Inspection on 04/12/05 for Astley House

This inspection was carried out on 4th 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 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

Astley House 14/09/09

Astley House 02/07/09

Astley House 05/07/07

Astley House 01/06/06

Astley House 11/08/05

Astley House 31/01/05

Astley House 01/07/04

Astley House 05/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Astley House 1/2 Hartley Gardens Seaton Delaval Whitley Bay Tyne & Wear NE25 0AB Lead Inspector Karena M Reed Unannounced Inspection 4th December 2005-25th January 2006 10:30 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 Astley House DS0000000518.V275225.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. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Astley House Address 1/2 Hartley Gardens Seaton Delaval Whitley Bay Tyne & Wear NE25 0AB 0191-2377209 0191 2377209 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) Mrs M Powers Mr R Powers Miss L A Campbell Care Home 15 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (5) of places Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th August 2005 Brief Description of the Service: Astley House is a large, detached house which used to be the village police station. The home is situated in a residential area within the village community of Seaton Delaval, it is close to local facilities. It is in close proximity of the Northumbrian coast and the nearby countryside. It is registered to provide personal care to fifteen service users , the categories of registration are for five older people and ten older people with memory loss. Bedrooms are all for single occupancy, some are situated on the ground floor.There is a large lounge and dining room combined lounged overlooking a wellstocked garden to the front of the building. there are two bathrooms, one of which contains an assisted bath. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 10 hours. A partial tour of the premises took place and a sample of care records were inspected as well as other records. Records included: 4 care plans, the fire log record, the accident book, admission/discharge register, complaints record, maintenance contracts, staffing rotas and daily communication book. The proprietor, manager, cook and seven carers were spoken to during the inspection period. Time was also spent with 12 service users during the inspection. What the service does well: What has improved since the last inspection? What they could do better: To review the size of portions and amount of food served to service users. Full fat butter to be used as part of daily diet of service users. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 6 Full fat and semi skimmed fresh milk to be used as part of daily diet. Bedroom doors to be kept unlocked unless service users wish to lock them and are issued with a door key. Establish an effective complaints procedure. Review the cleaning routine in the home and ensure enough ancillary hours are supplied for the number of service users. Review care staffing levels to ensure needs of service users may be met as individually as possible. Provide training for staff regarding challenging behaviour. To ensure there is a comfortable, warm temperature in the building over the twenty four period. Review the care and support needs of the identified service users. Obtain a reassessment of the care needs of the identified service users. 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. Astley House DS0000000518.V275225.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 Astley House DS0000000518.V275225.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): These standards were not assessed at this inspection. EVIDENCE: Astley House DS0000000518.V275225.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, There are basic arrangements in place to ensure that service users’ health, personal and social care needs are met. Care plans do not provide evidence of the care being provided to service users as their needs change as they become more physically or mentally dependent. No service users are self- medicating at this time. EVIDENCE: Inspection of the records for four service users showed that an assessment had been carried out prior to their admission. This was combined with information received from the care manager’s assessment of the service user’s care needs. The resulting care plan recorded detailed information about the health and medical needs of the service user and the amount of staff intervention required in order to provide support. A separate assessment was carried out of social care needs of individuals. Some care plans required reviewing and updating to detail the intervention and amount of support required for two people whose needs had changed. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 10 The recording for one service user showed no assistance from outside agencies or evidence that a reassessment had been obtained by the home to assist them to work with the person to manage some behaviour that was quite challenging to other service users and staff. Service users have a choice of General Practitioner if they are unable to retain their own when they move into the Home. There was evidence that GPs and Community Nurses were regularly consulted for advice and treatment. Records were available to show district nurses visit the home as required and service users are assisted to access chiropody and optical services at least annually or as often as required. Staff receive training about medication before they are given the responsibility of administering it to service users. The medication system was not examined at this inspection. Astley House DS0000000518.V275225.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): 13,14,15 The systems for service user consultation in this home are very poor with little evidence that service users views are sought or acted upon. Visitors are made welcome which enables service users to keep in close contact with their family and friends. Service users’ diet is not a wholesome, balanced diet. EVIDENCE: Staff consult individually with service users to try to find out their wishes but specialist training is required in order to make the interaction more meaningful and in order to ensure service users are provided with choice and in order to maintain some control of their lives. On the day of inspection, the lunch comprised one turkey, approximately four pounds for fourteen people with cabbage, turnip, mashed potato, roast potatoes, Yorkshire pudding and stuffing and a pudding. There was 50 reduced fat spread for the use of service users and for baking. Several boxes of long life skimmed milk were stored and are used for drinks and cooking for service users, although full fat long life milk is available for cereals. In the kitchen pantry Fortisip Liquid was available as a food Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 12 supplement to build up frail, older people rather than the use of butter, fresh milk and cream. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 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 complaints procedure requires updating. There is no evidence of a culture of empowerment whereby service users or relatives may bring a matter to the attention of staff and know they will be listened to. EVIDENCE: The home has a complaints procedure that requires updating and a complaints log that did not record evidence of any complaints or concerns received by the home since the last inspection. CSCI has received a complaint about some aspects of care provided by the home that has been investigated and partially upheld. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 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): 23,25,26 Service users own rooms suit their needs. Service users live in comfortable surroundings for the most part. The standard of hygiene in the home is not adequate and the cleanliness is achieved to the detriment of care provided to service users. EVIDENCE: Service users’ bedroom doors are kept locked by staff in order to safeguard service users possessions. Service users should however be able to enter their bedrooms freely without their doors being locked unless they choose to lock them. If staff believe there to be a risk to service users’ possessions then an appropriate risk assessment should be carried out. The building was cold by 11.30am as there is not a constant temperature within the home as the heating goes off between 9.30am until the afternoon. A senior member of staff has the authority to alter this but this should not be necessary the heating should provide a constant, comfortable warm temperature over the twenty four hour period. At the time of inspection over the weekend period the level of hygiene within the home was not satisfactory, no domestic was on duty that day. Staffing rosters showed that only twenty hours rather than the forty five hours required Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 15 of domestic cover is provided and this is not over a seven day period. Carers are expected to maintain a satisfactory standard of hygiene and cleanliness when domestic staff are not employed at the same time as providing care and support to some quite mentally frail service users. The lavatories and a bathroom were not clean. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 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): 27,28,30 Service users needs are not met by the numbers and skill mix of staff. Service users are not in safe hands at all times. Staff have basic training to do their jobs. EVIDENCE: Records and staffing rosters and conversation with staff maintain staff are not working the designated amount of care hours required for the needs of service users who have become more frail and dependent. On the day of inspection only two carers were on duty between 8.00am and four thirty pm, no domestics were on duty and the cook was only on duty from 9.00am until 2.00pm. Therefore two carers were carrying out care duties as well as food preparation attending to tea, doing laundry tasks and trying to maintain a clean environment over the wee end. Ancillary hours must be increased and staffing levels to meet the needs of service users. It would be difficult for staff to spend time with service users for stimulation in view of the amount of ancillary work they are expected to carry out at week ends.. Night time staffing levels should be reviewed too due to the needs of service users and the layout of the building. Care records showed that staff were providing care to some people with complex needs and at least one person displayed needs that may be a challenge to themselves, staff and other service users. Current staffing levels do not provide a safe environment within the home. There is a training programme with ten staff members pursuing National Vocational Qualifications at levels 2 and 3, however as stated at previous Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 17 inspections staff need to pursue a more intensive training course about the needs of people with memory loss. This training will provide some insight into the needs of people with memory loss and provide staff with some more skills in order to engage with the service users and communicate and provide meaningful stimulation. Staff also still require training about working with behaviour that may be challenging. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 18 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): 33,37,38 The home is not run in the best interest of the service users. Service users’ rights and best interests are not safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are not promoted and protected. EVIDENCE: The home does not provide an ethos of empowerment of service users, despite different levels of memory loss, staff provide basic care to meet the needs of service users. No evidence is available to show that service users are encouraged to make decisions regarding their daily living requirements eg bathing once a week, changing clothing every two days, temperature within the home being set, care and ancillary staffing levels low, nutritional content of food, lack of activities, little time spent talking to service users. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 19 Most of the statutory records were up to date as stated but care records did not accurately record the current needs of some service users with advice and support being obtained from the relevant agencies to ensure the needs of the service user were being addressed by staff. Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 20 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 x x x x x x x 1 1 STAFFING Standard No Score 27 2 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x x x 2 2 Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 21 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 2 3 4 Standard OP37OP7 OP4 OP14OP12 OP15 Regulation 12(1)(a) 14(2)(a)( b) 14(2)(b) 12(1)(2)( 3) 16(2)(i) Requirement System for reviewing care needs of service users must be kept up to date. The identified service user’s care needs must be reassessed. Service users must be consulted and systems introduced for involving them. A dietician must be consulted about the use of reduced fat spread, size of portions, use of full fat diet for service users. A system must be introduced for the handling of complaints and the ethos within the home to accept complaints as a review of the quality of care provided and be part of the home’s quality assurance system. Service users must have access to their bedrooms at all times over the day. The home must be kept at a warm and comfortable temperature. The home must be kept clean and free from odours. There must be ancillary staff in DS0000000518.V275225.R01.S.doc Timescale for action 17/01/06 17/01/06 30/01/06 01/03/06 5 OP33OP16 22 (1) 24(1)(a)( b) 17/01/06 6 7 8 9 OP14 OP25 OP26 OP26 12(1)(2) 23(2)(p) 16(2)(k) 23(2)(d) 18(1)(a) 17/01/06 04/12/06 31/01/06 31/01/06 Page 22 Astley House Version 5.1 10 OP38OP27 18(1)(a) 11 OP30 18(1)(c) sufficient numbers employed. The home must ensure that at all 31/01/06 times suitably qualified, competent and experienced staff are working in such numbers as are appropriate for the health and welfare of service users. Staff must receive updated 10/03/06 training about challenging behaviour RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Astley House DS0000000518.V275225.R01.S.doc Version 5.1 Page 24 - 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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