CARE HOMES FOR OLDER PEOPLE
Anson Court Harden Road Leamore Walsall West Midlands WS3 1BT Lead Inspector
Maggie Bennett & Mandy Beck Announced Inspection 30th September 2005 08:30 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 Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 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. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Anson Court Address Harden Road Leamore Walsall West Midlands WS3 1BT 01922 409444 01922 409111 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) Manor Court Health Care Limited Mrs Mandy Jane Halls Care Home 33 Category(ies) of Dementia (33) registration, with number of places Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th April 2005 Brief Description of the Service: Anson Court is a purpose built two storey care home in the Harden area of Bloxwich. The home provides accommodation for 33 residents who are over 55 and whose mental health has deteriorated (as a result of dementia). The home is situated close to local shops. All bedrooms are single, are in excess of ten square metres and have an en suite toilet facility. Communal space consists of a large lounge, one smaller lounge, a conservatory, which is used by smokers, and a separate dining room. The home has an enclosed, secure courtyard area with raised flower beds. Entrance and exit to the main door of the home is via a security system and service users are unable to leave the home without staff assistance. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection was carried out on a weekday between the hours of 8.30 a.m. and 3.30 p.m. Two inspectors undertook the visit, Mrs. Mandy Beck and Ms. Maggie Bennett. Prior to the inspection a Questionnaire was completed by the Registered Manager and returned to the Commission. Anonymous questionnaires were also received from relatives, residents and visiting social and healthcare professionals. Various documents were seen during the inspection, including care plans, policies and procedures and certificates verifying training and health and safety checks. Two visiting relatives were spoken to and discussion took place with 5 members of staff and the Registered Manager. Standards not met or not assessed at the previous inspection in April 2005 were assessed on this occasion. What the service does well: What has improved since the last inspection?
Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 6 Information to prospective residents and their relatives can now be provided in large print. The home have managed to encourage residents to be further involved in regular meetings and this has resulted in some positive changes to the home, with the introduction of gardening equipment, benches and more organised outings. There continue to be improvements to the physical environment. The recommendations of the Fire Officer have been carried out and redecoration has taken place in a number of areas. The front of the home is now in better order. Staffing levels have been increased to meet the needs of an increased resident group. Care staff now stay on until 10.00 p.m. on the day-time shift, which has had benefits for the residents. The home’s procedures for gaining the views of its residents, relatives and professional visitors continue to improve. A representative of the Registered Provider now carries out monthly visits and writes a written report of his findings. 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. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 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 Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 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): 0 Anson Court provides clear information to prospective residents and their families to enable them to make a choice about whether or not they may wish to live in the home. Full assessments are carried out on all prospective residents to ensure that their individual needs will be met. The home no longer offers intermediate care or rehabilitation. (This Judgement is based on the inspection of 15th April 2005). EVIDENCE: None of these standards were assessed on this occasion. Standards 1 and 3 were met at the unannounced inspection. Standard 6 in not applicable, as the home does not offer intermediate care. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 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): 9 and 10. All residents have individual plans of care, which set out their needs in detail and enable staff to ensure that these needs are met. Medication is administered in a manner that safeguards residents’ safety. There needs to be a review of the storage and administration of controlled drugs. Residents at Anson court are treated with respect and dignity. Staff are aware of how to address the residents, of their individual needs and how to meet them. EVIDENCE: Standards 7 and 8 were not assessed in detail on this occasion, as they were met at the last inspection. It was, however, noted that the home’s system for care planning has further improved with the introduction of “My Life” booklets. These are compiled with assistance from residents and their relatives and ensure their involvement in the care planning process. Since the last inspection seated scales have been purchased. Medication is generally administered in a safe manner and staff are guided by robust policies and procedures. All staff who handle medication have received accredited training and are competent in administration. Care should be taken to record the refrigerator temperature to ensure medicines are kept at a safe temperature. There also needs to be changes made in the way the controlled
Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 10 drugs are stored and the home should purchase appropriate storage as soon as possible. Residents that we spoke to were very pleased with they way that they received their care. “the girls are always lovely” and “I can do what I want when I want to” were some of the comments. Staff are developing Person Centred Care Planning and Life History work with each resident to further enhance their knowledge of the people they look after. Everyone is seen by health and social care professionals within the privacy of their own rooms. After reading the individual care plans you are left feeling that you know the person before you begin caring for them. Staff should be commended on the Person Centred way in which they work. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 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 are able to exercise choice in relation to social activities and mealtimes. The home provides excellent and appropriate in house activities. Residents are encouraged to make decisions about their care. Their views are heard at Residents’ Meetings and this has resulted in positive changes to the environment. EVIDENCE: Standard 12 was exceeded at the last inspection and was not, therefore, inspected in detail on this occasion. The opportunities for social care activities continue to be given high priority at the home. The afternoon activities, observed during this inspection, included participation in music, light exercise and board games for one resident. A lot of smiles and laughter were observed during the afternoon. One resident said: “We get on lovely together.” The home now records residents’ individual participation in leisure activities in their care plans. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 12 Residents are encouraged to take part in a Residents’ Meeting, which has resulted in some positive changes within the home: the introduction of gardening equipment, benches and organised outings. The meetings are well attended. New residents are encouraged to bring with them personal possessions to help them familiarise themselves with their new environment. The residents/relatives’ notice board is very informative and contains information on how service users and their relatives can contact those external agents who will be able to act in their best interests. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 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): 18 There is an Adult Protection Procedure in place to protect residents from abuse. A section of this procedure needs to be reviewed to ensure that it is in line with local Social Services procedures and the Department of Health document “No Secrets”. EVIDENCE: Standard 16 was assessed at the last inspection and was met. Standard 18 was also met at the last inspection, but since then the home have updated their Adult Protection Policy. The Policy is robust and mostly meets the requirements of the Standard. The section on the investigation of an allegation, however, needs to be reviewed and the home should ensure that it is in line with the Walsall MBC Adult Protection Procedure and “No Secrets”. Care staff have taken part in Adult Protection training. The registered manager is clear of her responsibilities with regard to the Protection of Vulnerable Adults Scheme. The home have policies and procedures in place with regard to the care of residents’ monies. For further assessment on this subject, see Standard 35. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 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 and 25. Anson Court is well maintained and residents live in a safe and comfortable environment. The home is clean and hygienic, with procedures in place to control and minimise the spread of infection. EVIDENCE: Since the last inspection the home have produced a programme of works already carried out and projected dates for routine maintenance and renewal of the fabric and decoration of the premises. A great deal of redecoration and refurbishment has been carried out and the recommendations of the Fire Officer have been met. New light fittings have been provided in corridors, the dining room and lounge, making the home much brighter. The courtyard gardens were in good order, although the surface was slippy. The registered manager undertook to ensure that this was cleaned in the near future. The front of the property has been tidied since the last inspection. The home now has its own gardener. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 15 At the last inspection one resident complained that his room was cold and that the heating could not be adjusted. This problem has now been resolved, with the heating being adjusted by staff at the resident’s request. At the time of the inspection the home was clean and warm and there were no offensive odours. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 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, 29 and 30. Anson Court is adequately staff by people who are well trained. The needs of the residents are understood and met. There are robust recruitment procedures in place, which protect the residents. EVIDENCE: Rotas seen show that staff ratios have increased since the last inspection. There are usually 5 or 6 care staff on duty during the daytime shifts, with the Registered Manager’s hours being supernumerary. A further improvement is that there are now sufficient care staff on duty until 10.00 p.m. At night there are two waking members of care staff. Sufficient domestic staff are employed. These staffing levels meet the requirements of the Commission and reflect the high needs of the residents. There are robust recruitment procedures in the home and no new staff are commenced until satisfactory Criminal Records Bureau checks and Protection of Vulnerable Adults checks have been received. Staff files have been greatly improved since the last inspection and now contain all the documentation required by the Care Homes Regulations. There is a staff training plan in place and all new staff receive induction training. As well as the mandatory health and safety training, staff take part in other appropriate training, including dementia care and Adult Protection. Copies of certificates to verify training are kept in individual staff files. Residents and relatives spoken to during the inspection were full of praise for the staff. One relative said that all members of staff were very approachable.
Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 17 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): 33, 35 and 38. A variety of evidence shows that residents’ and relatives’ views are sought and acted upon. The personal allowances of residents are handled and stored appropriately. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The registered manager has produced an Annual Development Plan for the home, but at present this consists of environmental plans only. This needs to be developed further to include all aspects of the running of the home, including acting on residents’ views, the planned setting up of a relatives’ group and the training needs of the staff group. It is recommended that the Registered Manager take part in the Advanced Dementia Mapping Course, so that she can further enhance her skills in ascertaining the wishes and desired outcomes for residents. The home already seeks the views of relatives and visiting professionals. Residents’ meetings are regularly held. The home
Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 18 keeps up to date with current policies, procedures and practices. Visits by a representative of the Registered Providers take place on a regular basis and written reports are maintained, copies being forwarded to the Commission. Relatives or representatives of the residents take charge of the residents’ Personal Allowances. Monies are then brought to the home and kept in safekeeping on behalf of the residents. Records of all transactions and the individual monies were seen at the inspection and all were in order. The registered manager does not act as Appointee for any of the residents. Secure facilities are provided for the safe keeping of monies. Staff records seen show that staff take part in regular training in moving and handling, first aid, food hygiene, infection control and fire safety. An annual health and safety inspection is carried out at the home by a professional organisation. Evidence was seen that fire safety checks take place at the required intervals. An electrical safety check was carried out in September 2005 and a gas safety check took place in the same month. The water system is analysed for legionella each year and the temperature of the water at outlets accessible to residents is measured regularly to ensure that it does not exceed 43 degrees. Certificates were seen to verify that the hoists and lift are regularly serviced. Appropriate risk assessments have been carried out and three senior members of staff can out a 3 monthly health and safety audit. Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 19 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 X 8 X 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X 3 X STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 20 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 OP9 Regulation 13(2) Requirement Controlled drugs (including temazepam) must be stored in cupboards meeting the requirements of the Misuse of Drugs (Safe Custody) Regulation 1973 as amended. Timescale for action 28/10/05 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 OP18 Good Practice Recommendations The home should review its Adult Protection Procedure with regard to the investigation of any allegations of abuse. The procedure should be in line with the Walsall MBC Adult Protection Procedure and the Department of Health document, “No Secrets”. The home’s Annual Development Plan should be developed further to include all aspects of the running of the home. It is recommended that the Registered Manager take part in the Advanced Dementia Mapping training. 2 3 OP33 OP33 Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Anson Court DS0000020842.V254004.R01.S.doc Version 5.0 Page 22 - 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!
