Inspection on 18/10/05 for Antokol

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Antokol 10/06/08

Antokol 14/01/08

Antokol 18/09/07

Antokol 10/08/06

Antokol 27/06/05

Antokol 15/03/05

Antokol 26/10/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Antokol Antokol 45 Holbrook Lane Chislehurst Kent BR7 6PE Lead Inspector Miss Rosemary Blenkinsopp Unannounced Inspection 18th October 2005 12.45p 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 Antokol DS0000006883.V250314.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. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Antokol Address Antokol 45 Holbrook Lane Chislehurst Kent BR7 6PE 020 8467 8102 020 8468 7190 antokolhome@btconnect.com 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) Polish Citizens` Committee Housing Association Limited Ms Alina Gaskin Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 34 Elderly persons of either sex Date of last inspection 27/06/05 Brief Description of the Service: Antokol is a large detached house built in 1905. It was extended in 1986 and can now provide care to thirty-four elderly Polish people living in this country. The home maintains the Polish language and those Polish traditions which the residents were accustomed to in their younger days. The rooms can be accessed by stairs or a lift. All the rooms have wash-hand basins. The bathrooms, shower room and toilets are located on both the ground floor and first floor. Some of these facilities have special adaptations and equipment to meet the needs of the residents. On the ground floor there is a large dining room, a sitting room with a library, and a separate lounge, which has a Polish satellite TV. Residents may have telephones in their own rooms at their own expense. A pay phone is provided for both incoming and outgoing calls. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted unannounced by two inspectors. At the time of the inspection the home had thirty residents in and three vacancies as one shared room is used as a single bedroom. The inspectors monitored the progress made in respect of the last requirement, arising out of the inspection 27 June 2005. The inspectors were provided with good feedback in respect of the care provided, staff attitudes and daily living routines in the home. Residents looked well cared for and appeared relaxed. In relation to staff recruitment there are still outstanding issues in relation to staff contracts, job descriptions, terms and conditions of employment. The inspector is aware that the Polish Citizens Committee has addressed some work, although these are still not in place nor have they been issued to staff. What the service does well: What has improved since the last inspection? What they could do better: The detail in care plans needs to fully reflect residents’ needs including physical, mental and social issues. The interventions section needs to comprehensively detail the action to be taken by staff to address the problems. The current care plans are limited in this respect. The manager is aware of this and is seeking appropriate training in order to address this matter. As stated previously, the staff employment records remain incomplete and must be addressed to provide both protection to the employer and the employee. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 6 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. Antokol DS0000006883.V250314.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 Antokol DS0000006883.V250314.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): EVIDENCE: All standards in this section had been considered at the announced inspection 27 June 2005 and all were satisfactorily addressed. Antokol DS0000006883.V250314.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): 7,9. Health and personal care are well addressed in this home although supporting care plans do not evidence the care provided on some occasions. EVIDENCE: Arising out of the previous inspection were two requirements in this section, one relating to care plans the other medication. Two care plans were inspected of those residents who have been recently reviewed by the care manager and for whom the home is seeking a variation, as both have developed Dementia. Both had clear photographs in place and a background history. Risk assessments were in place including those for manual handling and falls with review dates. The information and intervention in respect of their mental health problems was limited with little reference to how staff should deal with some of their behaviours. One resident had details of inappropriate behaviour, which was stated as exposing herself with the door open, banging on walls, shouting for no reason and walking to the front door. The care plan itself referenced none of these issues. The staff said the behaviour was intermittent and had been less recently. All identified problems must have the actions and interventions to be taken by staff fully detailed. All Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 10 identified problems must be kept under review. Residents must be referred to appropriate specialist teams where necessary. The manager is looking for suitable care plan training for staff to attend. At the last inspection the inspector raised issues around the instructions in respect of medications given as required. The” as required” medication were inspected and on some, the instructions were “as directed “. Full instructions need to be recorded, detailing dose, frequency and duration. The records should specify exactly what the PRN medication is to be used for. Please see repeated requirements 1 and 2. Antokol DS0000006883.V250314.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): 12,13,1,4,15. Residents’ lives and social activities are in line with their traditions, culture and religious expectations providing a positive ethos where residents have choice and individuality respected. EVIDENCE: The inspector received positive information in respect of residents’ daily lives and social activities. It was evident that residents can spend time either in their own bedrooms or communal areas. The home has an activities person who organises various events. Some residents do participate. Two with whom the inspector met, preferred their own company. One resident had been in the home eighteen months and said that after two/three days it felt like home – and she felt safe. She added that “my language, my culture, my traditions and my prayers” all made her stay an enjoyable one and she had no desire to return to her own home. Polish TV and newspapers are provided for residents. This keeps the residents informed about developments in Poland and is often a point of conversation. The kitchen has been fully refurbished with new appliances, worktops and flooring. This has been a major task, although through effective management, has impacted little on residents themselves. The residents, however, did state that they preferred their own cook’s food to that provided by the external catering company. Church services are held in-house and visiting is open. