Inspection on 08/12/05 for Aspreys Nursing Home

This inspection was carried out on 8th December 2005.

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

Aspreys Nursing Home 23/04/09

Aspreys Nursing Home 04/06/08

Aspreys Nursing Home 06/12/07

Aspreys Nursing Home 25/04/07

Aspreys Nursing Home 13/09/06

Aspreys Nursing Home 06/04/05

Aspreys Nursing Home 12/10/04

Aspreys Nursing Home 29/06/04

Aspreys Nursing Home 04/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Aspreys Nursing Home I Kents Road Torquay Devon TQ1 2NL Lead Inspector Rachel Proctor Unannounced Inspection 8th December 2005 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 Aspreys Nursing Home DS0000028780.V254975.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. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Aspreys Nursing Home Address I Kents Road Torquay Devon TQ1 2NL 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) 01803 201500 01803 201700 matron@aspreys.co.uk Friendly Care Homes Ltd Vacancy Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (10), Physical disability over 65 years of age of places (25) Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two lower ground floor rooms must not be used for Residents who require nursing The number of Residents who require nursing is limited to 31 A minimum staffing level that follows the previously agreed Health Authority staffing notice must be available to meet the needs/dependency of Service Users who require nursing One named Resident, named elsewhere, under 60 yrs of age (PD Category) Residents from age 60 years and above may reside at the home. 4. 5. Date of last inspection 6th April 2005 Brief Description of the Service: Aspreys Nursing Home is located in Wellswood, approximately one mile from Torquay town centre. It has level access to the local shops, pubic house and restaurants all being within 100 yards from the home. The St Matthias Church is within 200 yards of the home. The home operates its services on all of the four floors with the dining room and rear garden area being on the lower ground level, the lounges, matrons office and some rooms on the ground floor and the remaining rooms being on each of the two upper floors. All floors can be reached by a shaft lift. The home offers both Nursing and personal care mainly to people over the age of retirement but can admit younger people with medical needs. The staff group is made up of registered nurses and trained social care staff (Health Care Assistants). There is a good level of specialist equipment like a Parker bath, hoists and stand aides available to meet the needs of disabled people. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission for social care inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. This was an unannounced inspection, which took place over two days, 8th December 2005 between 11 a.m. and 3 p.m. and the 14th of December 2005 between 9:30 a.m. and 10:30 a.m. A tour of the home was completed and some records were inspected. Five residents, to visitors and four staff members were spoken to during the inspection. The manager was present on both inspection days. What the service does well: What has improved since the last inspection? What they could do better: New staff must have pre employment checks completed before they start work at the home. In order to ensure the residents are protected from unsuitable staff. Radiators should be covered to reduce the risk of accidental scalding/burns. It is still unclear how new staff are trained to care for the residents. Documentation must show how understanding of care has been achieved and how it links to best practice guidelines. Aspreys Nursing Home DS0000028780.V254975.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. Aspreys Nursing Home DS0000028780.V254975.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 Aspreys Nursing Home DS0000028780.V254975.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 The assessment process adopted by the manager continues to ensure that the care needs of the residents are assessed prior to the delivery of care. EVIDENCE: Three residents plans of care were viewed during the inspection. Assessments of need had been completed for these residents, which included risk assessments. Two residents who had recently been admitted to the home were spoken to. Two family members were visiting at the same time. The residents said they were being well cared for and had had the opportunity to speak to the staff prior to the admission. The family confirmed that they were satisfied that the staff had assessed the care needs of their relatives. The manager advised that she was in the process of updating the care planning process and the way the residents care assessments were recorded. A risk assessment process has been introduced for reviewing the risks of falls, dehydration infection, skin breakdown, manual handling and isolation. Aspreys Nursing Home DS0000028780.V254975.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, The residents are cared for by a friendly supportive staff team who have their best interests at heart. EVIDENCE: Residents spoken to during the inspection said that the care staff were friendly and supportive towards them and understood their care needs. The three plans of care reviewed during the inspection had been reviewed monthly or sooner if the resident’s condition had changed. One resident reported that they had been asked about their personal choices and preferences and had been involved in developing their plan of care. The resident’s personal preferences and choices were recorded in their plans of care. Specialist pressure relief mattresses were in use for the residents who had been identified as a risk of pressure sores development. The manager uses the Waterlow scoring system for each of the residents to establish their risk of developing pressure sores. Nutritional assessments are an integral part of the care planning process for residents. The manager confirmed that these are reviewed on a regular basis to ensure that the residents are receiving adequate nutrition. The residents were being given drinks during the inspection. Drinks had been placed in easy reach of those residents who were unable to move independently. