Inspection on 23/03/09 for Angel Court Residential Home

This inspection was carried out on 23rd March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Angel Court Residential Home 14/01/08

Angel Court Residential Home 21/02/07

Angel Court Residential Home 02/02/06

Angel Court Residential Home 31/08/05

Angel Court Residential Home 30/09/04

Angel Court Residential Home 12/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Angel Court Residential Home Angel Street Hadleigh Ipswich Suffolk IP7 5HA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: June Humphreys     Date: 2 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Angel Court Residential Home Angel Street Hadleigh Ipswich Suffolk IP7 5HA 01473823147 01473829157 lucy.roughley@suffolk.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Suffolk County Council care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Angel Court is a residential home 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 29 residents. 10 places are allocated for those with special needs (inclusive of one special needs respite bed), the remaining 19 places also includes one respite bed. 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. The accommodation, located on two floors, includes a Care Homes for Older People Page 4 of 24 Over 65 0 19 10 0 Brief description of the care home lift, and a staircase, connecting the two floor levels. The home has a garden, which includes patio-seating areas, birdbath and table. There is off road car parking at the front of the home. Current fees for this home range £400 to £709 per week. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that people who use this service experience good quality outcomes. This was a routine unannounced inspection, which included a visit to Angel Court on the 23rd March 2009. One inspector undertook the site visit, and all of the key national minimum standards were addressed. Opportunity was taken to speak with residents, relatives, staff, and the registered Manager. The Manager completed and returned the Annual Quality Assurance Assessment to the Commission, which is a self-assessment of how the service is doing. Information from the document has been included in the report. As part of the inspection 7 staff surveys, and 9 residents/relatives surveys were Care Homes for Older People Page 6 of 24 returned. The comments made have been useful, and have helped in understanding what it is like to live at Angel court. Records and documents were looked at in detail, including a sample of care plans, Two staff files and supervision records, the staff rota, complaints, medication and accident records. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home have their needs fully assessed so that they, and the home can be sure the placement is appropriate. Evidence: The assessment formatt used for assessing peoples needs prior to moving into the home is adequate in detail and content, to ensure peoples needs can be fully met by the home, when completed by an experienced assessor. Concerns had been raised at the last inspection that a person had been admitted to the home whos needs could not be met. Two assessments were looked at as part of this inspection, that had been completed by the new manager. The assessments clearly outlined the needs of the person being assessed, and the level of care and support the people required. The manager showed a good awareness of the needs that the home is able to meet and clearly took this into account when considering prospective admissions. The manager stated in the AQAA When a person is admitted, 6 weeks later, a review of care would take place and hopefully make the placement permanent however it is an assessment Care Homes for Older People Page 10 of 24 Evidence: review for both parties. For the potential; resident to decide if they wish to stay in a permanent capacity and for the home to indicate if they feel they can meet the individuals needs. The home does not provide intermediate care. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes care plans enable residents to be confidant that staff understand their health and personal care needs are fully met in a consistent and caring manner. Evidence: Three care plans were looked at as part of the inspection. . They were personalised, and contained good detail of individual needs. The manager stated that most care plans had been updated since the last inspection, and were easy for staff to access. Residents spoken with reported that staff gave them the level of support and assistance they required and provided care in the way that they preferred. One resident said, I am never afraid to ask for help. Another person said you have to wait sometimes, as staff are busy, but staff are always helpful and nothing is too much trouble. The Manager spoke of good working relationships with all health care professionals. Health care needs were recorded appropriately. Opticians, dentists and chiropodists Care Homes for Older People Page 12 of 24 Evidence: visit on a regular basis, and there was clear recorded evidence of district nurse visits, GP interventions, emergency services being called when required. Two residents medication was case tracked as part of the inspection and found to be accurate. Medication is supplied in both blister packs, and boxes. all boxes are marked with the date upon which it was opened. Staff who administer medication had received training. This covered safe handling practice and the importance of recording. There were records of training, and dates when refresher training should be undertaken. Observation of the care staff at work showed that interaction with residents was positive, appropriate and in keeping with their needs. Residents looked well cared for, were well presented physically with tidy hair and fingernails etc. and were dressed in their own clothes. Personal care was delivered discreetly and those service users spoken with who were able to express a view said that they were well-treated by the staff and felt that their privacy was respected - this was seen to be the case in several instances seen during the inspection i.e. at lunch time when a resident received assistance from a staff member to eat. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Angel Court are supported to live their lives according to their personal and individual preferences. Evidence: All staff support and encourage service users to maintain and develop social skills. Residents were observed undertaking a variety of tasks throughout the inspection. Dedicated activity staff are not employed to work in the home, and the residents do not attend the day centre which is located within the building, but managed separate to the home. Six residents were asked about the activities that were provided in the home, and all felt that a range of different things to do were offered. The manager stated in the AQAA that activities are put on regularly for residents according to their wishes. Entertainment and trips are organised to enable to have a diverse choice of activity. On the day of inspection Elvis (an entertainer) was visiting and all the residents and staff were talking about it. Staff spoken to stated that prospective residents are encouraged to bring photographs and personal belongings into the home. Relatives are wherever possible encouraged to provide information about the persons interests, family friends and social history. This is often helpful when talking to residents or encouraging them to join in. One staff member said People often find they have a lot more in common then they realized. Care Homes for Older People Page 14 of 24 Evidence: Contact with relatives and friends is encouraged by the home and visitors made welcome. One relative spoken with said she was always made welcome when they visited and was kept up to date with any relevant information. People living at the home were spoken with during lunch- time. All residents said they enjoyed the food presented, had a choice of meals available and were supported by staff if they needed it. The food on the day was of a very good standard. There was a main meal offered, with two possible choices. The home operates a five-week menu which was seen to be regularly updated and reviewed by residents and staff. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open culture where individuals feel safe and supported to share any concerns in relation to their protection and safety. Evidence: A robust complaints procedure is in place that contains the required elements to meet the standard. There is a copy of the complaints procedure on display in several communal areas of the building. Most residents asked, said they knew how to go about making a complaint and expressed confidence that the senior staff and manager would listen and react promptly to resolve the matter if possible. Policies and procedures relating to the protection of vulnerable adults were in place with appropriate guidelines for staff to follow should a complaint of abuse be made or they observe an incident of abuse taking place. Two staff induction checklists were looked at as part of the inspection, and both had covered basic safegarding issues and how to respond. All senior staff had attended a two day course in safeguarding which was organised by Suffolk county council, and when spoken to were clear about reporting and recording. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home environment provides a clean, comfortable and safe environment in which to live in. Evidence: A physical tour of the premises was undertaken as part of this inspection. The building and grounds were well maintained and provided a pleasant and homely environment. Since the new manager as come into post every effort has been made to re decorate communal areas. Residents rooms contained personal possessions and photographs creating an individual feel. One of the downstair bathrooms is currently used as storage. The room was untidy, and the should be made fit foe purpose. Communal areas felt comfortable; this was confirmed by two visitors, however one felt that the home was always clean and hygienic, but there was not enough staff provided to help residents. Asking for further detail the relative stated that staff worked extremely hard and did not always have time to speak to relatives. Angel Court has four dedicated cleaning staff; the home appeared clean and fresh on this day with no unpleasant odours present. Records showed that most staff members had attended infection control courses/refresher in November and December 2008. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff who receive appropriate training to support and protect the residents. Evidence: The homes rota was looked as part of this inspection and confirmed the current level of staffing on duty on the day. There is five carers plus a team leader in the morning, and four carers and a team leader in the afternoon. The service provides twenty-four hour staff support, and at night there is two carers and one team leader. The current staffing levels are sufficient to meet the needs of the current residents, but at times due to new staff, and the use of agency workers their has been some inconsistency in the experience and skills of staff on duty. This was raised in discussion by both relatives and staff, but also acknowledged by them was that this has improved since the new manager has come into post. The manager stated that thorough assessment of prospective residents prior to admission, and the employment of four domestic staff, a handyman, and a significant reduction in the use of agency staff, due to increased recruitment of permanent staff has helped improve staff morale and performance. Two staff files were looked as part of the inspection. All staff files identified the training staff had undertaken. The homes mandatory training i.e. first aid, manual handling, safeguarding and medication administration, had been completed by staff. Care Homes for Older People Page 18 of 24 Evidence: Staff felt that they had good access to relevant training opportunities, and new staff undergo a thorough induction within the early stages of being employed to work in the home. Part of this familiarises staff with the policies, procedures and routines of the home. The records of all of new staff currently in post were inspected and found to hold all of the required checks and information i.e. criminal record disclosure and references. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager at the home has a clear understanding of the principles and focus of the service provided, and has well-organised systems and processes to support staff, and protect residents. Evidence: The manager has clearly made a positive impact on the running of the home. Staff and residents spoke of the changes made since the manager has taken up post. The manager has experience of caring for older people and has RMA (registered managers award) NVQ 4 in care. The home provides a good standard of experienced staff who hold a mixture of NVQ 2 and above. The manager has a strong commitment to raise and sustain standards, and residents personal wellbeing and safety is promoted through staff training, comprehensive policies, procedures, and regular health and safety checks. The accident book was examined during the site visit, and this contained well-recorded information, and risk assessments and care plans had been updated regularly where concerns had been recorded i.e. in relation to falls etc. The Care Homes for Older People Page 20 of 24 Evidence: home had a fire risk assessment that had been completed, and updated, there was evidence of fire drills and fire alarm tests. Regular support of staff is continuous, and residents views underpin the philosophy of the home. One resident stated She is always available to help us, and support staff when necessary. A member of staff said it is much improved, when feel able to talk to her. A supervision matrix has been devised by the manager, and it was positive to note that all of the staff files looked at in relation to this had received supervision, and that this had improved since the last inspection. Staff meetings and residents meetings are held regularly, and recorded. Service users monies were examined and these were seen to be well managed and to tally with the recorded information. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 22 23 Suitable provision must be made for storage in the home to ensure residents live in an environment, which remains safe and free from clutter. (refers to downstairs bathroom) To ensure residents live in a safe environment 01/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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