Inspection on 10/06/05 for Applegarth Care Home

This inspection was carried out on 10th 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

Applegarth Care Home 30/07/08

Applegarth Care Home 08/08/06

Applegarth Care Home 02/11/05

Applegarth Care Home 21/06/04

Applegarth Care Home 04/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE APPLEGARTH 24 Huntercombe Lane North Maidenhead Berkshrie SL6 0LG Lead Inspector Sally Newman Unannounced 10 June 2005 @ 09:15 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. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Applegarth Address 24 Huntercombe Lane North Maidenhead Berkshire SL6 0LG 01628 662387 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) Mr Harbhajan Surdhar Mrs Jennifer Margaret Shaw Care Home 14 Category(ies) of Older Persons (OP) registration, with number of places APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15/11/04 Brief Description of the Service: Applegarth provides accommodation and care for up to fourteen service users over the age of sixty five years, who have care needs associated with old age. The home is not registered to provide care for people with dementia or who require nursing care; this would require additional categories. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which was conducted over the course of a morning and lunch time period. 7 service users were spoken to and the inspector spoke in private to 2 visiting relatives, a social worker and a G.P. 5 staff were spoken to of which 3 were seen in private. The main purpose of this inspection was to monitor progress since the last inspection through talking to individuals. Time was also spent with the assistant manager to ascertain compliance with requirements. Throughout the course of the inspection staff were helpful and assisted the inspector with the inspection process. The inspector spoke with the Proprietor on the telephone and following the inspection provided detailed feedback directly to the manager via the telephone. The home has experienced a significant turnover in staff since the last inspection. Despite this the manager, supported by her assistant and other key staff members, has maintained good standards of care. It was evident from talking to visitors to the home that the service is well regarded and communication with other professionals is very good. The home is now almost fully staffed and the manager is confident the improvements made to date will continue and will provide the basis for further good work. The home has been partially refurbished and it was clear that service users who expressed a view appreciated the results. However, work still remains to be completed in particular to the front of the home and to the kitchen. What the service does well: The home looks after the needs of service users well. The home is warm. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 6 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. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 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 standard(s) 4 & 5 Prospective service users and their representatives are provided with appropriate information prior to a decision to move to the home. EVIDENCE: Evidence from talking to a visiting relative and a visiting professional indicated that exploratory visits to the home were encouraged and supported. A tour and information was provided which enabled informed decisions to be made as to whether the home was appropriate. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 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) 8, 9 & 10 Service users health care needs are fully met. The arrangements for service users medication are mostly robust. Service users are treated with respect. EVIDENCE: Evidence from talking to service users, and visitors who were seen during the course of the inspection confirmed that the health care needs of service users are fully met. It was clear that staff are pro-active in identifying health care needs and accessing the appropriate services promptly. As a result of discussions with the assistance manager it was evident that there is a commitment to good medication practice. Information was given by the inspector with regard to more specialised advice for an unusual situation that had arisen in the home. Throughout the course of the inspection interactions between staff and service users were warm, friendly and respectful. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.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) 13, 14 &15 The home encourages contact for service users with significant people and with the community. The home encourages service users to make choices about their lives. Until recently all food provided in the home was of a high standard and took account of individual preferences. EVIDENCE: Discussions with visitors to the home confirmed that they are welcomed and can visit and any time. One visitor confirmed that they always called in without prior notice. Another visitor indicated that he was often invited to stay to lunch and in fact did so on the day of the inspection. It was clear from talking to staff that regular contact with significant others occurred for many service users in the home and staff were familiar with regular visitors. Community links are maintained for as long as individual service users are able. One service user confirmed that he regularly attends and day centre on a weekly basis. One respite service user was out at a day facility during the course of the inspection. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 11 Evidence was provided from observations of interactions between staff and service users. Service users were given choices with regard to comfort and meals. The food provided in the home has historically always been a particular strength. Recently changes to the arrangements have caused a variation in the standard and quality of meals. Some service users have found these changes very difficult to cope with. It was also highlighted that the standards for table setting can be variable. Such detail is very important to presentation of a meal and to the overall enjoyment of it. It will be recommended that current arrangements are kept under review and training is provided where required. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 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 Complaints are taken seriously and are acted upon appropriately. EVIDENCE: The complaints record contains appropriate and comprehensive information. There is a complaints policy and procedures to guide complainants. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 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 & 26 Areas of maintenance to the environment remain outstanding and require attention. Although the home is generally clean concerns remain over arrangements for the control of infection. EVIDENCE: The front of the property was cleared of trees and plants in September 2004. It has remained in this unsatisfactory state to date. The Proprietor confirmed that he had the work in hand but realistically nothing would be done for the next 8 to 12 weeks. It will be a requirement that the Proprietor provides a detailed timescale for the work which must be completed within 12 weeks. The rear garden area has been used to store an old industrial washing machine and various items of furniture from the home. It will be a requirement that these items are removed within one month. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 14 Confirmation needs to be sought from the Fire Authority that the new arrangements for locking the front doors complies with their regulations. A requirement will be made in this regard. It was not clear whether all the recommendations made in an Occupational Therapy report had been implemented. A requirement will be made to inform the CSCI of progress with the recommendations. Consultation with the Environmental Health Department needs to take place in order to ascertain whether the fly screen in the kitchen needs to be replaced. During the inspection it could not be ascertained as to whether the washing machine was operating according to the standards and to ensure effective control of infection. It will be a requirement that either confirmation that the machine is working properly is sent to the CSCI or that it has been replaced. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 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 Service users needs are met by the ratio and experience of staff. EVIDENCE: Service users spoken to confirmed that their needs are met by the current staff group. Confirmation was also obtained from visitors to the home on the day of the inspection. It was noted that some service users found it difficult to understand some staff members who did not have English as a first language. This could cause frustration on both sides and had resulted in some service users refraining from making requests. It will be recommended that this situation be kept under constant review. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 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 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, 33 & 36. The homes manager is competent and professional and runs the home with the best interests of service users as a priority. EVIDENCE: There was evidence from talking to staff, service users and visitors to the home that the manager is efficient and is approachable and fair. This evidence is supported by the obvious progress that has been made in the home since her appointment. The manager acknowledges that there is still room for improvement and is fully aware of where attention needs to be focussed. However, there is sound evidence of confidence in the managers’ ability to make further improvements in the best interests of the service users. Staff confirmed that they receive regular one to one supervision which is recorded. An annual appraisal system has been introduced. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 1 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 4 x 3 x x 3 x x APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 18 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 19 Regulation 23 (2)(o) Requirement That a plan together with timescales for the completion of work to the front of the property is forwarded to the CSCI. That old furniture and a washing machine be removed from the rear garden. To confirm with the Fire Authority whether compliance with their recommendations has been achieved. To ascertain any outstanding recommendations from occupational therapy report and inform CSCI. To consult with the Environmental Health Dept regarding the removal of the kitchen fly screen. Timescale for action 30/6/05 2. 3. 19 19 23 (2)(o) 23 (4) (a) 15/7/05 30/6/05 4. 19 23 15/7/05 5. 19 23 (5) 15/7/05 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 12 Good Practice Recommendations Consider implementation of a list of activities for service users. H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 19 APPLEGARTH 2. 3. 4. 15 9 27 To review the current arrangements for meal preparation and presentation. To seek professional advice regarding the current service user who self-medicates. To review the effectiveness of staff communication with service users. APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading RG7 4SA 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 APPLEGARTH H51-H01 57355 Applegarth V217128 100605 Stage 4.doc Version 1.30 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. 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!