Inspection on 04/05/05 for Anzac House

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Anzac House 19/09/07

Anzac House 15/08/06

Anzac House 11/11/05

Anzac House 11/10/04

Anzac House 15/04/04

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 Anzac House London Road Devizes Wiltshire SN10 2DY Lead Inspector Sally Walker Unannounced 4th May 2005 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. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Anzac House Address London Road Devizes Wiltshire SN10 2DY 01380 722623 01380 730061 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) The Orders of St John Care Trust Susann Linsley Care Home Only 30 Category(ies) of DE(E) Dementia - over 65 (30) registration, with number MD(E) Mental Disorder - over 65 (1) of places Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 30 service users with Dementia at any one time 2. One named service user in the of Mental Disorder , excluding Learning Disability or Dementia, aged over 65 years of age. Date of last inspection 11th October 2004 Brief Description of the Service: Anzac House is situated on the outskirts of Devizes set in its own grounds. It provides care to older people with a diagnosis of dementia with one place for an older person with mental health needs. The home is not registered to provide nursing care. The home was built by the local authority in the 1970s and the accommodation is to 2 floors accessed by a lift and two staircases. The home is divided into separate units, namely Perth, Wellington, Canberra and Melbourne. Each unit has its own sitting room and small kitchen. There is a central dining room and adjacent sitting room. All the bedrooms are single accommodation. The care staffing rota provided three care staff and a care leader during the waking day with three waking night staff. The home has 2 beds for respite care made available to people with dementia in the local community. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9.50am and 5.05pm. Five residents were spoken with, 2 in greater detail. Three relative were also spoken with together with 2 staff and Mrs Linsley. Residents case notes were examined as were the fire log book and the accident records. 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. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.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 Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.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 & 3 Residents and their families have good information about the service provided before coming to live at the home. Residents can know that the home fully assesses their needs in order to provide a detailed plan of care. EVIDENCE: The statement of purpose had been revised as recommended at the last inspection and is now in large print and easily read. Mrs Linsley updated the statement of purpose as the provision changed. All prospective residents must have a written diagnosis of dementia. A full assessment had been carried out with each resident before they were offered a place at the home. Care plans were in place when the residents arrived so that staff had a good understanding of residents’ needs. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 8 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 & 10 Residents can be confident that staff know about them and have planned for all aspects of their care needs. Residents have good access to healthcare professionals. Residents’ privacy, dignity and confidentiality are respected at all times. EVIDENCE: Each resident had a care plan with full details of their care needs together with assessment of risks. There was guidance on residents preferred routines, social care needs and clear strategies for managing any behaviours. Weights were being monitored with guidance for managing risk. Any restrictions for residents were clearly documented with an agreed rationale and guidance to staff. Care plans were regularly reviewed and the daily report showed good evidence of monitoring of progress. The language of the care plans and daily reports was respectful of residents. It was clear from the records that the care plans directed the care. It was also clear from the recording that staff had a good understanding of working with people with dementia. The Tissue Viability Specialist Nurse had provided training in assessing the risk of residents developing pressure sores. One of the care leaders was responsible for carrying out the assessment and if risk was identified the Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 9 assessment would be faxed to the district nurse at the surgery for attention and advice. No invasive treatments were being carried out by staff; this responsibility remaining with the district nursing service. Although some staff had been trained by the nurse to monitor blood tests for sugar levels in diabetes. This was confirmed by a list of named staff and accompanying certificates of competence signed by the district nurse. Relatives said that they were kept informed of their relatives’ progress and could discuss issues at any time. They were also invited to regular reviews. Staff were seen to treat information and discussions about residents in a confidential manner. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 10 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 The home ensures that a diagnosis of dementia does not restrict residents from a full and active life. Staff support residents to retain as much control and choice as their dementia will allow. Contact with family, friends and the local community continues. Residents benefit from a good range of stimulating and appropriate activities which are geared to a good outcome. EVIDENCE: Residents were asked about how they spent their day. One resident said they pleased themselves when they got up or went to bed. They also explained the different activities that they were involved with. Two visitors confirmed that their relative followed their own routine which included having a rest in the afternoon. A few of the residents were walking around the home and were spoken with. The impression was that they were interested in their environment, seeking out other people to talk to or enjoying their walk. None of these residents had any of the anxiety, a sense of being lost or looking for familiar people or surroundings which may often be associated with people with dementia who do not have sufficient engagement from staff or stimulating activities. Mrs Linsley said that the pilot project recently run by the organisation to have a separate activities person had been a success. She said that the post was Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 11 now permanent and compliments the activities already provided by the day service. The member of staff new to this post previously worked as a carer and was well known to the residents. Since coming to post she had attended a course specifically for providing activities with people with dementia. She had carried out a survey with residents and their families to find out what their interests were. The member of staff said they had a monthly budget for activities. A plan was produced for the month with some activities taking place at the same time as a matter of continuity for residents; other activities took place in the evenings. Care staff also provided activities. At least two activities were held each day and included, bingo, sing-alongs, crafts, exercises, snooker, gardening, word games, quizzes and reading the newspaper. All activities were aimed to gain the residents attention for different time spans, for people with different abilities and have positive outcome for people with dementia. The member of staff said