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 12 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. Systems in this home are not sufficiently robust to protect residents particularly those for residents’ finances and staff recruitment. EVIDENCE: The staff training in respect of abuse and whistle blowing had been considered at the previous inspection. The management are undertaking POVA checks prior to employment on all staff although CRB checks are not always in place. Please see comments under staffing section. The inspector viewed the records pertaining to residents’ finances. The procedure states that two signatures are required for the money coming in and going out of the residents’ accounts. It is evident from the records viewed that this has not been happening and potentially may present risks of financial abuse. Please see requirement 3. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 13 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): EVIDENCE: All standards in this section had been considered at the announced inspection 27 June 2005 and all were satisfactorily addressed. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 14 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): 28,29,30. Staff recruitment is not satisfactorily robust and some of the essential training has lapsed which means that not staff all are sufficiently skilled for the job that they do. EVIDENCE: Recruitment procedures were audited with three files viewed. The last report identified the need to improve these procedures to ensure all checks are made prior to employment. There has been some improvement but due to the recruitment of staff from Poland there are some gaps. Many have police checks completed by their country of origin but commence work without CRB checks in this country. However, there is little risk due to the short timescale between leaving Poland and entering the UK. POVA checks are completed but it is not possible for staff to work with supervision at all times before the full police check is completed. Completed application forms are not always provided to the manager and therefore she is not aware of the individual’s experience or employment history. This is despite the manager developing procedures which included the provision of application forms. Other documents such as references and proof of identity were all in place. The last report also identified the need to produce job descriptions and contracts of employment or terms and conditions. There is evidence of some work being addressed in respect of this issue, although it has not yet been completed. It is the case that staff recruited from Poland are unaware of their terms and conditions of employment or their job description prior to taking up posts and even when in post. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 15 One staff member was concerned that she had been promoted although she was still without any confirmation of this either by way of a contract, job description or appropriate remuneration. Over the last year staff have undergone training in moving and handling, medication training, adult protection and dementia training. The records indicate that there are gaps in the training provided including fire, food hygiene and infection control. The manager has also identified this shortfall in training. Four staff have currently achieved NVQ 2 with two registered for NVQ 3 and two NVQ 2. It is difficult for the home as staff recruited from Poland do not speak English. However, this is a benefit to the residents as the staff are able to talk to them in their native language and bring to the home the ability to continue the Polish culture, which is of great importance to them. With the staff currently registered, the home would meet the target of 50 of staff with the qualification. However, this is a movable feast due to the ever changing staff group. Please see requirements 4, 5, and 6. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 16 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 The quality assurance systems in the home needs to be more comprehensive to include all quality indicators and applied consistently. EVIDENCE: One requirement was made at the last inspection in relation to quality assurance measures. Antokol has its own quality assurance system in place. This has not been used in a consistent manner and therefore loses some of its effectiveness. The quality assurance tool could be reviewed to include other areas to monitor which would provide quality indicators. The system for reviewing the quality of care includes sending residents and their relatives a questionnaire. The home is sending out these questionnaires at present. The manager was advised that once the information had been collated, the Commission must be provided with a copy of the report along with the action to be taken for improvement. Please see recommendation 1. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 17 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 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 X 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X X Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 31/03/06 1 OP7 15 2 OP9 13 3 OP18 20 4 OP29 19 5 Antokol OP29 19 The Registered Manager must ensure that comprehensive care plan information is available for all residents, which accurately reflects all of their needs, details interventions and is reviewed at appropriate intervals. Previous time frame for action 31/8/05. The Registered Manager must ensure that all PRN medication has comprehensive instructions in place. Previous time frame for action 30/7/05. The Registered Manager must ensure that all financial transactions for residents are subject to robust checking procedures. The Registered Person must ensure that staff are subject to robust recruitment procedure including CRB, POVA and fully completed application forms with supporting references are in place prior to employment. Previous time frame for action 31/8/05. The Registered Person must DS0000006883.V250314.R01.S.doc 30/11/05 30/01/06 30/01/06 30/01/06 Page 19 Version 5.0 6 OP30 18 ensure that all staff are issued with a contract of employment, terms and conditions and a job description prior to employment. The Registered Manager must ensure that staff are provided with mandatory training at appropriate intervals. 30/11/05 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 OP33 Good Practice Recommendations The Registered Manager should review the quality assurance systems to ensure that all quality indicators are included and applied consistently. Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Antokol DS0000006883.V250314.R01.S.doc Version 5.0 Page 21 - 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. 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