Inspection on 24/10/08 for Applewood Care Home

This inspection was carried out on 24th October 2008.

CSCI found this care home to be providing an Good service.

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

Applewood Care Home 07/07/06

Applewood Care Home 27/02/06

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 27/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Applewood Care Home Coopers Lane Bramley Basingstoke Hampshire RG26 5BZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kima Sutherland-Dee     Date: 2 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Applewood Care Home Coopers Lane Bramley Basingstoke Hampshire RG26 5BZ 01256881756 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Milkwood Residential Care Ltd care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 39. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Applewood is a large detached property situated in a quiet residential area in the village of Bramley, Hampshire. The home provides care and accommodation for thirty nine older persons. Accommodation is provided over two floors with a passenger lift and stair chair lift allowing residents access to each floor. Since an extension and refurbishment programme the home has several new communal areas. The home has pleasant gardens where seating is provided for residents and their visitors. The homes ownership changed in December 2005 and it is now registered with Milkwood Care Ltd, Care Homes for Older People Page 4 of 23 Over 65 0 39 39 0 Brief description of the care home an organisation that owns a number of care homes in the South of England and in Wales. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The service was inspected on the 24th October 2008 for 5 hours and 15 minutes. The inspection included speaking with the service users and visiting relatives, speaking with staff and both the manager and the visiting provider. A sample of the records were reviewed and the care was observed, as well as the home environment. During preparation for the inspection we reviewed the last inspection report and any information that had been sent to the commission since then including the homes own assessment called the AQAA. Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are given the information they need to make an informed decision about this service. Evidence: The records were seen for three recently admitted service users, it showed that the service had clearly assessed each persons needs before they moved in. The manager said that they have just started to write to prospective service users to confirm that their needs can be met and to offer a place at the home. the provider said that prospective service users are invited and encouraged to spend time at the home before they make a decision. Each new service user is given a copy of the service users guide and the homes statement of purpose which contain the terms and conditions of the service. Care Homes for Older People Page 9 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from improved care planning, individual personal care and suitable health care. Medication is stored and administered safely and the service users are treated with respect. Evidence: A sample of the care plans demonstrated that they give the staff the details they need to care for each service user. They included details about the service users daily needs and their preferred routines as well as risk assessments regarding how to help people mobilise and their nutrition and whether they are at risk of developing pressure sores. The staff said they knew each service user well and they had time to meet their needs. Two service users were seen to have unbrushed hair and one had dirty fingernails. The staff said it is difficult sometimes when service users have dementia and they refuse to accept the personal care. They said they deal with this by offering help from different members of staff or waiting until later in the day. The service users did have their needs recorded in the care plans and one service user who challenges the staff when they attempt to offer personal care requires sensitive care that meets their needs. The Care Homes for Older People Page 10 of 23 Evidence: other service users looked well cared for, with tidy hair and clothing. The care plans have improved since the last inspection and the transfer and discharge information is more detailed. The plans recorded the service users health care needs and how these are met including any visits from doctors or other health care professionals. Two relatives said they were satisfied with the health care and that their family members were well looked after. A service user said I can see a doctor if I need to and the staff care for me well. The home has policies and procedures for the safe storage and administration of medication and the staff are trained to safely administer medicines as the doctor prescribes. The manager gave an example of a service user who was having their medication reviewed in consultation with a local G.P so they spent less time asleep during the day. The staff care was observed and all the staff spoke kindly to the service users and ensured their dignity and privacy. Care Homes for Older People Page 11 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from a variety of activities and they can choose how to spend their time. The service users are supported to maintain contact with their family and friends. The service users are offered meals that suit their needs and preferences. Evidence: The activities co-ordinator at the home explained that they organise group activities as well as spending time individually with service users, especially those that stay in their rooms through choice or medical condition. A wide range of activities were offered including quizzes and bingo, reminiscence and sing alongs as well as trips out to places of interest and entertainers who visit the home. A service user said they enjoyed an afternoon when an accordion player came to the home. One visitor said that another family member came to the home to join in with activities with their relative and they were always welcome. The service users said they enjoyed the activities and they could choose whether to participate. One relative said Theres no restrictions on the service users and they do what they want. One service user said A minister brings in a church newsletter that I read and there are church services in the home. Other service users said they