Inspection on 31/10/05 for Astell

This inspection was carried out on 31st October 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

Astell 13/11/06

Astell 20/03/06

Astell 15/03/05

Astell 27/10/04

Astell 09/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Astell Overton Park Road Cheltenham Glos GL50 3BT Lead Inspector G Goldfinch Unannounced Inspection 12.10p 31 October 2005 st 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 Astell DS0000016372.V251589.R01.S.doc Version 5.0 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. Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Astell Address Overton Park Road Cheltenham Glos GL50 3BT 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) 01242 529012 Cheltenham Old People`s Housing Society Limited (The Lilian Faithfull Homes) Mrs Rosemary Brooks Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2005 Brief Description of the Service: Astell is a large attractive Victorian property, which has been adapted to provide comfortable accommodation for 36 elderly residents who require personal care. The Home is maintained and decorated to a good standard. The Home is owned and managed by a charitable organisation and is one of the Lilian Faithfull Homes. It is situated in a residential area, close to the centre of Cheltenham and to local amenities. Residents are accommodated on three floors of the Home, accessed by a shaft lift. The majority of the bedrooms have en suite facilities. A variety of aids and adaptations have been provided throughout the property to assist the less able residents. Communal areas consist of a large comfortable lounge, which may be divided by screens to provide two separate rooms, when desired. There is also a pleasant dining room and small library, which may be booked for private use. The Home has the benefit of enclosed well-maintained gardens. These are easily accessible and may be enjoyed by the residents in pleasant weather. Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place from 12.10pm –15.45 pm. The inspection was carried out as part of the regular planned program of inspections. A brief tour of the premises took place, and a selection of care records were examined. Some health and safety documents were also seen. The responsible individual, five of the staff on duty, the training officer and four residents were spoken to during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 5 The home had a Statement of Purpose and Service User Guide. These documents were not being promoted to provide residents or prospective residents with details of the service the home provides. Residents’ needs were assessed and they were able to visit the home to help them make a choice about whether they wanted to move there. EVIDENCE: Staff spoken to were unfamiliar with the Statement of Purpose or Service User Guide. Although these documents had been produced by the organisation, they were difficult for staff to find, and there was no evidence that either was in use by the home to provide residents’ or prospective residents with details of the services the home provides. Those residents who spoke with the inspector stated they had not seen or been given a copy of the Statement of Purpose or Service User’s guide. Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 8 An assessment document was seen which covered all areas of residents’ needs. Residents confirmed they had been visited and assessed by the home before moving in. Three residents were able to say that they had been able to visit the home and have a look around before admission. Astell DS0000016372.V251589.R01.S.doc Version 5.0 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 and 10 Residents had a plan of care setting out their health, social and personal care needs. More detailed written information is needed to inform and assist staff in meeting the identified care needs of each resident. The health needs of residents were met with evidence of good multidisciplinary working. Personal support was offered in such a way as to promote and protect residents’ privacy, dignity and independence. EVIDENCE: The records of four residents were fully checked. Each had an assessment and a care plan. Individual care needs were recorded on the care plans. However, it was not always clear from the care plans how identified needs were to be met, or by whom they were to be met. Those care plans seen had not been signed by the service user or their representative. There was no evidence of a regular system of formal review of care plans or of involvement of residents or their representatives in this process. Daily records showed that primary health care professionals were consulted and called in as necessary and residents had access to chiropody, opticians and Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 10 dental services. Staff stated they had positive working relationships with primary health care professionals who visit the home. All residents spoken with stated their care needs were met and that they were happy with the service received via the primary health care team. One resident stated ‘I am very well looked after and the health care services and quick response is excellent’. Observations made during the inspection showed that staff were respectful and promoted residents dignity. All residents spoken to confirmed that staff were respectful of their privacy and dignity. Medication systems were not inspected in detail. However evidence was seen to indicate recommendations made at the previous inspection relating to medication had been implemented. Astell DS0000016372.V251589.R01.S.doc Version 5.0 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, 13 and 15 Residents experience a fairly stimulating and varied life at the home with visitors encouraged. Links with the community are also maintained. EVIDENCE: The home employs an activities organiser; this post was vacant at the time of the inspection. An appointment had been made and the new activities organiser was due to commence employment in the near future. It is to the credit of staff in the home that in the absence of a designated activities organiser the home has continued to provide a variety of activities designed to meet the needs and preferences of residents. Examples include music, poetry readings, quizzes, craft, outings and reminiscence. A minibus is available for use and trips out are organised for example to the theatre. Residents spoken to confirmed their involvement in activities and commented on how much they enjoyed the activities on offer in the home. The home has a policy of open visiting with visitors welcome at any reasonable time. Residents stated that their family and friends were always welcomed into the home by staff. Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 12 The home has a Visitors Committee, made up of volunteers who act as a friend and additional support to individual residents as required. An independent catering company provides meals in the home. Residents who were spoken to gave differing opinions about the choice and quality of food provided. The menus indicated that a variety of food was available each day. One resident said, “The food is satisfactory” and another said, “The choice of food is not quite as good as when I first came here.” Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 13 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 The home has a complaints procedure. It was not clear whether this procedure was being properly implemented in the home. The present arrangements for dealing with complaints in the home require review. EVIDENCE: Staff stated there was a complaints procedure contained in the manual of procedures. This was not being routinely distributed to residents or prospective residents within the Statement of Purpose or Service User Guide. It was unclear how the home would ensure that residents were made aware of the complaints procedure and its contents. Residents spoken to felt that staff were approachable and all stated they were confident to discuss any concerns, knowing that they would be taken seriously. However, residents were not aware of how to contact the Commission for Social Care Inspection, should they wish to at any time. Staff on duty were not aware of the record of complaints or of where to locate it. Senior staff on duty should be aware of and have access to the record of complaints. Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 14 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): 26 Refurbishments continue to be made to improve laundry facilities. EVIDENCE: This standard was not inspected in detail. However, requirements made at the previous inspection relating to the laundry were assessed. The requirement to ensure that liquid soap was provided for hand washing in the laundry had been met. Requirement relating to replacement of the laundry floor and ensuring that wall surfaces in the laundry are readily cleanable had not been met. The laundry area was inspected and seen to be in the process of complete refurbishment. New washing machines had been purchased and fitted, the laundry area was being made larger, cupboards had been removed from the walls and the walls were to be made readily cleanable. Staff stated that when these works were Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 15 complete the laundry floor would be replaced to provide a safe impermeable finish. Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 16 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): 30 Staff receive training to do their jobs. Some staff training requires updating to ensure the continued safety of residents. EVIDENCE: The training officer stated that induction training was available for all new staff. It was not possible to inspect evidence to support this, as there had been no staff appointments at the home since the previous inspection. The home is committed to NVQ training and the majority of staff were working towards or held the qualification. There were no staff on duty with up to date first aid training. Senior staff on duty had previously received training in first aid but this was outdated and required renewal. This situation does not ensure the continued safety of residents. A qualified first aider should be available in the home at all times. This was discussed with the training officer who confirmed that prompt action would be taken to address this situation. Astell DS0000016372.V251589.R01.S.doc Version 5.0 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): 38 Safe working practices were in place but not being fully implemented in respect of fire safety and first aid. EVIDENCE: As stated elsewhere in this report there was no qualified first aider on duty during this inspection. Fire safety records were inspected. All were up to date with the exception of the weekly fire alarm test; this had not been carried out since 13/10/05. An immediate requirement notice was issued in respect of this requiring action to be taken to ensure the test is carried at the required intervals and appropriately recorded. Staff on duty had received training in infection control, food hygiene and safe moving and handling. Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 18 It was stated by the responsible individual that requirement made at the previous inspection in relation to Regulation 26 reports being forwarded to the commission was being met. Astell DS0000016372.V251589.R01.S.doc Version 5.0 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 2 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X X X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 2 2 Astell DS0000016372.V251589.R01.S.doc Version 5.0 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 OP1 Regulation 4(1)(2) 5(1)(2) Requirement The registered person shall make available to residents an up to date statement of purpose setting out the aims, objectives, philosophy of care, services and facilities, and terms and conditions of the home; and provide a service users’ guide to the home for all current and prospective residents. The registered person shall ensure that all care plans set out in detail, the action to be taken by care staff, to meet the identified health, personal and social care needs of residents. The registered person shall ensure that residents care plans are reviewed and updated to reflect changing needs. The registered person shall ensure that whenever appropriate, residents and/or their representatives, are involved in the preparation and review of their care plan. DS0000016372.V251589.R01.S.doc Timescale for action 01/01/06 2 OP7 15(1) 01/01/06 3 OP7 15(2)(b) 01/01/06 4 OP7 15(3)(c) 01/01/06 Astell Version 5.0 Page 21 5 OP16 22(5) 6 OP16 17(2) 7 OP26 13 (3) 23 (2)(b) 8 OP30 13 (4) c 18 (c) i 9 OP37 17(2)(14) 10 OP38 12 (1) The registered person shall supply a written copy of the complaints procedure to every resident and to any person acting on behalf of a resident if that person so requests. The registered person shall keep a record of all complaints made by a resident or representatives or relatives of a resident or by persons working at the home about the operation of the home, and the action taken by the registered person in respect of any such complaint. The registered person Shall ensure that the laundry floor covering is replaced to provide a safe impermeable finish and that the wall surfaces in the laundry are readily cleanable. Previous timescale of 30/9/05 not met. The registered person shall make suitable arrangements for the training of staff in first aid and provide a qualified first aider at all times. The registered person shall ensure that the records in respect of fire safety are maintained up to date at all times. The registered person shall ensure that the care is conducted so as to promote and make proper provision for the health and safety of residents. Specifically this means ensuring the weekly fire alarm test is undertaken. 01/01/06 01/01/06 01/01/06 01/01/06 31/10/06 31/10/06 Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 22 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 Refer to Standard OP1 OP7 OP15 Good Practice Recommendations Ensure that staff receive training on the content and use of the statement of purpose and service users’ guide. All residents and/or their representatives should sign their individual care plan. A system of communication should be established between the catering manager and the residents, to ensure that effective feedback is received about meals provided and that such feedback is appropriately acted on by the catering service. Ensure that staff receive training on use of the complaints procedure. 4 OP16 Astell DS0000016372.V251589.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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