modules Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 10 covers the right to privacy and dignity that should be afforded to all service users. All resident bedrooms have the advantage of ensuite facilities affording maximum privacy and all bedroom doors are fitted with appropriate locks. Residents could confirm that they were assisted with their personal care needs in the privacy of their own bedroom. All medical interventions and consultations were also carried out in the privacy of residents’ bedrooms. All residents were smartly dressed and it was noted that one residents preferred form of dress was a shirt and tie which they had been assisted to wear. It as noted that each unit was provided with a portable payphone which could be connected up in each resident bedroom. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 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 the following standard(s): 12 and 14 Residents living at the home can expect to be supported to make choices around their daily lives and to be provided with activities which are appropriate to their interest and abilities. EVIDENCE: Standards 12, 13 and 15 were assessed as part of the previous inspection which took place on 31 August 2005. On the day of the inspection, the manager advised that no currently accommodated residents were able to or chose to manage their own finances. The home was able to evidence that residents are supported to make choices in relation to their personal daily routines, how they spent their time and what they would like to eat. A tour of the building evidenced that when moving into the home residents are encouraged to bring personal possessions and small items of furniture with them from their former accommodation. All rooms seen on the day of the inspection had a homely feel and contained personal possessions such as pictures, furniture, ornaments and family photographs. On the day of the inspection, it was noted that posters were displayed around the building informing residents of what functions were being held in the home during the month of January 06. These had included a Karaoke sing-along and Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 12 a grand new year party with live music and a buffet. Additionally a programme was displayed on each unit which informed residents of what activities were being offered. On Kingfisher and Swallow Unit the activities programme included a gentle exercise class, reminiscence session, cooking, bingo and a beetle drive. One resident reported that they liked to help out in the home’s greenhouse during the warmer weather where salad and vegetable items were grown. Two residents remarked that they found plenty to do and two female residents reported how much they had enjoyed the bingo and quiz session which had taken place the previous day. During the inspection, one service user reported that they were not permitted to sit in the lounge with the other residents as they were suffering from an infection. The service user was unable to provide further information but advised that they felt quite lonely being unable to socialise with other residents. It was evident from the correct hygiene procedures being followed that staff were taking every measure to ensure that this infection did not spread. However it was confirmed by the Inspector that as long as staff continued to follow the correct infection control procedures, this resident was not required to be isolated in their room. It was agreed with the Manager that contact would be made with local health authority infection control team with a request that they provide an information and training session on the management of MRSA within the home. It was also agreed that a risk assessment would be produced which would provide all staff with details on actions to be taken to minimise the risk of the spread of infection. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 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 the following standard(s): Not assessed as part of this inspection. EVIDENCE: Standards 16 and 18 were assessed as part of the previous inspection which took place on 31 August 2005. Since the previous inspection, the Commission has received no complaints in relation to this service. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 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 the following standard(s): 19-26 Residents can expect to be provided with accommodation which is well maintained and comfortable and appropriate to meet their individual assessed needs. EVIDENCE: Angel Court is a local authority residential home which was purpose built in the 1960s and further refurbished during 1996/1997 to provide all single room accommodation with ensuite facilities. Accommodation is divided into three living units, one sited on the ground floor and the remaining two on the first floor. Both floors can be accessed via a passenger lift. Each living unit includes single bedroom accommodation, living room, kitchen/diner and communal bathrooms. In all, the home has six communal bathrooms, four are equipped with a hoist, one has a parker bath and the sixth is unassisted. All bar six of the ensuite facilities include a shower. Temperature of hot water delivered to communal bathrooms was found to be within the recommended safe range. The home has well maintained gardens to the front and rear of the property. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 15 On the day of the inspection a tour of Kingfisher and Swallow Units was undertaken. All accommodation both communal and private was maintained to a very good standard of decorative order and repair. The standard of accommodation was discussed with a number of residents all of whom reported that they were very satisfied. The home was comfortably furnished and furnishings were of a good standard. Residents had been assisted to make their bedrooms as homely as possible and lounge and dining areas were provided with pictures, flower displays and domestic style furniture to provide a homely feel. All areas of the building were well lit and maintained at a comfortable temperature. All areas of the home were maintained to a high standard of cleanliness and hygiene and aids and adaptations to assist with mobility were provided throughout the building. Every bedroom had been provided with a handrail by the ensuite toilet and communal baths had also been provided with handrails. The Manager reported that eight “rise and fall” beds had been provided by the Friends of Angel Court. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Residents living at the home can expect to be supported by competent and caring staff in sufficient numbers that ensure their well-being and safety. EVIDENCE: Standards 27, 28, 29 and 30 were assessed as part of the previous inspection which took place on 31 August 2005. On the day of the inspection the home was being staffed by a Team Leader, assisted by five carers. Two agency carers were covering for permanent members of staff who were on sick leave. The staffing rota correctly reflected the number of staff on duty. During the afternoon period, residents are supported by a Team Leader and four members of care staff. During the night period this level decreases to one Team Leader and two carers. The Registered Manager maintains a presence in the home during the day. Four residents spoken to reported that staff were very helpful and nice. One resident went so far as to say that the staff were “unbelievably marvellous”. One district carer who is employed by the local authority to cover staff sickness and annual leave reported that they always liked to come and work at Angel Court as there was a very good staff team. On the day of the inspection, staff were observed interacting with residents in a professional, yet warm manner. They appeared to be confident in their roles Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 17 and evidenced a sound knowledge of the needs and preferences of individual residents. Angel Court Residential Home DS0000037158.V281096.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): 35 Service users financial interests are safeguarded by the home’s policies and procedures in relation to the administration and safe keeping of resident monies. EVIDENCE: Standards 33, 36 and 38 were assessed as part of the previous inspection which took place on 31 August 2005. During this inspection, the systems used for the safe keeping and administration of service users finances was examined. The home keeps a small amount of money for each service user where required, which is stored in individual wallets within a secure safe. The Administrative Assistant was able to show how all transactions made by service users or on their behalf are recorded and receipts retained. Any monies withdrawn from by a service user or on their behalf requires a signature. Monies withdrawn on service users Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 19 behalf by the Administrative Assistant is signed for and in most cases this signature is witnessed by a staff member for additional security purposes. The home was able to evidence, by a random sample, that the indiviudal monies held for residents balanced with the figure recorded on the transaction sheet. Angel Court Residential Home DS0000037158.V281096.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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 2 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 21 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 Standard OP14 Regulation 12(1)(2) Requirement The Registered Persons must ensure that a Risk Assessment is produced in relation to one service user with MRSA and that the service user in question is not isolated in their room unnecessarily. Timescale for action 02/02/06 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 Refer to Standard OP7 OP26 Good Practice Recommendations The Registered Persons should ensure that service user care plans are reviewed on a minimum monthly basis. The Registered Persons should ensure that care staff receive appropriate training on the management of hospital acquired infections. Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Angel Court Residential Home DS0000037158.V281096.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!