she was looking at widening the choice of activities and entertainment. Entertainers had been engaged to come to the home at least once a month. The member of staff said they would provide group activities as well as visit those people who did not always join in, for a chat. Residents would be taken to the town shopping or for coffee and 2 residents were going to see the visiting circus the following evening. All activities were recorded in a separate book for those residents on each unit for continuity of care. Various activities and competitions had been organised with other nearby homes in the organisation. Fundraising events had been organised including a sponsored walk and tabletop sale. A barbeque had been organised for July with relatives invited. The home had celebrated May day, Anzac day and would be celebrating Victory over Europe day. There was a monthly newsletter advertising events. A person authorised by the church had come to give the sacrament to some of the residents and later in the day a vicar held a service in the conservatory for some of the other residents. There was a hairdressing salon and all of the residents were well groomed with staff paying attention to clean clothing. One of the activities was manicures and beauty. Staff also paid good attention to residents having their dentures in place, clean glasses and any watches or clocks showed the correct time. A new digital TV had been purchased as an aid for educational activities. There were notices in each of the units inviting visitors to make drinks in the small kitchens. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.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 & 18 Residents and their families can be confident that the home takes any complaints seriously without victimisation. Systems are in place for the protection of vulnerable adults. EVIDENCE: The home worked to the organisation’s complaints procedure which was included in the service users guide given to residents or their families. Those residents could comment said that they would go to the person in charge to make suggestions or complaints. Mrs Linsley said she was required to inform the organisation each month of complaints and compliments and kept a log of both. No complaints had been received for some time but there were many complimentary letters. The home worked to the local vulnerable adults policy entitled “No Secrets in Swindon and Wiltshire”. Staff had received training and were confident in using the procedure. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.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 & 26 The home continues to improve the quality and safety of the environment for residents. The home is clean and does not smell unpleasant. EVIDENCE: The dining room and adjoining sitting room had been refurbished, re-decorated and the dividing doors removed. There was new flooring in the dining room, new tables, chairs, armchairs and curtains. Mrs Linsley said the budget had been approved for a new carpet in the sitting area. The corridors were in the process of being re-decorated and the budget had been approved for new carpets. The handyman deals with minor repairs. New signing had been put up around to the home to identify the different units. Any other notices were in large print and easily to people with a visual impairment. New pictures had been purchased with a focus on local scenes which may be familiar to most of the residents. Most of the bedrooms had a large print list of mealtimes. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 14 The grounds were well maintained with an enclosed garden to the rear for the safety of residents. There were no unpleasant smells noted at any time during the inspection. There was seating placed at different points along the corridors for residents to use. All of the bedrooms seen were individually decorated and furnished to reflect each residents’ personality. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.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 & 30 Improved staffing levels will provide good continuity of care for residents and allow senior staff to concentrate on administrative responsibilities exclusive of their caring duties. Staff are well trained and experienced in caring for people with dementia. EVIDENCE: Mrs Linsley said that the staffing hours had been increased during the day by 52 hours a week. She said she had already filled one 25-hour post and was awaiting the Criminal Records Bureau certificate. These extra establishment hours will increase the number of care staff during the day to 5, including a care leader, for the morning, afternoon and evening; at the weekends as well as during the week. Staff also had areas of administrative responsibility, for example, medication, rota, care planning and reviews. The care leaders ran the shift and would deal with the allocation of duties. Those residents who could make comments said the staff were friendly. This was echoed by the relatives who were spoken with. Staff knocked on service users doors and waited to be invited in before entering residents’ bedrooms. Staff said they had good access to training and this was available to all staff. Staff had undertaken a range of dementia related training. Mrs Linsley had a training plan for 2005/6 together with a matrix showing essential and desirable training for each staff role. All staff had regular dementia training. Courses Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 16 recently undertaken included: protection of vulnerable adults, food hygiene and memory rehabilitation in dementia. Three staff had NVQ Level 2, 1 had Level 3, 10 staff were undertaking Level 2 and 2 were doing Level 3. Mrs Linsley said that the organisation was piloting sending staff from its homes with a Category of dementia to Anzac House for a 3 month placements to improve their awareness of providing specialist care to people with dementia. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.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) 33 & 38 Residents best interests are at the centre of the home’s ethos. Residents safety and welfare are promoted and protected. EVIDENCE: Mrs Linsley was clear about offering what she described as an ‘ordinary’ life for residents. She said she had researched environmental best practice recommendations for people with dementia and decided, along with her manager, that residents were well orientated in the home, so no specialist advice was taken up. Mrs Linsley was also a strong advocate for residents access to community and healthcare services. Mrs Linsley said that she had submitted final parts of the Registered Managers Award and was awaiting verification. She already has the NVQ level 4. The organisation had recently produced a new policies and procedures file and all staff were expected to sign up to them. Mrs Linsley had gone through a different policy with staff at the monthly meetings. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 18 One of the care leaders was responsible for risk assessments of tasks and the environment which had been reviewed in February this year. The fire log book was being satisfactorily completed. Mrs Linsley said that the requirements of the Fire Officer’s report were being addressed. Accidents were being recorded in a log and removed to residents files. Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 4 x x x x 3 Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 Good Practice Recommendations Anzac House D51_D01_S28282_ANZACHOUSE_V198384_040505_Stage4.doc Version 1.30 Page 21 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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. 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