Inspection on 27/06/05 for Antokol

This inspection was carried out on 27th June 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 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 18/10/05

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 45 Holbrook Lane Chislehurst Kent BR7 6PE Lead Inspector Rosemary Blenkinsopp Announced 27 June 2005 08:00 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. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Antokol Address 45 Holbrook Lane, Chislehurst, Kent, BR7 6PE 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) 020 8467 8102 020 8468 7190 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 G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 34 Elderly persons of either sex. Date of last inspection 15/03/05 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 service users 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 service users. 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. Service users may have telephones in their own rooms at their own expense. A pay phone is provided for both incoming and outgoing calls. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted as an announced visit of which the home was notified in advance. The manager had completed the pre-inspection questionnaire and nine relatives/visitors comment cards were returned. The comment cards all contained positive information relating to the home. The inspector undertook a short tour, inspected records including the Statement of Purpose, care plans and staff personnel files. Generally the standard of care is good and residents are well provided for. The home ,with its mainly Polish staff team, is able to address residents’ needs and closely identify with their culture and traditions. The inspector met with staff, residents and the management team throughout the inspection. What the service does well: What has improved since the last inspection? 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. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 6 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 Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 7 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) 1,2,3,4,5,6. It is evident that prospective residents are furnished with information on which to base their decision with respect to placement at Antokol residential home. However this is a very specific service and such homes are in limited supply hence this would limit choice. EVIDENCE: The Statement of Purpose and Service User Guide contained relevant information in respect of the home and the care provided. These documents will need to be updated once the Committee membership has reached its full complement; currently there are only three members who have an active part due to sickness and vacancies. Copies of contracts are retained in the Service User Guide. The manager, Ms Gaskin, assesses all prospective residents once referral has been made. Information is obtained from the resident, the family, social worker and any other members of the multi-disciplinary team. The family members are requested to complete a pre-admission form, which provides information on their family networks, past life etc. The assessment form details social history, dietary preferences and activities of daily living. In addition all prospective residents complete an application form. Potential residents are invited to visit the home; if this is not possible a committee Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 8 member would visit them in their own home. The home does not provide intermediate care. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10. The health and personal care needs are well addressed in this home although the supporting care plan and risk assessment documentation needs to be more comprehensive in content to reflect the practice. EVIDENCE: The care plans of four residents were viewed. The care plans contained the identified needs of activities of daily living, a record of reviews and a GP medical form, which details medication and mental health issues. The daily events are written in Polish, as these are the working documents for staff to use, some staff have limited English. In the event that records were needed for other purposes, e.g. an investigation or a complaint, then these documents would not be able to be understood and would lead to limited information. The care plans to meet residents’ needs must have more detail to ensure comprehensive information is available to all staff to direct the care and specify the actions to be taken. All information must be available in English. Please see requirement 1. The home has a visiting GP, District Nurse, and Optician with audiologist appointments on referral. There is both an NHS and private chiropodist visiting the home. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 10 The medication systems were inspected. The administration records were fully completed without any gaps in recordings. Some medications had been ordered on an “as required basis”,i.e. PRN. In the event that PRN medications are used, full instructions need to be detailed by the GP including when it should be used, maximum dose and duration. Medication that is hand transcribed onto the medication sheets should have two staff signatures in place to confirm the accuracy of the information recorded. Please see requirement 2. Please see recommendation 1. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15. Daily life and social activities are specific to the residents’ needs and reflect their previous social, cultural and recreational lifestyles. EVIDENCE: The home is specifically designed to meet the needs of the Polish community. Staff are recruited from Poland, all staff speak Polish and information, including the menu, is in Polish. Polish newspapers are available. In addition books and Polish TV are also available in all bedrooms. Residents have their own telephones. Visiting is open. A service is held in Polish on a daily basis. Two residents have the Roman Catholic priest visiting. The home has a large enclosed garden several residents were seen sitting in it during the inspection. Summer activities, including a bbq, are held in the garden. On the day of the inspection the residents and staff were celebrating a Polish tradition “ names day “. The home has an activities organiser twice weekly for two hours. The inspector was advised that there have been no residents/ relatives meetings recently. This is something which should be reviewed. The food is traditional Polish and the residents enjoy this, although choices and variation must be incorporated into the menu. Fluids, fruit and biscuits were all evident and freely available. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 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 standard(s) 16,17. Residents are provided with information and avenues for raising concerns / complaints. All concerns are taken seriously including those raised by residents, staff and visitors. EVIDENCE: The complaints information is included in the Statement of Purpose .The home has a specific complaints form and all information relating to complaints is retained including outcomes. The time frame for responses is 28 days. The contact details of the regulating authority need to be changed to the CSCI. The complaints procedure needs to be on display in a visible/public place. Please see recommendation 2. There have been two complaints regarding this service, one of which is still ongoing some months after the initial complaint was raised. The delay is due to on going legal issues. The other complaint was investigated internally and substantiated. Residents with whom the inspector met felt that they were listened to and issues acted upon promptly. The financial records for two residents were inspected and found to be correct. Each resident has an individual account sheet. Within this, the details of all the transactions were recorded and receipts are retained. The inspector noted that money retained on site for residents is in fairly large amounts. For safety reasons, this should be reviewed. Training in relation to abuse has been conducted with the senior staff. This needs to be cascaded to all staff. Training on whistleblowing has been conducted in-house. Staff with whom the inspector met confirmed the training and were aware of the principles. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 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 standard(s) 19,20,21, 22, 23,24,25,26. The building is an adapted building and not wholly suitable as a care home. However, with ongoing refurbishment and maintenance and a strict admission criteria, it is able to meet residents’ needs and provide a home-like environment. EVIDENCE: The home is an adapted building in a residential area of Chislehurst. Communal areas are on the ground floor and bedrooms located throughout the home. Bedrooms were personalised and residents had items of their own furniture. In bedrooms viewed, call bell leads were at hand. Hot water tested was satisfactory. In communal areas there was some evidence of specialized and individual seating. The dining room has been newly refurbished and it is very pleasant. Dining tables were laid in preparation for lunch with table clothes; cutlery, fruit, juice and hot drinks were freely available. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 14 The home was clean, tidy and hazard free. The kitchen and laundry were inspected. The kitchen is due for refurbishment in the coming months, plans are underway to ensure that there is no disruption to services. Other areas of the home are also part of planned refurbishment including the bathrooms. The manager expressed concerns regarding the funding of the refurbishment and business plans were not available to inspect. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 15 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) 27,29. Staff are sufficiently skilled and provided in sufficient numbers to address the residents’ needs. The recruitment and supporting records for employees is not robust enough to provide adequate protection for staff in respect of their roles, responsibilities and rights. EVIDENCE: The home has a competent team of staff led by strong experienced management team. Staff are provided throughout the 24 hour period, with care staff numbers of, 4-6 in the morning, 3-4 in the afternoon and at night two waking staff. The management team address the administration tasks in the home and this can impact on care and supervision of staff and should be reviewed. The personnel files for four staff were inspected. They were limited in their content. Staff are still without job descriptions, contracts or terms and conditions. One long term employee had no references. The lack of employment documentation makes it difficult, in many respects, to manage e.g. there is no formal cut off point for full sick pay and the commencement of statutory sick pay to begin. Without job descriptions and terms and conditions it would be difficult to address supervision, performance and appraisals. This is a situation which has been ongoing for some considerable time. The CSCI is in the process of trying to meet with Committee Members regarding these matters. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 16 Three files had enhanced CRB in place, however ,one did not and there was no confirmation that the home had received POVA clearance. The home had not ever received POVA clearance on any staff; it appears this system had not been in place. This matter was addressed with the umbrella body, whilst the inspector was in the home. Please see requirement 3. Residents with whom the inspector met spoke highly of staff with comments such “Staff do whatever you need”. Copies of training certificates were viewed and each member of staff has an individual training record. Staff’s training needs are outlined at supervision, which is conducted by six senior staff in the home. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 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 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) 31,32,33,34,35,36,37,38. The home is well managed in respect of care practices, staff management and resident focused services, however there is no evidence of the financial viability of the home and to date this has been impossible to confirm. EVIDENCE: The business plan has previously been requested. To date this has not been received. There was no financial records relating to the home to view. The insurance liability certificate was valid up to December 2005. Please see requirement 4. The service records were inspected, including those for the fire equipment, the lift hoists, and gas appliances. All were found to be satisfactory. The portable appliance testing is due; the handy man is waiting for the testing equipment to be recalibrated so that he can continue to address this on an annual basis. Weekly fire alarm testing is recorded. The staff fire drills had been conducted monthly although staff signatures were not in place. It is recommended that staff sign for all training. In respect of fire training all day staff must have this Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 18 twice a year whilst night staff have this four times annually. Please see recommendation 3. Quality assurance monitoring consists of internal monitoring, staff meetings and the Regulation 26 visits. There is concern that the Regulation 26 visits may not continue as the committee member who conducts these has resigned. Other quality assurance measures need to be put in place, which includes the views of residents, relatives and other relevant parties. Please see requirement 5. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 2 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 x 3 3 2 1 3 3 3 2 Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 20 yes 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 7 Regulation 15 Requirement The Registered Manager must ensure that comprehensive information is recorded in respect of the interventions needed to meet residents identified needs. Previous time frame for action 31/8/05 The Registered Manager must ensure that all PRN medication has comprehensive instructions in place. The Registerd Person must ensure tht all staff are issued with job descriptions, contracts, terms and conditions. All staff must be subject to robust recruitment procedures, including reference checks and CRB/ POVA. Previous time frame for action 31/8/05. The Registered Person must have available a business plan to confirm that the home is financially viable. Previous time frame for action 20/6/05 The Registerd Person must ensure that quality assurance measures are in place. Previous time frame for action 31/8/05. Timescale for action 30/9/05 2. 9 13 30/7/05 3. 29 19 30/9/05 4. 34 25 30/7/05 5. 33 24 30/9/05 Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 21 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. 3. Refer to Standard 9 16 38 Good Practice Recommendations The Registered Manager should ensure that two staff sign for all hand transcriptions of medication. The Registered Manager should place the complaints procedure in a public place. The Registered Manager should ensure that all staff sign for training including fire drills. Antokol G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 G51-G01 s6883 Antokol AI v224067 2760605 Stage 4.doc Version 1.30 Page 23 - 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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