Inspection on 05/05/06 for Appletree House Care Home

This inspection was carried out on 5th May 2006.

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 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

Appletree House Care Home 31/10/05

Appletree House Care Home 05/05/05

Appletree House Care Home 29/11/04

Appletree House Care Home 26/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Appletree House Care Home 9 Pratton Avenue Lancing West Sussex BN15 9NU Lead Inspector Mrs K Allen Unannounced Inspection 5th May 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Appletree House Care Home Address 9 Pratton Avenue Lancing West Sussex BN15 9NU 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) 01903 762102 Mr Angelo Injenis Dalpadado Mrs Hiranthi Dalpadado Mr Angelo Injenis Dalpadado Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 15 Persons in the registration category I - Old Age over 65 Years Date of last inspection 31st October 2005 Brief Description of the Service: Appletree House is a care home registered to provide care and accommodation for up to fifteen older people over the age of 65 years of age. It is a detached property located in a residential area of Lancing, West Sussex and close to local amenities. Accommodation consists of one double room and thirteen single rooms on the ground and first floors. Three rooms have en-suite facilities. Both floors are served by a passenger lift. On the second floor there is a bed-sitting room for a resident member of staff. There are two lounge/dining rooms on the ground floor and a large rear garden. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of all previous documentation, letters to relatives and comment cards received as well as contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection. This included an analysis of incident reports and those of other statutory bodies such as the fire service. The inspection took place over seven hours during which time all of the residents were spoken to either in communal areas or the privacy of their own room. In addition, a visitor was spoken to. Staff were seen going about their duties and two care assistants were interviewed. A discussion was held with the manager and a number of records were seen. The owner uses a questionnaire to obtain the views of residents, relatives and others involved in the home about the care provided. However the results of these are not published. A requirement has been made that the record of resident’s medication must be kept up to date. It is further recommended that staffing levels be reviewed due to the increasing frailty of residents. The overall quality of the service is good. What the service does well: What has improved since the last inspection? What they could do better: All records of medication must be accurate and up to date. Staffing levels should be reviewed to ensure the increasing needs of residents are met. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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 Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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): 3 & 6 The outcome for service users is good. No resident moves into the home without first having their needs assessed. The home does not provide intermediate care. EVIDENCE: The person most recently admitted to the home had a written needs assessment. Others had them on their file from the date when they were admitted to the home. Staff confirmed that an assessment was carried out by the owner of the home in conjunction with the person, their placing authority and family, as appropriate. None of the people at the home were there for intermediate care. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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, 8, 9 & 10 The outcome for service users is good. Residents health, personal and social needs are set out in an individual plan of care. Their health needs are met and they are treated with respect and dignity at all times. The arrangements for the administration of medication should be improved so that the details kept are up to date. EVIDENCE: A sample of residents files showed that a care plan was written up for each person and that it was reviewed every month. It gave clear details about resident’s needs and how they were to be met. All of the residents were well presented. They said that they could see a doctor, dentist, optician or chiropodist when they wished. Most services came to the home and residents were able to see people in the privacy of their own room. There were good arrangements for the storage and administration of medication, however the record kept of current medication was not always updated when the residents GP made a change. Residents said that staff were careful to protect their privacy. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 & 15 The outcome for residents is good Residents are satisfied with the lifestyle provided at the home. They are able to maintain contact with family and friends as well as the local community. They can choose how they spend their time and have control over their own lives. The meals provided are wholesome and residents eat in satisfactory surroundings. EVIDENCE: Residents said they liked the home and what it had to offer. In particular, they enjoyed music and exercise sessions. They also appreciated weekly visits by boys from a local independent school who either took them out for a walk, talked or read to them or played table games. A communion service is held regularly at the home. Visitors are welcome and residents said that tea was provided when they arrived. Residents handle their own money usually with the help of relatives or a solicitor. They can bring their own possessions into the home and a record is kept of these. The meals are greatly appreciated by residents who were heard to compliment the cook after enjoying their meal. Hot and cold drinks are regularly available and residents confirmed that drinks were made for them during the night if they required it. Special diets are Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 11 catered for as well as the likes and dislikes of individual residents. There is a written menu although this is not available to residents for reference. It was suggested to the home that they display the menu for residents convenience. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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): 16 & 18 The outcome for residents is good Residents and relatives are confident that their complaints will be listened to and taken seriously. Service users are protected from abuse. EVIDENCE: There is a written complaints procedure which includes details of the CSCI. Residents knew who was in charge of the home and understood that any concerns should be taken to him in the first instance. They confirmed that he was in the home ”most days” and therefore available to them should they wish to raise a concern. A record is kept of complaints although none have been received in the last six months. Staff were familiar with the homes adult protection procedures and had received training in the matter. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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): 19 & 26 The outcome for residents is good. Residents live in a safe and well-maintained environment. It is kept clean and hygienic. EVIDENCE: The home is suitably located for its purpose and is comfortably furnished. Whilst there is no written programme of maintenance it is evident that regular maintenance takes place. There is a large rear garden and a gardener is employed to maintain it. Residents really enjoy having a nice outlook and the opportunity to watch wildlife and sit outside in the better weather. A recent inspection from the local fire service deemed the home to be meeting all of its standards. The premises are clean and hygienic throughout. The laundry is located away from food preparation areas and hand washing facilities are provided nearby. There are written procedures on infection control and staff have received training in this area of their work. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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): 27, 28, 29 & 30 The outcome for residents is adequate. Residents needs could be more fully met by a review of staffing levels. They are in safe hands due to a good level of training and NVQ qualifications. They are supported and protected by the homes recruitment procedures. EVIDENCE: A written rota is kept and shows that two care staff are on duty at all times. In addition, there is a part-time cook and cleaner. The manager is in the home most days although his hours are not recorded. This level of staffing does not allow for any emergency or unexpected event. The deputy or manager are on call and contacted should additional staff be required in such circumstances. On the day of the inspection one person needed to go to hospital and the existing arrangements meant that she had to wait until a member of staff, who was off duty, could be called to the home to accompany her on the trip. A good programme of NVQ training is in place with more than 50 of the care staff having obtained level 2 or 3. Ongoing training was also available which gave staff knowledge in core areas of their work such as infection control, adult protection, safe lifting and handling, food hygiene, fire safety and medication administration. Records showed that a thorough recruitment procedure was followed. It included two references and a Criminal Records Bureau check. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 15 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): 31,33, 35 & 38 The outcome for service users is good. Residents live in a well run home which is managed by a person fit to do so. It is run in their best interests where their financial interests are safeguarded. The health and safety and residents and staff is promoted and protected. EVIDENCE: The manager is also the owner of the home and is experienced and competent. He is in the home most days and makes himself available to both residents and staff, both of whom said that he was approachable. There is a quality assurance system in place whereby questionnaires are sent to people who have any connection with the home. The outcome of this questionnaire was collated and formed the basis for the homes development for the forthcoming year. The owner confirmed that he intended to repeat this exercise again this year and would broaden the scope of the questionnaire and think of other ways of gaining peoples opinions. Action is taken on any requirements or recommendations following CSCI inspections. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 16 As previously stated, residents manage their own money usually with assistance from family or solicitors. Good arrangements are in place to ensure residents and staff are safe. They include induction and training in safe working practices such as fire safety, lifting and handling, medication, food hygiene and infection control. There are maintenance contracts in place for the lift, fire safety equipment, gas and electrical equipment and water temperature controls. There is a written statement of the homes health and safety policy. All accidents are recorded and a good system of risk assessments is in place. Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard CH9 Regulation 13 Requirement The record of residents medication must be kept up to date Timescale for action 05/05/06 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 CH27 Good Practice Recommendations A review of staffing levels should be carried out due to the increasing frailty of residents Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Appletree House Care Home DS0000014363.V293014.R01.S.doc Version 5.1 Page 20 - 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. 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