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 10 Staff were using the hoists to assist residents during the inspection. The manager confirmed that staff are encouraged to use the manual handling aids and manual handling training is provided for staff. The controlled drug record book was checked against stock for one resident as correct. The new system for disposing of unwanted drugs had been introduced since the last inspection. The records held for the disposal of medication had been completed and signed and dated as expected. Lunchtime medication was being dispensed on an individual resident basis and signed for when it was given. No out of date are expired medication was being stored in the medication storage area the inspector checked. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, There has been an improvement in the activities available for the residents at Aspreys, which they can choose to participate in. EVIDENCE: The manager advised that Antics and Activities and ‘’Brixham Activities’’ visit the home on a fortnightly basis. One resident told the inspector that she had really enjoyed taking part in the activities provided. The manager confirmed that these two organisations provide weekly sessions for the residents on a Thursday. The manager advised that the home has close links with the local St Matthias Church. The residents are enabled to take part in religious services if they wish. Three separate lounges and a small dining room are available for the residents use. During the inspection residents were using one of the lounges to take part in a reminiscence program organised by Antics And Activities. The resident’s spoken to told the inspector they were able to choose what they wanted to eat. If they didnt like what was on the menu they were offered alternatives. Two residents told the inspector that they had chosen to stay in their own rooms and preferred not to go down to the lounge. The staff had enabled them to do this. Some resident’s lunchtime meal was provided for them in their own rooms at their request. Aspreys Nursing Home DS0000028780.V254975.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 caring attitude of the staff towards the residents enables them to express their concerns and wishes in the knowledge that staff will deal with them sensitively. The failure to complete all pre-employment checks for new staff may put the residents at risk. EVIDENCE: The commission had received no complaints since the last inspection. The manager confirmed that she regularly talks to residents and their representative to ensure that the service they provide is meeting their needs and expectations and any issues are dealt with as they occur. The complaints procedure and policy is easily available for the staff and residents to use. The residents asked said they knew who to complain to if they had any concerns and didnt have any worries about speaking up about things that affected them. The manager advised that new staff appointed were working supervised until they had had their CRB check was returned. This was the case on the day of inspection. However the shift pattern for the healthcare assistants on some days would make it difficult for new healthcare assistants to work supervised all the time given the dependency of the residents and the need for two healthcare assistants to provide care. The requirement that all new staff must have all pre-employment checks as for the homes policy and the satisfactory police checked prior to starting employment had not been met this inspection. Contact numbers for social services were available in the office. Aspreys Nursing Home DS0000028780.V254975.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): 19,25,26 Overall the home provides a pleasant and homely environment for the residents. However the reduced numbers of ancillary staff employed at the time of this inspection has meant that the home does not appear as clean as it did. EVIDENCE: The redecoration of the home has continued since the last inspection. New carpets have been put down in the lower ground floor area. Woodwork on doorframes and skirting boards in the corridors had been repainted in the communal areas. The manager advised that the maintenance man who had been appointed before the last inspection had left and she was in the process of recruiting a new person. Some routine maintenance and renewal was taking longer without access to an in-house maintenance man. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 14 Call bells were being used by the residents during the inspection and each of the residents visited in their own room had to call bell within easy reach if they were able to use it. The manager confirmed that any new residents are assessed regarding their ability to use a lockable door to their room. She further advised that none of the current residents were able to benefit from this. Height adjustable beds had been provided for the residents who require them. Not all the radiators in the home have been guarded. The manager confirmed that the radiators were being covered using a risk assessment basis. Heating can be adjusted in the individuals rooms to suit the resident’s tastes or requirements. A tour of the home revealed that individual rooms varied in temperature. The home smelt fresh during the inspection, however some of the resident’s rooms had dust, crumbs and bits of paper on the floor and did not appear to have been vacuumed. Two toilets hadnt been cleaned and were stained with faeces. The manager advised that they were in the process of recruiting new domestic staff. Two members of care staff spoken to confirmed that they alternated between domestic duties i.e. cleaning and laundry and providing personal care for the residents. Both said they were doing this because they wanted the home to look nice for the residents. The laundry floor had washing powder and dust in the corners and several piles of laundry in baskets were around the laundry floor. Clean and dirty laundry had not been clearly separated. The manager advised that the night staff are doing the laundry on a temporary basis until a laundry person can be appointed. She also stated that if the night staff time had been taken up caring for residents in the laundry was left. A risk assessment for the prevention of legionella has been put in place. The manager advised that this had been delayed when the maintenance man had left. Staff providing personal care for residents were using gloves and aprons. Gloves and aprons were easily available for the staff to use. A yellow bag system for clinical waste disposal was in use and staff are using these during the inspection. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 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 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 staff team in place continue to be friendly and supportive towards the residents. However, the way staff are recruited, trained and developed needs to follow good practice guidelines to ensure the residents continue to be carried for by a suitable staff team, that understands their care needs. EVIDENCE: Some of these residents were not got out of bed until lunchtime during the inspection. One resident commented that they get up later when the staff are busy. 19 residents required two healthcare assistants to assist them. Two residents told the inspector that they thought the home was short staffed and staff sometimes took a long time to answer their call bells. Since the last inspection the number of ancillary staff available in the home has reduced. There were no kitchen assistants or laundry person on duty at the time of the inspection. Some resident’s rooms had not been vacuumed and the bins in resident’s rooms had not been emptied. The manager was in the process of introducing a new style induction programme that broadly follows the guidelines set. The manager advised that six new staff were in the process of completing the new induction programme. However one staff members file viewed during the inspection did not support that they had received adequate induction in the principles of care prior to working unsupervised. A tick list induction programme was in use for this carer. No manual handling training had been signed off for this healthcare assistant. The manager advised that she was having difficulty keeping up-toAspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 16 date with some of the paperwork relating to staff files because of the difficulties she was having recruiting suitable ancillary staff. Six new staff members had been appointed since the last inspection three of these staff files reviewed. The manager advised that she was awaiting the return of CRB cheques sent off and staff were working supervised until these have been returned. However the shift rota pattern for the healthcare assistants on some days would make it difficult for the new carers to work supervised at all times, given the dependency of the residents and the need for two healthcare assistants to provide their care. The manager advised that she had started to develop a system linked to induction and appraisal to provide training and development plans for all staff. However these were not in place at the time of the inspection. The staff spoken to during the inspection said they did have access to the statutory training such as manual handling, health and safety and fire lecturers. The manager confirmed that staff would be put forward for the National vocational qualification in care, although at present less than 50 of the staff have achieved this award. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 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 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, 38 The e new manager has started to make changes to the way care is delivered and the service managed and has the support of a dedicated staff team. However there are still some outstanding requirements that the manger needs to address to ensure the improvements continues. EVIDENCE: The commission is awaiting the application of the manager to enable the completion of the fit person process for registration. The manager was able to provide information that she kept herself up to date with current practices. The residents also told the inspector they thought the manager was friendly and approachable. Four staff members said the manager was supporting them to do their work and was open to suggestions to improve the way care is delivered. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 18 The new quality audits has not been completed since the last inspection although the manager has advised that she is planning to do this. The audit completed in December 2003 was available. Redecoration of communal areas and some resident’s rooms has continued since the last inspection. A continuous self monitoring method of quality audit has still to be fully implemented. The homes insurance certificate is displayed which covers against loss or damage and the registered persons liabilities to employees, residents and third-party persons. Health and safety policies and procedures are in place and available to staff and residents on request. A risk assessment process for individual residents care is in place and was in use at the time of the inspection. A risk assessment of legionella in the water systems has been completed. A record of water temperature checks was provided for inspection. Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 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 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 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X 2 2 STAFFING Standard No Score 27 2 28 1 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X 3 Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? yes 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 OP18 Regulation 19(1)(b)(i ) Requirement All New staff must have all pre employment checks as per the homes policy and a satisfactory police check prior to starting employment. The registered person must not employ a person to work at the care home unless- he has obtained in respect of that person the information and documents specified in Schedule 2 Brought forward from last inspection time scale extended from 06.06.05 As Above Brought forward from last inspection time scale extended from 06.06.05 Staff must have training and development plans appropriate to the work they perform Timescale for action 28/02/06 2 OP29 19(1)(b)(i ) 18(1)(c)(i ) 28/02/06 3 OP30 08/06/06 Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 Refer to Standard OP19 OP25 OP26 OP27 OP28 OP31 OP33 Good Practice Recommendations A routine programme of maintenance should be available for inspection The covering of all radiators in residents areas should continue using the risk assessment process in place The premises should be kept clean Sufficient numbers of ancillary staff should be employed to keep the home clean in all areas and complete laundry in a timely manner The induction process for new staff should link to best practice. 50 of the care staff should be trained to N.V.Q level 2 or above The manager should submit an application for registration as the manager with the Commission Continuous self monitoring internal audit should take place at least annually Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Aspreys Nursing Home DS0000028780.V254975.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!