Inspection on 02/08/07 for Annabel House Care Centre

This inspection was carried out on 2nd August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Annabel House Care Centre 06/06/06

Annabel House Care Centre 21/10/05

Annabel House Care Centre 24/06/05

Annabel House Care Centre 25/11/04

Annabel House Care Centre 03/08/04

Annabel House Care Centre 17/03/04

Annabel House Care Centre 06/08/03

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOMES FOR OLDER PEOPLE Annabel House Care Centre 57 Lower Bristol Road Weston Super Mare North Somerset BS23 2PX Lead Inspector Juanita Glass Unannounced Inspection 09:30 2 August 2007 nd 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 Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Annabel House Care Centre Address 57 Lower Bristol Road Weston Super Mare North Somerset BS23 2PX 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) 01934 416648 01934 415922 Dr Martin Thomas Wyatt Mrs Pamela Delphine Wyatt Ms Jean Bracegirdle Care Home 32 Category(ies) of Dementia (32), Dementia - over 65 years of age registration, with number (32), Mental disorder, excluding learning of places disability or dementia (32) Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 32 persons aged 50 years and over with mental disorder requiring nursing care May accommodate up to 32 persons aged 50 years and over with dementia requiring nursing care. Manager must be a RN on part 3 or 13 of the NMC register Staffing notice 19/3/2001 applies Date of last inspection 06/06/06 Brief Description of the Service: Annabel House is a Victorian building with a purpose built two-floor extension at the rear. The home is registered with the Commission for Social Care Inspection for 32 residents with dementia or mental health problems. Resident’s rooms are on the ground and first floor, access is provided by a lift. Whilst the office and staff room are in the basement. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day with a total of 5 hours spent in the home. The manager was not present. Evidence to support this inspection was gained through 1-1 discussions with eight residents, and three members of staff. Due to an oversight on behalf of CSCI an AQAA (Annual Quality Assurance Assessment) and Written surveys were not obtained in this instance. The records for six residents and four members of staff were reviewed as well as maintenance, health and safety checks, medication, and a tour of the premises. What the service does well: What has improved since the last inspection? The deputy manager confirmed that the three requirements made at the last inspection have been met. We confirmed this through reviewing documentation held in the home. All care plans had been implemented within the first week of admission and were reviewed regularly. Regulation 37 forms have been received by CSCI. We noted from staff personnel records that training in Dementia Care has been provided for care staff. Care staff attends meetings when training sessions specific to the diverse needs of residents are carried out. Since the last inspection a new dining area has been built. This is a vast improvement and residents can eat in a brighter less crowded area. A sensory roof garden has been developed with a water garden in the small enclosed area below. One resident and visitor said they enjoyed sitting in the garden. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, and 5. 6 does not apply Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Admissions to the home are only undertaken following a full needs assessment. Prospective residents are given the opportunity to visit the home. Contracts are issued to privately funded residents. Residents placed by funding authorities did not have statements of terms and conditions with the home. EVIDENCE: Care records for five residents were reviewed; these included three residents who had been admitted within the last six weeks. All care records reviewed for self-funding residents contained a signed contract. Residents being funded by social services did not have signed statement of terms and conditions. This needs to be provided and needs to set out clearly the responsibly of the provider and the rights and obligations of the resident. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 9 The manager carries out preadmission assessments for all prospective residents within travelling distance. If she is unable to carry out the assessment herself there was evidence of social services and hospital care plans. All preadmission assessments seen provided clear information enabling staff to implement a preliminary care plan on admission. All records reviewed had care plans implemented within the first week of admission. The assessment included behavioural and psychological needs they were all dated and signed. Residents spoken to were unable to comment on the admission procedure. During the inspection staff demonstrated an understanding of the needs of the residents. We saw evidence of care staff attending meetings when specific needs of residents would be discussed. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal health care needs are clearly recorded in each residents care plan. The delivery of care is person centred and consistent. There is a clear emphasis on respect, privacy and dignity. Staff adhere to the homes policies and procedures for the administration of medication. EVIDENCE: We reviewed the care plans for five residents. The care plans reviewed showed that a lot of thought has been put into how to implement a person centred approach; they identify specific needs and give guidance for care staff on how they should meet these needs. The care plans then go on to show what the outcome for the resident will be if these needs are either met or not met. This is commendable practice. The deputy manager confirmed that diverse needs were met by training sessions with care staff raising their awareness of residents’ specific needs. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 11 Regular meeting are also held with the homes cook when a nutritional assessment is revisited for all residents identifying those requiring a specialist diet. Most of the residents spoken to were not able to comment on their care plans. One resident may have understood the process but did not comment. Care records reviewed showed that residents are enabled to access health care services; this includes chiropodist, optician, dentist, mental health professionals and outpatient clinics. The home has clear policies and procedures for the ordering, storage, administration and disposal of medication. An audit on the day of the inspection showed no errors, and the administration of medication was carried out within current guidelines. During the inspection staff were observed to treat residents with both dignity and respect. They were observed to have a friendly and respectful rapport. Residents spoken to say staff are kind and respectful, one resident said they are always nice. Another resident commented on the friendly and cheerful approach of the deputy manager. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given the opportunity to take part in a variety of meaningful activities. The home has open visiting arrangements and residents can entertain visitors in their own room or the activities room. Routines and activities in the home enable staff to be flexible in meeting the choices of residents. A nutritious and well balanced diet is provided with emphasis on special requirements. EVIDENCE: All care workers including the cook have an allocate list of residents. They are responsible for ensuring the residents takes part in a meaningful activity of their choice. Care records evidenced that care workers were spending time sitting and talking about families and photographs. One care record stated they had sat and read a story to the resident as it had relaxed her. Care workers were also recording activities such as Aromatherapy, ball games, magazines, group art, sing a long, trips to town and walks in the park. The home has purchased a karaoke machine, which has proved popular with both staff and residents. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 13 Visitors were observed coming and going through out the day. Staff were polite and accommodating they showed a friendly and respectful approach to visitors. The homes revised routines which fit in with residents preferred times of going to bed and rising in the morning appears to be beneficial as less night medication is required. During the day residents were observed exercising choice in where they sat either one of the lounges, the hall or their room, or whether they took part in activities. The cook confirmed that the menus were reviewed regularly and provided nutritious and appetising meals produced from fresh ingredients. An awareness of personal likes and dislikes as well as special diets for specific resident was evident. A regular meeting is held between with the cook. This meeting identifies residents who may have special needs or be experiencing weight loss. Weights showed that 85 of residents had maintained or increased their weight whilst at Annabel House. Residents spoken to said they enjoyed their meals, one lady said the meals were excellent and she had eaten everything provided and enjoyed it. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 ands 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure, and clear guidance for the protection of vulnerable adults; all staff spoken to demonstrated a clear awareness of adult protection issues. EVIDENCE: The home has a clear complaints policy and procedure, which is made available for residents and relatives. Staff record concerns on a form, which shows action taken, and outcome. One resident spoken to was able to comment on raising a concern. They said they would ‘talk to Peter (deputy manager) every time.’ The homes procedures for the protection of vulnerable adults are in line with local guidelines. Members of staff have attended North Somerset social services training in the protection of vulnerable adults. Staff spoken to showed an awareness of the procedure to follow if they felt a resident was at risk. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and homely environment, which is appropriate to the needs of the resident group. Specialist aids are provided where necessary. Residents are encouraged to personalise their rooms. The home is clean tidy and free from offensive odours. EVIDENCE: A tour of the premises was carried out. The home continues to be pleasant clean and tidy with no unpleasant odours and with evidence of regular maintenance. The registered provider has increased the communal areas and the kitchen area. A new dining room has been built and gives residents a brighter less crowded room to take their meals in. The cook said it was good to have a larger working kitchen. Residents spoken to who could express an opinion said they liked their rooms, and rooms contained evidence of personal Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 16 property. In addition to the new dining room a sensory roof garden has been developed with a water garden in the small enclosed area below. During the inspection we found a resident sat in the garden area with a visitor. They both said the garden was a really nice idea and that they spent as much time as possible in it. The water garden was a very relaxing sheltered area. Domiciliary staff have attended training infection control and staff were observed carrying out the homes policies and procedures to reduce the risk of cross infection. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from adequate numbers of staff who are competent and trained to meet their individual needs. The home is working to meet the 50 NVQ trained staff. Robust recruitment procedures protect residents from abuse. EVIDENCE: Staffing records reviewed and residents, visitors spoken to confirmed that there are adequate numbers of staff on duty to meet the assessed needs of the current resident group. During the inspection staff were observed to carry out their duties in a relaxed and unhurried manner. One Resident when asked about staff said ‘there’s a lot of them dear.’ Staff records showed that the home encourages training and personal development either within the home or from outside agencies. The manager is currently encouraging care staff to take up the NVQ level 2 and 3 training. Care staff attend regular meetings when residents needs are discussed. Trained staff hold training sessions with carers identifying specific needs. This addresses the need for staff to receive training in person centred care and care of the elderly with dementia A review of staff personnel records showed the manager adheres to a robust recruitment procedure. This ensures residents are protected from abuse. All Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 18 required checks and documentation had been obtained for new staff before they commenced work. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the required qualifications and experience to run the home. The ethos is open and inclusive resulting in people feeling that they do have a say in the management of the home. Residents’ financial interests are protected through a robust system. Staff are regularly supervised providing continuity of care for residents. The home has sound policies and procedures and works to a clear health and safety policy. EVIDENCE: The manager is a qualified registered mental nurse, and has the support of registered general nurses in the home. She has also obtained the registered managers award. She has experience in the care of the elderly with dementia, and the management of a care home. There is an open and approachable Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 20 ethos in the home. Visitors felt they could approach the manager or deputy manager at any time. The manager also allows relatives’ access to her home phone number if they wish to talk to her. The home carries out an annual quality assessment by sending questionnaires to the relatives of residents within the home. Comments received were largely complementary, residents spoken to were unable to comment on whether they had completed a satisfaction survey or not. The manager has introduced Quality Circle meetings, which include staff, residents and relatives. Comment cards are kept in the entrance so visitors can comment at any time. Due to an oversight by CSCI the home had not been sent an AQAA (Annual Quality Assurance Assessment). A copy of the AQAA had been down loaded from the CSCI website and the manager and provider were working through this to ensure they were meeting the NMS (National Minimum Standards). This reflects good practice. The home maintains pocket money for some residents who are unable to manage their own finances. An audit was carried out of four accounts maintained by the home. They all had a running total and evidence of transactions were kept for each resident. The manager carries out supervision with all staff in the home. Evidence was seen of issues being discussed and training identified. Staff members spoken to said they felt they could raise issues at supervision. The implementation of health and safety in the home is satisfactory, current COSHH records are maintained; the fire log showed that all checks were being carried out following current guidelines and all staff had attended training and a fire drill. All service records were up to date and available for inspection. Staff were observed to be following the homes infection control policies, and adequate protective clothing was provided. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 22 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. 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 Refer to Standard OP2 Good Practice Recommendations Funded residents need to have a signed statement of terms and conditions with the home which identifies the fee and who is responsible for paying that fee. Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Annabel House Care Centre DS0000020226.V337212.R01.S.doc Version 5.2 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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