Inspection on 31/08/05 for Angel Court Residential Home

This inspection was carried out on 31st 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

Angel Court Residential Home 23/03/09

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 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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Angel Court Residential Home Angel Street Hadleigh Ipswich Suffolk, IP1 2BX Lead Inspector Tina Burns Unannounced 31 August 2005 st 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. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Angel Court Residential Home Address Angel Street, Hadleigh, Ipswich, Suffolk, IP7 5HA 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) 01473 823147 01473 829157 None Suffolk County Council Mrs Frances Mary Nunn CRH 28 Category(ies) of DE - 10, OP - 18 registration, with number of places Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 30th September 2004 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 upto 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 I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was a routine unannounced inspection, carried out on a weekday between 9.45am and 4.15pm. The Registered Manager, Mrs Frances Nunn, was present and fully contributed to the inspection process. A number of staff, residents and visitors were spoken with during the inspection. The Inspector also toured the premises and examined documentation including residents care plans, staff files, health and safety records, risk assessments and policies and procedures. What the service does well: What has improved since the last inspection? Since the previous inspection the home had recruited an activities co-ordinator on a part time basis. Staff and residents reported that this had been a “good appointment”. Residents spoken with said that they were enjoying more planned activities including, outings and visiting entertainers. The activities programme displayed included a good number of varied activities. During the last inspection the hot water temperature in one of the en suites exceeded the recommended 43 degrees centigrade. The registered manager Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 6 reported that action had been taken to control the hot water temperature and on this occasion the water was tested at below 43 degrees centigrade. 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 I54-I04 S37158 Angel Court V247362 050831 Stage 4.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 Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.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) 1, 2, 3 & 5 Prospective residents can expect to have their needs assessed before admission and be able to make an informed choice about moving into the home. They can also expect to have a written agreement stating terms and conditions of occupancy. EVIDENCE: The home’s Statement of Purpose and Service User Guide provides detailed information for prospective residents and their families. The manager confirmed that both of these documents are given to prospective residents prior to admission. The Statement of Purpose includes a summary of the admission process and includes information about pre admission assessments and visits. The manager confirmed that all prospective residents have the opportunity to visit and stay on a trial basis before moving into the home although it is fairly common that new residents are familiar with the home already having accessed the respite service. One resident spoken to during the inspection said that they had moved into the home permanently after several years of respite Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 9 care at the home and this had made the transition into residential care much easier. During the inspection three residents records were examined and all contained signed copies of the residents contract that included details of the accommodation, care and services, fees and expenses and terms and conditions of occupancy. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9. Residents can expect to have an individual plan of care, which is updated regularly and reflects their needs. They can also expect to have their health care needs met, however the current system in place for transporting medication does not fully safeguard residents or staff. EVIDENCE: During the inspection three residents care plans were examined. Each plan included detailed information relating to the individuals social, emotional and physical needs. Manual handling and risk assessments were in place and each care plan had been reviewed on a monthly basis. Residents spoken with made positive comments about their personal care and support and observations were that everyone seemed physically well cared for. The care plans examined evidenced that the home monitors the health and well being of residents and enables them to access community health facilities. Records of visits by GP’s, community nurses, chiropodists and opticians were well documented. A resident’s relative, spoken with during the inspection, confirmed that the home works closely with health professionals to ensure that the optimum level of health care is available to residents. The relative said I couldn’t speak more highly of the care, kindness and attention”. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 11 On the day of inspection the manager confirmed that there were no residents administering their own medication. The home used a monitored dosage system for their permanent residents. Medication belonging to respite users was labelled appropriately and in their original containers, clearly identifiable in small named baskets. Both were stored appropriately in locked metal cabinets. The medication records were printed and supplied by the local pharmacy with clear details of medicines and instructions. Medicines administered by the home had been recorded appropriately and the manager confirmed that the team leader on duty administers medication. All team leaders have had training in the administration of medicines. During the inspection the process of transporting the medication to residents was discussed, the home is currently using an open trolley for this purpose and although the manager confirmed that staff are instructed to remain with the trolley at all times this cannot be accepted as safe practice. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 12 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 & 15 Residents can expect to have social and leisure opportunities and be supported to maintain contact with friends and relatives. Meals are appetising and nutritious and provided at times convenient to residents. EVIDENCE: Since the previous inspection the home has appointed a part time activities coordinator. The manager, staff and residents spoken with during the inspection all confirmed that the co coordinator had made a positive impact on daily life at the home. Some of the residents spoken with during the inspection talked about activities, outings and events that they had been involved in and also mentioned future plans with enthusiasm. The programme of activities had been distributed amongst the residents and was also on display throughout the home. Recent and forthcoming outings and events included visiting a restaurant in Walton, a sing a long evening, visiting entertainers, a cream tea, board games, bingo, a fish and chip supper, a barbeque, bell ringers, a clothes sale, French theme day and a visiting story teller. Residents spoken with during the inspection confirmed that their visitors were always made welcome. Several people were seen visiting residents on the day Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 13 of inspection, either privately in resident’s own rooms or in one of the several communal or seating areas within the home. One visitor spoken to said that she was encouraged to visit regularly and always made welcome, she also said that she was usually offered meals and refreshments or could use the communal kitchen area. Observations were that visitors felt comfortable and at ease in the home and were familiar with the staff on duty. Each of the home’s three units were self-contained, having their own wellequipped kitchen and dining area. The dining areas were clean, pleasantly decorated and furnished rooms but residents could chose to take their meals privately in their own rooms if they wished. The unit’s kitchen areas were available for residents, visitors and staff to make drinks and snacks, the main meals being cooked and prepared in the main kitchen. The main kitchen was spacious, well equipped and sited on the ground floor, next to the day service. The inspector was informed that it supplies meals to the home, day service and community. On the day of inspection the kitchen appeared well organised, clean, tidy and hygienic. During the inspection several residents spoken with made positive comments about meals at the home and confirmed that there was flexibility about when and where meals were taken. The menu was on display in each dining area and offered varied, balanced and nutritious options. The main meal on the day of inspection was roast pork with applesauce and cinnamon and lemon eves pudding with custard. There were a good variety of alternatives available. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 14 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 The home has clear procedures in place to deal with complaints and allegations or suspicions of abuse. EVIDENCE: The home has a detailed complaints procedure that has been produced by Suffolk County Council. The manager confirmed that the leaflet ‘Having Your Say! Comments, Compliments and Complaints about Social Care Services’ is given to all new residents and their relatives. One resident spoken with on the day of inspection said, “I have no complaints, the home is under good management”, another said that they felt able to complain or raise any concerns. A visitor also said that they had not had cause to complain but always felt able to express their views and felt listened to. They also commented that they felt that their relative was “in safe hands”. The home had a copy of the Suffolk inter agency policy and procedures for the protection of vulnerable adults. The manager informed the inspector that all staff had their own individual copy of the guidelines and relevant training was provided through the foundation training package. Records seen during the inspection confirmed that staff employed have had Criminal Records Bureau Enhanced Disclosure checks. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 15 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) 19,20,23,24,26 Residents can expect to enjoy a good standard of accommodation and be safeguarded by a good standard of cleanliness and infection control. EVIDENCE: Angel Court is a local authority residential home, purpose built in the 1960’s. During 1996/1997 the building was extensively refurbished and upgraded to provide single room accommodation, with ensuite facilities for all residents. Accommodation is provided on two floors and there is level access throughout the building via a passenger lift. There are three living units each having their own living and dining area and communal bathroom. The home is sited in the central area of the market town of Hadleigh and all local shops and community facilities are easily accessible. During the inspection the home was seen to be well maintained and in a good standard of decorative order. There were pleasant, well kept grounds to the front and rear of the property. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 16 The home has a good number of communal areas for its size. As well as each unit having its own living and dining areas there was also a selection of smaller rooms and spaces available for residents to meet, this is particularly helpful when entertaining visitors. All of the communal areas were attractively decorated with pleasant fixtures, fittings and furniture. All of the resident’s bedrooms had ensuite facilities including WC’s and wash hand basins, some also included showers. Five bedrooms were seen during the inspection, all were well maintained and comfortably furnished; those belonging to permanent residents had personal belongings displayed, including photographs, paintings and ornaments. Each bedroom had lockable storage space and call systems in place. On the day of inspection, the home was maintained to a good standard of hygiene and cleanliness and no unpleasant odours were detected. The home employed a laundry assistant and four domestic assistants. Residents spoken to on the day confirmed that the home is “nice and clean”. Laundry facilities on both floors consisted of commercial washing machines and dryers. Both laundry rooms were clean and tidy and infection control measures were in place. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 17 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, 28, 29, 30 The home follows safe recruitment procedures and employs sufficient staff to meet resident’s needs. Staff receive appropriate training and development but adequate systems are not in place to ensure that staff training remains up to date. EVIDENCE: Staff spoken with on the day of inspection informed the inspector that the home has five care staff and a team leader on duty throughout the day and four care staff and a team leader in the afternoon / evening period. At night the home had two awake care staff and a team leader on duty. The registered manager and activities co coordinator were supernumerary. Examination of the staff rota confirmed these arrangements were in place. Staff spoken with said that agency staff are often used to cover staff absence but that the home tries to use the same agency staff to ensure consistency. Records in staff files and discussions with staff on the day of inspection indicated that several staff had completed NVQ training. The manager confirmed that fourteen of the current twenty-two care staff had completed NVQ 2. During the Inspection three staff files were examined and each contained satisfactory recruitment records including Enhanced Disclosure Criminal Record Bureau Checks, two references, evidence of identity and health checks. The staff files examined also contained evidence of staff induction and foundation training, manual handling training, dementia training, medication training and fire safety training. Staff spoken with also confirmed that they had Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 18 undertaken training and development in key areas, however the home’s training and development plan was not up to date, consequently the inspector was unable to determine whether all care staff had received essential core training. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 19 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, 36 & 38 Residents can expect to have their health, safety and welfare protected and have increasing opportunities to be involved in decisions about the home. EVIDENCE: Quality assurance questionnaires, completed at the end of 2004, were looked at during the inspection and included feedback from permanent and respite residents. The manager confirmed that the system was being developed to include residents meetings to discuss the outcomes and agree an action plan. The intention was that the Activities Co coordinator would take an active role in the development of quality assurance systems within the home. Through conversation with staff and the examination of staff files and supervision records it was evident that the home provides good induction training and supports staff in their professional development. The homes policy is that formal supervision should occur every six to eight weeks but records indicated that individual supervision had taken place twice yearly. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 20 Conversations with the manager and care staff, and examination of staff files indicated that health and safety training was provided including manual handling, fire safety, first aid, food hygiene and infection control. However there was not a clear plan in place to ensure that staff knowledge remains current and up to date. Policies and documents examined during the inspection and seen to be satisfactory included the homes fire precautions log, environmental risk assessments and infection control procedures. Hot water temperatures were tested twice, at hand basins in both a ground floor and first floor residents WC; they were tested at 41degrees and 42 degrees centigrade. One resident spoken to during the inspection praised the management of the home and feedback from staff also indicated that the manager promotes high standards of care and safe working practices. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 21 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 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 4 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 2 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 x 2 x 3 Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 22 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 9 Regulation Requirement Timescale for action 30th September 2005 13.2 Care Medicines that are transported Homes around the home must be done Regs 2001 so in a secure manner using a method that allows the medicines to be quickly and securely locked away in the event of an emergency. 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 30 36 Good Practice Recommendations Staff training and development needs to be well documented and planned to ensure all staff are appropriately trained and competent to do their jobs. Care staff should have formal supervision at least six times a year in line with the homes policy and good practice identified in the National Minimum Standards. Angel Court Residential Home I54-I04 S37158 Angel Court V247362 050831 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 5th Floor, St Vincent House 1 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 I54-I04 S37158 Angel Court V247362 050831 Stage 4.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. 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