attended church or the services at the home. Other people said Care Homes for Older People Page 12 of 23 Evidence: they were aware that ministers came to the home but they choose not to attend. The service users were all complementary about the food at the home, they said There is plenty of good food and enough to drink We are given what we like and the food is always good. One visitor said the food was good and their relative enjoyed the meals, they also commented that they could have a meal at the home. The dining room was light and comfortable and as the staff helped people into the dining room before lunch there was a friendly atmosphere with staff chatting to service users and their relatives. The care plans included an assessment of the service users nutritional needs and any food preferences. Care Homes for Older People Page 13 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from an improved system for dealing with complaints and protection and from an ongoing staff training programme in the protection of vulnerable adults. Evidence: The service had the procedures they required to deal effectively with complaints and they had been used correctly. Three recent complaints regarding the care of four service users had been investigated in co-operation with social services and improvements to one aspect of the records have been made as a result. At the conclusion to the investigations social services found that the allegations were unfounded and no actions were taken against the home. Social services have provided two safeguarding vulanarable adults training sessions for the staff. Care Homes for Older People Page 14 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the needs of the service users, it is comfortable and clean. The manager must ensure the home is kept free from hazards at all times. Evidence: The provider explained that the home has been fully refurbished throughout in the last three years and an extension has been completed. All the service users we spoke with said they liked the home and it was kept clean and fresh. Three visiting relatives also commented on the home being comfortable A home from home and clean. One visiting relative showed their family members room, which was very personalised with comfortable furniture,ornaments and pictures. This relative said they had been so pleased because they had mentioned that some shelves would be useful and they had been fitted within days of the request. The home is fully equipped to meet the needs of the service users and there is an ongoing maintenance programme. The AQAA stated that the service intended to improve the garden to include raised beds and a sensory area. These improvements have been made and the service users said they liked the garden and it was fully accessible. The home employs cleaning staff and maintenance staff to ensure the environment is safe and comfortable. It was noted that a full mop bucket and a vacuum cleaner had been left unattended in a corridor. The manager agreed that this could be a risk to the Care Homes for Older People Page 15 of 23 Evidence: service users and would be attended to. The cleaner on duty said they had attended a health and safety course with their previous employer. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from enough trained and safely recruited staff to meet their needs. Evidence: The staff spoken with said they enjoyed working at the home and they had the training and support they needed to do their job. The staff also said they had time to meet the service users needs and they particularly enjoyed spending time talking to the service users. One carer had completed and National Vocational Qualification (N.V.Q) level three and had gained promotion to a senior role. They had received training and a new job description so they were clear about their responsibilities. The manager said that eight out of the twenty staff had and N.V.Q at level two or above and six staff were working towards this qualification. The staff said the manager is approachable and they can seek support and guidance. Recent training courses have included, Dementia care, manual handling and the protection of vulnerable adults. The provider stated that they were committed to developing their staffs skills and they sought to promote staff internally to more senior roles, they said this allows the staff to get to know the service users well and to promote good team working. The staff files demonstrated that staff had been safely recruited for the protection of Care Homes for Older People Page 17 of 23 Evidence: the service users. One recently employed member of staffs file did not contain a criminal records bureau check, but the provider was able to demonstrate that the document was at the head office and would be forwarded to the home immediately. The files also contained records of staff training and certificates. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed effectively and safely for the benefit of the service users. Evidence: The home is managed effectively with the support of the providers organisation by a qualified manager with experience. The staff and the service user said that the manager was approachable and supportive. The manager and the provider agreed that the AQAA they had completed was inadequate, with very little of the information we had asked for. The provider explained that they had employed a new operational manager and they would work with the manager to complete the next AQAA to a better standard. The service offers the service users and their relatives a number of ways of contributing to the home, these include meetings and surveys. The relatives said they could approach the manager at any time to seek advice or gain information about the care at the home, or their relatives health. The staff are regularly supported and supervised by the manager or senior staff and these meetings are documented. The staff said the manager was supportive and they could seek advice at any time. Care Homes for Older People Page 19 of 23 Evidence: The service is maintained safely with equipment regularly serviced and fire checks being completed according to the fire officers guidance. the fire log book was up to date and the staff said they had taken part in fire drills. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 22 of 23 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 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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